MEDICAL TREATMENT SYSTEM
20220287765 · 2022-09-15
Inventors
- Ashok Nageswaran (Irvine, CA, US)
- Gaurav Girdhar (Ladera Ranch, CA, US)
- Hoai Nguyen (Westminster, CA, US)
- Daniel Deen (Long Beach, CA, US)
Cpc classification
A61B17/221
HUMAN NECESSITIES
A61B18/1492
HUMAN NECESSITIES
A61B2018/00214
HUMAN NECESSITIES
A61B2017/22034
HUMAN NECESSITIES
International classification
Abstract
A medical treatment device is disclosed herein. In one example, the medical treatment device includes a core assembly which has a first conduct and a second conductor. An insulative material can surround the second conductor and define an electrode portion of the second conductor that is uncovered by the insulative material. The medical treatment device can include an interventional element that electrical couples to the first conductor. The electrode portion of the second conductor can be disposed radially adjacent to or distal of the interventional element.
Claims
1. A medical device comprising: a core assembly configured to be advanced within a corporeal lumen, the core assembly comprising: a first conductor having a proximal end portion and a distal end portion, the first conductor forming a lumen; a second conductor at least partially disposed within the lumen of the first conductor, the second conductor having a proximal end portion and a distal end portion; and an insulative material surrounding the second conductor along at least a part of its length, the insulative material defining an electrode portion of the second conductor that is uncovered by the insulative material; and an interventional element coupled to the distal end portion of the first conductor, the interventional element electrically coupled to the first conductor, wherein the electrode portion of the second conductor is disposed radially adjacent to or distal of the interventional element.
2. The medical device of claim 1, wherein the core assembly comprises a distally located joining element having an opening therein, and wherein the second conductor extends through the opening.
3. The medical device of claim 1, wherein the interventional element defines a lumen, and wherein the second conductor extends at least partially through the lumen.
4. The medical device of claim 1, wherein the electrode portion comprises a plurality of openings in the insulative material, the openings being spaced apart along the length of the electrode portion.
5. The medical device of claim 4, wherein the plurality of openings are located at substantially the same angular position about a longitudinal axis of the second conductor.
6. The medical device of claim 1, wherein the electrode portion of the second conductor comprises a first material, wherein the interventional element comprises a second material disposed an outer surface of the interventional element, and wherein the first material is the same as the second material.
7. The medical device of claim 1, wherein the interventional element comprises an electrode surface having a first material, wherein the electrode portion of the second conductor comprises a second material, and wherein the first material is the same as the second material.
8. The medical device of claim 1, wherein the interventional element comprises a plurality of struts that are bounded to form a cell opening, the electrode portion of the second conductor being positioned radially adjacent to the cell opening.
9. The medical device of claim 1, wherein the electrode portion of the second conductor is configured to be oriented to face radially away from a portion of the interventional element that is nearest the electrode portion.
10. The medical device of claim 1, wherein the interventional element comprises a plurality of struts, the electrode portion of the second conductor being oriented to face away from the plurality of struts.
11. A medical device comprising: an elongated shaft having a proximal portion configured to be electrically coupled to a current generator, an intermediate portion covered with an insulative material, and a distal portion defining an electrode portion; an elongated tubular member having a proximal portion configured to be electrically coupled to a current generator, a distal portion, and a lumen receiving the elongated shaft therethrough; and an interventional element coupled to the distal portion of the elongated tubular member, the interventional element at least partially surrounding the distal portion of the elongated shaft.
12. The medical device of claim 11, wherein the interventional element is electrically coupled to the elongated tubular member.
13. The medical device of claim 11, wherein the electrode portion comprises an uninsulated portion of the elongated shaft.
14. The medical device of claim 11, wherein the elongated tubular member and the elongated shaft are non-slidably coupled together.
15. The medical device of claim 11, wherein the elongated tubular member comprises a distally located joining element having an opening therein, wherein the elongated shaft extends through the opening, and wherein the interventional element comprises a proximally located attachment element that extends through the opening.
16. The medical device of claim 15, wherein the proximally located attachment element interlocks with the distally located joining element, and wherein the elongated shaft retains the proximally located attachment element within the opening.
17. A medical device comprising: a first conductor having a proximal end portion and a distal end portion configured to be positioned proximate a thrombus within a lumen of a blood vessel at a treatment site; an interventional element coupled to the first conductor, the first conductor configured to convey electrical current to the interventional element; a second conductor having a proximal end portion and a distal end portion, at least a part of the distal end portion of the second conductor extending through the interventional element; and an insulative material disposed over the second conductor, the insulative material configured to electrically insulate the second conductor, the insulative material defining an electrode portion on the second conductor, the second conductor and the electrode portion being configured to provide a return path for an electrical current from the interventional element.
18. The medical device of claim 17, wherein the first conductor comprises a distally located joining element having an opening therein, wherein the second conductor extends through the opening, and wherein the interventional element comprises a proximally located attachment element that extends through the opening.
19. The medical device of claim 18, wherein the proximally located attachment element interlocks with the distally located joining element, and wherein the second conductor retains the proximally located attachment element within the opening.
20. The medical device of claim 17, wherein the interventional element defines a lumen, and wherein the second conductor extends at least partially through the lumen.
21. The medical device of claim 20, wherein the electrode portion is disposed within the lumen.
22. The medical device of claim 17, wherein the electrode portion comprises a spiral opening in the insulative material.
23. The medical device of claim 17, further comprising a plurality of electrode portions, wherein the plurality of electrode portions comprises a plurality of openings in the insulative material, the openings being spaced apart along the length of the electrode portion.
24. The medical device of claim 17, further comprising a plurality of electrode portions, wherein the plurality of electrode portions comprises an uninsulated portion at the distal end portion of the second conductor.
25. The medical device of claim 17, further comprising a plurality of electrode portions, wherein the plurality of electrode portions comprises a plurality of annular openings in the insulative material, the annular openings being spaced apart along the length of the electrode portion.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0092] Many aspects of the present disclosure can be better understood with reference to the following drawings. The components in the drawings are not necessarily to scale. Instead, emphasis is placed on clearly illustrating the principles of the present disclosure.
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DETAILED DESCRIPTION
[0102] The present technology provides devices, systems, and methods for removing clot material from a blood vessel lumen. Although many of the embodiments are described below with respect to devices, systems, and methods for treating a cerebral or intracranial embolism, other applications and other embodiments, in addition to those described herein, are within the scope of the technology. For example, the treatment systems and methods of the present technology may be used to remove emboli from body lumens other than blood vessels (e.g., the digestive tract, etc.) and/or may be used to remove emboli from blood vessels outside of the brain (e.g., pulmonary, abdominal, cervical, or thoracic blood vessels, or peripheral blood vessels including those within the legs or arms, etc.). In addition, the treatment systems and methods of the present technology may be used to remove luminal obstructions other than clot material (e.g., plaque, resected tissue, foreign material, etc.). In some embodiments, aspects of the present technology can be applied to medical devices and systems that are not configured for removal of material from vessel lumens, for example systems and devices for ablation, neuromodulation, or any other suitable medical procedure.
[0103]
[0104] The core assembly 105 is configured to be slidably disposed within the lumen of the third catheter 114. In the illustrated embodiment, the core assembly 105 can take the form of an electrical cable or other such assembly that includes a first electrical conductor 116 and a second electrical conductor 118. As discussed in more detail below, in some instances the first conductor 116 can take the form of an elongated tube (e.g., a hypotube) made of or including an electrically conductive material, and the second conductor 118 can take the form of an elongated wire or rod that is made of or includes an electrically conductive material. In some embodiments, the second conductor 118 is configured to be disposed within a lumen of the first conductor 116. In some embodiments, the first conductor 116 and second conductor 118 are coaxial. In various embodiments, the first conductor 116 and second conductor 118 are non-slidably coupled together. The first conductor 116 and second conductor 118 can be sized and configured to be advanced through a corporeal lumen to the treatment site. For example, the first conductor 116 and second conductor 118 can be sized to be positioned proximate a thrombus within a lumen of a blood vessel, such as within a patient's neurovasculature. The first conductor 116 and/or the second conductor 118 can be electrically insulated along at least a portion of their respective lengths. In some embodiments, the first catheter 110 can be coupled to (or incorporate) the handle 108, which provides proximal access to the first conductor 116 and second conductor 118.
[0105] The current generator 102 may be coupled to the core assembly 105 to deliver electrical current to the interventional element 106 and thereby provide an electrically charged environment at the distal portion 104b of the treatment device 104. Further, the current generator 102 may be coupled to the core assembly 105 to return electrical current from the electrically charged environment to the current generator 102. In various embodiments, the current generator 102 can be electrically coupled to the first conductor 116, the second conductor 118, or both.
[0106] In some embodiments, the treatment system 100 includes a suction source 120 (e.g., a syringe, a pump, etc.) configured to be fluidically coupled (e.g., via a connector 122) to a proximal portion of one or more of the first catheter 110, the second catheter 112, and/or the third catheter 114 to apply negative pressure therethrough. In some embodiments, the treatment system 100 includes a fluid source 124 (e.g., a fluid reservoir, a syringe, pump, etc.) configured to be fluidically coupled (e.g., via the connector 122) to a proximal portion of one or more of the first catheter 110, the second catheter 112, and/or the third catheter 114 to supply fluid (e.g., saline, contrast agents, a drug such as a thrombolytic agent, etc.) to the treatment site.
[0107] According to some embodiments, the catheters 110, 112, and 114 can each be formed as a generally tubular member extending along and about a central axis. According to some embodiments, the third catheter 114 is generally constructed to track over a conventional guidewire in the cervical anatomy and into the cerebral vessels associated with the brain and may also be chosen according to several standard designs that are generally available. Accordingly, the third catheter 114 can have a length that is at least 125 cm long, and more particularly may be between about 125 cm and about 175 cm long. Other designs and dimensions are contemplated.
[0108] The second catheter 112 can be sized and configured to slidably receive the third catheter 114 therethrough. As noted above, the second catheter 112 can be coupled at a proximal portion to a suction source 120 (
[0109] According to some embodiments, the bodies of the catheters 110, 112, and 114 can be made from various thermoplastics, e.g., polytetrafluoroethylene (PTFE or TEFLON®), fluorinated ethylene propylene (FEP), high-density polyethylene (HDPE), polyether ether ketone (PEEK), etc., which can optionally be lined on the inner surface of the catheters or an adjacent surface with a hydrophilic material such as polyvinylpyrrolidone (PVP) or some other plastic coating. Additionally, either surface can be coated with various combinations of different materials, depending upon the desired results.
[0110] In some embodiments, the current generator 102 may be coupled to a proximal portion of the first conductor 116, and/or a proximal portion of the third catheter 114, the second catheter 112, and/or first catheter 110 to provide an electric current to the interventional element 106. For example, as shown in
[0111] The system can include multiple (e.g., two or more), distinct conductive paths or channels for passing electrical current along the system. The interventional element 106 can serve as one electrode (e.g., a positive electrode) in electrical communication with a conductive path via the first conductor 116. Another of the conductive paths of the system can be in electrical communication with another electrode (e.g., a negative electrode). For example, the second conductor 118 can serve as the second conductive path, with one or more uninsulated portions of the second conductor 118 forming the negative electrode(s).
[0112] As shown in
[0113] In certain embodiments, the polarities of the current generator 102 can be switched, so that the negative electrical connector is electrically coupled to the first conductor 116 and the positive electrical connector is electrically coupled to the second conductor 118. This can be advantageous when, for example, attempting to attract predominantly positively charged material to the interventional element 106, or when attempting to break up a clot rather than grasp it with an interventional element 106. In some embodiments alternating current (AC) signals may be used rather than DC. In certain instances, AC signals may advantageously help break apart a thrombus or other material.
[0114] In various embodiments, the interventional element 106 can take any number of forms, for example a removal device, a thrombectomy device, or other suitable medical device. For example, in some embodiments the interventional element 106 may be a stent and/or stent retriever, such as Medtronic's Solitaire™ Revascularization Device, Stryker Neurovascular's Trevo® ProVue™ Stentriever, or other suitable devices. In some embodiments, the interventional element 106 may be a coiled wire, a weave, and/or a braid formed of a plurality of braided filaments. Examples of suitable interventional elements 106 include any of those disclosed in U.S. Pat. No. 7,300,458, filed Nov. 5, 2007, U.S. Pat. No. 8,940,003, filed Nov. 22, 2010, U.S. Pat. No. 9,039,749, filed Oct. 1, 2010, and U.S. Pat. No. 8,066,757, filed Dec. 28, 2010, each of which is incorporated by reference herein in its entirety.
[0115] The interventional element 106 can have a low-profile, constrained or compressed configuration for intravascular delivery to the treatment site within the third catheter 114, and an expanded configuration for securing and/or engaging clot material and/or for restoring blood flow at the treatment site. The interventional element 106 has a proximal portion including an attachment portion 106a that may be coupled to the first conductor 116 and a distal portion comprising an open cell framework or body 106b. In some embodiments, the body 106b of the interventional element 106 can be generally tubular (e.g., cylindrical), and the proximal portion of the interventional element 106 can taper proximally to the attachment portion 106a. In various embodiments, the interventional element 106 can define a lumen that is located radially inward from the body 106b.
[0116] The interventional element 106 can be a metallic and/or electrically conductive thrombectomy device. For example, the interventional element can include or be made of stainless steel, nitinol, cobalt-chromium, platinum, tantalum, alloys thereof, or any other suitable material. In some embodiments, the interventional element 106 is a mesh structure (e.g., a braid, a stent, etc.) formed of a superelastic material (e.g., Nitinol) or other resilient or self-expanding material configured to self-expand when released from the third catheter 114. The mesh structure may include a plurality of struts and open spaces between the struts. In some embodiments, the struts and spaces may be situated along the longitudinal direction of the interventional element 106, the radial direction, or both.
[0117] In some embodiments, the first conductor 116 can be a structural element configured to push and pull a device such as the interventional element 106 along the bodily lumen. The first conductor 116 can be any suitable elongate member configured to advance the interventional element 106 to a treatment site within a blood vessel. For example, the first conductor 116 can be or include a wire, tube (e.g., a hypotube), coil, or any combination thereof. According to some embodiments, the first conductor 116 comprises an elongate tubular member defining a lumen therethrough. In some embodiments, the first conductor 116 can comprise a distally located aperture configured to receive the attachment portion of the interventional element. In some embodiments, the first conductor 116 comprises a distally located joining element comprising the aperture configured to receive the attachment portion. The first conductor 116 can have a length sufficient to extend from a location outside the patient's body through the vasculature to a treatment site within the patient's body. The first conductor 116 can be a monolithic structure or formed of multiple joined segments. In some embodiments, the first conductor 116 can comprise a laser-cut hypotube having a spiral cut pattern (or other pattern of cut voids) formed in its sidewall along at least a portion of its length. The first conductor 116 can be metallic and/or otherwise electrically conductive to deliver current from the current generator 102 to the interventional element 106. For example, the first conductor 116 can comprise or consist of nickel titanium alloy, stainless steel, or other metals or alloys. In embodiments that comprise multiple joined segments, the segments may be of the same or different materials. For example, some or all of the first conductor 116 can be formed of stainless steel, or other suitable materials known to those skilled in the art. Nickel titanium alloy may be preferable for kink resistance and reduction of imaging artifacts.
[0118] In some embodiments, the second conductor 118 can be a structural element configured to secure or retain a position of the interventional element 106 relative to the first conductor 116. Additionally, or alternatively, the second conductor 118 can be configured to be a negative electrode. The second conductor 118 can be any suitable elongate member configured to extend through a lumen of the first conductor 116. For example, the second conductor 118 can be or include a wire, tube (e.g., a hypotube), coil, or any combination thereof. The second conductor 118 can have a length sufficient to extend from a location outside the patient's body through the vasculature to a treatment site within the patient's body. The second conductor 118 can be a monolithic structure or formed of multiple joined segments. The second conductor 118 can be metallic or electrically conductive to deliver current from the surrounding media (e.g., blood, tissue, thrombus, etc.) to the current generator 200. For example, the second conductor 118 can comprise or consist of nickel titanium alloy, stainless steel, or other metals or alloys. In embodiments that comprise multiple joined segments, the segments may be of the same or different materials. For example, some or all of the second conductor 118 can be formed of stainless steel, or other suitable materials known to those skilled in the art. Nickel titanium alloy may be preferable for kink resistance and reduction of imaging artifacts. The second conductor 118 can be electrically insulated along some or all of its length. In some embodiments, the second conductor 118 comprises an insulated wire or guide wire having one or more exposed, electrically conductive portions. For example, a distal end portion of the second conductor 118 can be exposed to conduct current from surrounding media (e.g., blood, tissue, thrombus, etc.) at a treatment site.
[0119] In some embodiments, the treatment device 104 can comprise one or more electrically insulating materials. For example, an insulating material can be disposed on one or more portions of the second conductor 118 to electrically isolate the second conductor 118 from the first conductor 116, the connection 126, and/or the interventional element 106. Additionally or alternatively, an insulating material can be disposed within a lumen of the first conductor 116 to electrically isolate the first conductor 116 from the second conductor 118 and/or the attachment portion of the interventional element 106. In some embodiments, an insulating material is disposed over an outer surface of the first conductor 116 along at least a portion of a length of the first conductor 116 to direct current through the first conductor 116 and prevent current loss from the first conductor 116 to the surrounding environment. As shown in
[0120] As shown in
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[0122] In some embodiments, the connection 126 can comprise a bonding agent in addition or alternative to the joining element 128 and/or second conductor 118. The bonding agent can comprise adhesive, solder, welding flux, brazing filler, etc., disposed within the joining element 128, and/or adjacent to it, just proximal of and/or just distal of the joining element 128. In some embodiments, the bonding agent can bond to the connection 126 without applying heat. For example, the bonding agent can comprise a UV-curable adhesive. In embodiments that comprise a polymer coating of the wire or polymer tubing, use of a bonding agent that avoids application of heat that would damage the polymer may be preferred.
[0123] In some embodiments, the connection 126 can comprise a locking element. The locking element can be coupled with the joining element 128 and can be configured to inhibit motion of the attachment portion 106a. Examples of suitable locking elements can include any of the disclosed locking elements in U.S. Provisional Application No. 63/199,352 filed Dec. 21, 2020, which is hereby incorporated by reference in its entirety.
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[0126] The second conductor 118 can include an insulative material 142 that surrounds the second conductor 118 and which has several openings formed within the insulative material 142. These openings can define electrode portions 140. The insulative material 142 can be the same, or similar to, the insulative material 127. Accordingly, the portions of the second conductor 118 that are surrounded by the insulative material 142 can be electrically isolated from other components, while the openings formed within the insulative material 142 can provide electrical access to the second conductor 118 at the openings. In some embodiments, the electrode portions 140 include a coating or other conductive element that is applied over the surface of the second conductor 118.
[0127] In various embodiments, the insulative material 142 can define the electrode portions 140. For example, as illustrated in
[0128] As illustrated in
[0129]
[0130] As previously discussed, the insulating material 142 can define one or more electrode portions 140 of the second conductor 118. The electrode portions 140 can include one or more uninsulated portions of the second conductor 118 that allow for the second conductor 118 to electrically couple to other components via, e.g., surrounding media such as thrombus, blood, saline, tissue, etc. For example, as illustrated in
[0131] In various embodiments, the electrode portions 140 can include one or more openings 144 formed into the insulating material 142. For example, as illustrated in
[0132] In various embodiments, the electrode portions 140 can include one or more annular openings 146 formed into the insulating material 142. For example, as illustrated in
[0133] In various embodiments, the electrode portions 140 can include one or more spiral or helical openings 148 formed into the insulating material 142. For example, as illustrated in
[0134] In some embodiments, the electrode portions 140 can include a combination of openings formed in the insulating material 142. For example, in some embodiments, the electrode portions 140 can include one or more openings 144, one or more annular openings 146, and/or one or more spiral openings 148. In some embodiments, the electrode portion 140 can take the form of an uninsulated distal terminus 118b of the second conductor 118; such an electrode portion can be employed instead of or in addition to other electrode portion(s) 140 located along the length of the second conductor 118 proximal of the distal terminus 118b.
[0135] In some embodiments, some or all of the electrode portions 140 can include the same material as a part of the interventional element 106. For example, the uninsulated material of the second conductor 118 within the electrode portion 140 can be the same material as the interventional element 106. In some embodiments, the interventional element 106 is coated, plated or surface-treated with an outer layer of electrically conductive material, which can be the same material as the uninsulated portions of the second conductor 118.
[0136] In some embodiments, components of the treatment device 104 can electrically couple to the second conductor 118 through the electrode portions 140 (e.g. via surrounding media). Because the second conductor 118 is not electrically isolated completely at the electrode portions 140, the second conductor 118 can electrically couple to other components at the electrode portions 140. For example, in some embodiments, the interventional element 106 can couple to the second conductor 118 through the electrode portions 140. In various embodiments, the electrode portions 140 can be used to complete a circuit between the first conductor 116 and second conductor 118. For example, the current generator 102 can couple to the core assembly 105 at the proximal portion 104a of the treatment device 104 and send a current through the first conductor 116. This current can flow through the first conductor 116 to the interventional element 106. At the interventional element 106, the current can flow through the patient's surrounding media (e.g., blood, tissue, saline, thrombus, etc.) to the electrode portions 140 of the second conductor 118, where the current can then flow through the second conductor 118 and return to the current generator 102.
[0137] In various embodiments, the electrode portions 140 can be configured to prevent the circuit between the first conductor 116 and second conductor 118 from shorting. For example, by positioning the electrode portions 140 distally from the attachment portion 106a of the interventional element 106, the electrode portions 140 can prevent the circuit from shorting at proximate the attachment portion 106a. Additionally, in some embodiments, positioning the uninsulated portions of the second conductor 118 so that the uninsulated portions are proximate or radially adjacent to the spaces or cell openings 107 defined by the body 106b (e.g. by the struts thereof) can also prevent the circuit from shorting. In some embodiments, the electrode portions 140 can be configured to allow for the interventional element 106 to maintain a desirable electrical charge distribution. For example, positioning the electrode portions 140 proximate the distal terminus 118b of the second conductor 118 encourages the more current to flow through the distal portions of the interventional element 106 to reach the electrode portions 140, which in turn allows for the interventional element 106 to maintain a favorable electrical charge distribution (e.g., with sufficiently high charge density at the distal region of the interventional element, along the working length of the interventional element, or other suitable charge distribution). In some embodiments, spacing the openings (e.g. openings 144, annular openings 146, and/or spiral openings 148) of the electrode portions apart along the length of second conductor 118 can also allow for the interventional element 106 to maintain an electrical charge.
[0138] An example method of delivering a current to the treatment device 104 will now be described. First, the treatment device 104 is positioned within a patient at the treatment site. Once the treatment device 104 is properly positioned, the user can expand the interventional element 106 so that the interventional element 106 engages with the thrombus. After the interventional element 106 engages with the thrombus, the user can couple the core assembly 105 to the current generator 102. In some embodiments, the core assembly 105 is previously coupled to the current generator 102. The user can interact with current generator to initiate the supply of an electrical signal to the first conductor 116. The electrical signal can travel toward the treatment site through the first conductor 116 and to the interventional element 106. The electrical signal can return to the current generator 102 by flowing from the interventional element, through the surrounding media (e.g., blood, tissue, thrombus, etc.) to the electrode portions 140 of the second conductor 118 and through the second conductor 118 to the current generator 102. In some embodiments, the electrical signal is an electrical current of between about 0-5 mA. The electrical signal can be unipolar (e.g., DC) or bipolar (e.g., AC). In various embodiments, the current or voltage level of the electrical signal can be constant, periodic, irregular, or any combination thereof. In some embodiments, the electrical signal is supplied for a duration of time between about 30 seconds to about 10 minutes. In some embodiments, the electrical signal is supplied for a duration of time of two minutes or less. After the electrical signal is delivered to the treatment device 104 for the proper duration, the user can interact with current generator to stop the supply of the electrical signal. The user can then proximally retract the treatment device 104, including the thrombus, into a surrounding catheter, and then remove the entire assembly from the patient.
Conclusion
[0139] The descriptions of embodiments of the technology are not intended to be exhaustive or to limit the technology to the precise form disclosed above. Where the context permits, singular or plural terms may also include the plural or singular term, respectively. Although specific embodiments of, and examples for, the technology are described above for illustrative purposes, various equivalent modifications are possible within the scope of the technology, as those skilled in the relevant art will recognize. For example, while steps are presented in a given order, alternative embodiments may perform steps in a different order. The various embodiments described herein may also be combined to provide further embodiments.
[0140] Moreover, unless the word “or” is expressly limited to mean only a single item exclusive from the other items in reference to a list of two or more items, then the use of “or” in such a list is to be interpreted as including (a) any single item in the list, (b) all of the items in the list, or (c) any combination of the items in the list. Additionally, the term “comprising” is used throughout to mean including at least the recited feature(s) such that any greater number of the same feature and/or additional types of other features are not precluded. It will also be appreciated that specific embodiments have been described herein for purposes of illustration, but that various modifications may be made without deviating from the technology. Further, while advantages associated with certain embodiments of the technology have been described in the context of those embodiments, other embodiments may also exhibit such advantages, and not all embodiments need necessarily exhibit such advantages to fall within the scope of the technology. Accordingly, the disclosure and associated technology can encompass other embodiments not expressly shown or described herein.