Fenestration Over the Needle Catheter
20210060305 ยท 2021-03-04
Inventors
Cpc classification
A61M25/0631
HUMAN NECESSITIES
A61M25/0074
HUMAN NECESSITIES
A61M25/007
HUMAN NECESSITIES
International classification
Abstract
A fenestration over-the-needle catheter assembly which includes a catheter with a catheter body. The catheter body has a projection which extends in an axial direction from the distal end of the catheter. The projection may have a point of connection to the catheter body such that the projection can be transitioned into a closed position, covering an opening in the distal end of the catheter. The projection may be configured to interact with a needle which has been inserted into the lumen and extends through the opening in the distal end, such that the projection is in an open position when the needle is extended through the opening in the distal end and is in a closed position when the needle is withdrawn into the lumen or removed from the catheter.
Claims
1. An over the needle catheter assembly comprising, a catheter having a proximal end and a distal end, a body that extends from the proximal end to the distal end in an axial direction, wherein the body defines a lumen extending from the proximal end to the distal end, the body having at least one aperture and a projection that extends axially from the distal end of the body when the projection is in an open position, the projection being sized and connected to the body such that the projection closes an opening in the distal end of the catheter when the projection is transitioned into a closed position; and a needle releasably configured within the lumen of the catheter, wherein the needle extends beyond the distal end of the catheter in a first position and is withdrawn into the lumen or is removed from the catheter in a second position.
2. The over the needle catheter assembly of claim 1, further comprising a hub, the hub being fixedly or releasably secured to the proximal end of the catheter.
3. The over the needle catheter assembly of claim 1, wherein the projection is attached to the body via a heat treatment, a mechanical treatment, a chemical treatment, an adhesive or combinations thereof.
4. The over the needle catheter assembly of claim 1, wherein the projection has an axial length from a point of connection with the body to a distal end of the projection that is at least as long as an outer diameter of the catheter.
5. The over the needle catheter assembly of claim 1, wherein the projection is configured to transition into the closed position when the needle is withdrawn into the lumen.
6. The over the needle catheter assembly of claim 1, wherein the projection is configured to close the opening in the distal end such that the distal end of the catheter is beveled, pointed, rounded, flat, or blunt when the projection is in the closed position.
7. The over the needle catheter assembly of claim 1, comprising at least two apertures.
8. The over the needle catheter assembly of claim 7, wherein the at least two apertures are axially spaced apart along the body of the catheter.
9. The over the needle catheter assembly of claim 7, wherein the at least two apertures are radially spaced apart around the body of the catheter.
10. The over the needle catheter assembly of claim 7, wherein each aperture has a diameter from about 100 micrometers to about 1 millimeter.
11. The over the needle catheter assembly of claim 1, wherein the catheter is comprised of a polymer, wherein the polymer comprises a polyester, a polyurethane, a polyamide, a polyolefin, or a combination thereof.
12. The over the needle catheter assembly of claim 11, wherein the polymer further comprises a reinforcing material or a flexible material.
13. The over the needle catheter assembly of claim 1, wherein a portion of the body opposite the projection is configured to releasably or permanently attach to the projection when the projection is in the closed position.
14. An over the needle catheter assembly comprising, a catheter having a proximal end and a distal end, a body that extends from the proximal end to the distal end in an axial direction, wherein the body defines a lumen extending from the proximal end to the distal end, the body having at least one aperture and a projection that extends axially from the distal end of the body when the projection is in an open position, the projection being sized and connected to the body such that the projection closes an opening in the distal end of the catheter when the projection is transitioned into a closed position; wherein the lumen has a diameter larger than a diameter of a needle, wherein the needle extends beyond the distal end of the catheter when the needle is fully inserted through the opening in the distal end of the catheter, the projection being connected to the body such that the projection is in the open position when a needle is fully inserted through the opening in the distal end of the catheter and transitions into the closed position when a needle is retracted from the lumen such that the needle does not extend past the distal end of the catheter.
15. A method for administering a bolus or continuous flow of a drug or anesthetic to a target area of a patient comprising: piercing a surface of skin of the patient with an over the needle catheter assembly, the over the needle catheter assembly comprising a catheter having a proximal end and a distal end; a body that extends from the proximal end to the distal end in an axial direction, wherein the body defines a lumen extending from the proximal end to the distal end, the body having at least one aperture and a projection that extends axially from the distal end of the body when the projection is in an open position, the projection being sized and connected to the body such that the projection closes an opening in the distal end of the catheter when the projection is transitioned into a closed position; and a needle releasably configured within the lumen of the catheter, wherein the needle extends beyond the distal end of the catheter in a first position and is withdrawn into the lumen or is removed from the catheter in a second position; positioning the distal end of the over the needle catheter assembly adjacent the target area of the patient; withdrawing the needle into the lumen at least to a point of connection between the body and the projection or withdrawing the needle completely such that the projection transitions into the closed position; and administering a bolus or continuous flow of a drug or anesthetic to the target area.
16. The method of claim 15, wherein the catheter is repositioned after the needle has been at least partially withdrawn.
17. The method of claim 15, wherein the over the needle catheter assembly is positioned near a nerve or nerve bundle.
18. The method of claim 15, wherein the needle is withdrawn prior to reaching the target area.
19. The method of claim 15, wherein the at least one aperture is sized such that a drug or anesthetic is administered at a rate of about 0.01 ml/hr to about 35 mL/hr.
20. The method of claim 15, wherein the opening in the distal end of the catheter is completely closed by the projection such that no drug or anesthetic is administered from the opening in the distal end of the catheter and a drug or anesthetic is only administered from the at least one aperture.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] The invention will now be described, by way of example, with reference to the accompanying drawings, in which:
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DETAILED DESCRIPTION
[0029] Reference now will be made in detail to embodiments, one or more examples of which are illustrated in the drawings. Each example is provided by way of explanation of the embodiments, not limitation of the present disclosure. In fact, it will be apparent to those skilled in the art that various modifications and variations can be made to the embodiments without departing from the scope or spirit of the present disclosure. For instance, features illustrated or described as part of one embodiment can be used with another embodiment to yield a still further embodiment. Thus, it is intended that aspects of the present disclosure cover such modifications and variations.
[0030] The positional terms proximal and distal are used herein to orient the various components relative to each other. Distal refers to the direction that would be closest to a catheter insertion site in a patient, and proximal refers to the opposite direction. The positional terms axial and transverse are also used herein to orient the various components relative to each other. Axial refers to the direction generally extending from the distal end to the proximal end, and transverse refers to the direction extending through the catheter and generally perpendicular to the catheter body.
[0031] Generally, the present disclosure is directed to an OTN catheter assembly that may be used to administer a drug (e.g. anesthesia) during or after a surgical procedure or during or after an incisional nerve block procedure. An OTN catheter assembly of the present disclosure may comprise a catheter with a body that may have at least one aperture and a projection that extends axially from the distal end of the body when the projection is in an open position. The projection may be sized and connected to the body such that the projection may close an opening in the distal end of the catheter when the projection is transitioned into a closed potion. The OTN catheter assembly may further comprise a needle releasably configured within a lumen of the catheter such that the needle extends beyond the distal end of the catheter in a first position and is withdrawn into the lumen or is removed from the catheter in a second position.
[0032] A benefit of using an OTN catheter is that it eliminates the step of feeding the catheter through the needle, saving time and also lessening the chance of moving the catheter away from the target area. However, OTN catheters have not been used in and after surgical and nerve block procedures in particular, as the catheter has an opening in the distal end where the needle protrudes through the catheter in order to form the incision. This makes it extremely difficult to control an amount or a rate of administration of a drug or anesthesia. Therefore, by providing an OTN catheter with a projection that may close an open distal end of a catheter, an OTN catheter may be used in circumstances where greater control of the amount or rate of a drug or anesthesia is needed.
[0033] Accordingly, the OTN catheter assembly may generally include a catheter having a proximal end and a distal end and a body that extends in an axial direction from the proximal end to the distal end. The distance between the proximal and distal ends of the catheter may generally correspond to the length of a needle used with the catheter, or the catheter may have a greater or lesser length than the length of the needle. For instance, the length of the catheter or needle may be greater than about 2 centimeters, such as about 5 centimeters or greater, such as about 7 centimeters or greater, such as about 10 centimeters or greater, such as about 12 centimeters or greater, such as about 15 centimeters or greater, such as about 20 centimeters or greater, such as about 25 centimeters or greater, such as about 30 centimeters or greater, such as about 35 centimeters or greater, such as about 40 centimeters or greater, such as about 45 centimeters or greater, such as about 50 centimeters or greater, such as about 55 centimeters or greater, such as about 60 centimeters or greater, such as less than about 80 centimeters, such as about 75 centimeters or less, such as about 70 centimeters or less, such as about 65 centimeters or less, such as about 60 centimeters or less, such as about 55 centimeters or less, such as about 50 centimeters or less, such as about 45 centimeters or less, such as about 40 centimeters or less, such as about 35 centimeters or less, such as about 30 centimeters or less, such as about 25 centimeters or less, such as about 20 centimeters or less, such as about 15 centimeters or less in length. However, the catheter and/or needle may have a larger or smaller length in other embodiments. The catheter may include a piezoelectric or echogenic component as known in the art that may be configured within the body material or inside of the catheter, or alternatively may include no positioning aid, or another positioning aid known in the art.
[0034] The catheter may generally have a shape and size as generally known in the art such as described by the French gauge scale. Alternatively, the catheter may be tapered towards the distal end. In one embodiment, the catheter may be tapered such that the lumen of the catheter is also tapered, or, alternatively, only the exterior of the body may be tapered such that the outer diameter of the catheter is tapered without changing the diameter of the lumen which corresponds to the interior diameter of the catheter. The outer diameter of the lumen may be defined by the distance between opposing exterior edges of the catheter body, whereas the interior diameter or the lumen diameter may be defined by the distance between opposing interior edges of the catheter body. The lumen may have a length and diameter generally corresponding to the diameter and length of a needle that may be used with the catheter, or may have a smaller or larger length or larger diameter than a needle that may be used with the catheter. Regardless of the length and/or outer diameter of the catheter, the lumen may have a diameter larger than a diameter of a needle used with the OTN catheter assembly of the present disclosure. Alternatively, it may be desired that the catheter lumen have a relatively large diameter while maintaining the same outer diameter size for the catheter itself, thus, the catheter may have a thinner body, defined as the distance between the exterior diameter of the catheter body and the interior diameter of the catheter. In yet a further embodiment, it may be desirable to have a catheter body that is relatively thick, such that an outer diameter of the catheter may be maintained while the diameter of the lumen is decreased.
[0035] The catheter body of the present disclosure may also generally have an opening in the distal end. The opening may generally have the same shape and diameter as the shape and diameter of the catheter lumen. Alternatively, the opening in the distal end may have a smaller diameter than that of the catheter lumen. For example, the projection may extend into the opening from the catheter body, thus decreasing the diameter of the opening in the distal end. As an additional example, the diameter of the opening in the distal end may be smaller than the diameter of the catheter lumen and the projection may be made from a flexible material that may expand when subjected to a force, such as the introduction of a needle into the lumen, so as to form a releasable seal with the needle. Alternatively, the opening in the distal end may be larger than the diameter of the catheter lumen.
[0036] The catheter body may have a projection that extends in an axial direction from the distal end of the body when the projection is in an open position. The projection may generally be sized such that the projection may close an open distal end of the catheter when the projection is transitioned into a closed position. The projection may have an axial length from the point of connection with the body to the distal end of the projection that is at least as long as the outer diameter of the catheter. Alternatively, the projection may have an axial length that is shorter than an outer diameter of the catheter, such as an embodiment wherein the opposite side of the catheter body tapers towards the lumen or where the thickness of the catheter body is quite large such that the axial length of the projection is only as long as the diameter of the lumen. Alternatively, the projection may have an axial length that is longer than the outer diameter of the catheter.
[0037] The projection may be configured so that when the projection is transitioned into a closed position, an angle formed between the projection and the transverse direction is also closed, wherein the angle to be closed may range from about 1 to about 90, where the angle to be closed may be generally shown in the Figures as .sub.1. Of course the angle may be greater than about 90 depending upon the initial attachment to the catheter body, or it may be less. The degree or amount of closing may also depend on the shape and position of the termination of the portion of the open distal end opposite the projection. The portion of the open distal end opposite the projection may be tapered towards the needle such that the outer diameter of the catheter at the distal end may be smaller than an outer diameter at a proximal end of the catheter, or may be substantially consistent throughout the length of the catheter body. The portion of the open distal end opposite the projection may also have an interior surface that is generally planar with the catheter body and an exterior surface which may to taper towards the interior surface and/or towards the needle.
[0038] In an embodiment where the portion of the open distal end of the catheter opposite the projection has a taper, either in whole or in part, the taper may be fairly steep, such as at an angle of greater than about 45, such as greater than about 50, such as greater than about 55, such as greater than about 60, such as greater than about 70 where the degree of taper is the angle .sub.2 measured between the plane of the exterior surface of the catheter body P and the tapered portion of the catheter body as shown in
[0039] In an alternative embodiment, the tapered portion of the portion of the open distal end opposite the projection may be tapered at a fairly shallow angle, such as less than about 45, such as less than about 40, such as less than about 35, such as less than about 30, such as less than about 20 where the degree of taper is the angle .sub.2 measured between the plane of the exterior surface of the catheter body P and the tapered portion of the catheter body as shown in
[0040] Further, the projection may extend linearly from the distal end of the catheter body or may have a curve or angle, such that the projection is curved or angled towards the catheter lumen. In a further embodiment, the projection may be formed from a deformable or flexible material such that the projection is generally linear but may be released into a curved or angled shape when a needle is removed from the lumen.
[0041] The shape of the projection as well as the degree of transition may be selected based upon the desired shape of the distal end when the projection is in a closed position. For example, in certain circumstances, it may be desirable to have a closed distal end with a slightly pointed shape, such as if additional positioning may be necessary, which may be generally shown in
[0042] The body of the catheter may be comprised of various materials including polyesters, polyurethanes, polyamides, polyolefins, including polyethylene and polypropylene, and any copolymers thereof, such as nylon, polyester elastomer, polyether/block polyamide, and/or tetrofluorethylenes. Moreover, the body of the catheter may be fairly thick, wherein the thickness of the body is defined as the distance between the exterior diameter of the catheter body and the diameter of the catheter lumen and as generally shown by reference character t. For instance, the thickness of the body t may be greater than about 500 micrometers, such as about 600 micrometers or greater, such as about 700 micrometers or greater, such as about 800 micrometers or greater, such as about 900 micrometers or greater, such as about 1000 micrometers or greater, such as about 1100 micrometers or greater, such as about 1200 micrometers or greater, such as about 1300 micrometers or greater, such as about 1600 micrometers or less, such as about 1500 micrometers or less, such as about 1400 micrometers or less, such as about 1300 micrometers or less, such as about 1200 micrometers or less, such as about 1100 micrometers or less, such as a thickness of about 1000 micrometers or less. The body material and thickness may be selected based upon the target location of the catheter, the likelihood of positioning the catheter after removal of the needle, and additional considerations. For example, a thicker body or a stronger material may be selected if the catheter may need to be repositioned after removal of the needle, or a thinner or weaker material may be selected so as to decrease bulk and potentially increase comfort in areas where the catheter is less likely to need to be repositioned.
[0043] The projection and the point of connection of the projection to the body may be comprised of the same material as the catheter body or they may be formed from a separate material. In one embodiment, the projection, the catheter body, and the point of connection may all be comprised of a separate material. In yet a further embodiment, the body, projection, and point of connection may all be comprised of the same material, but the point of connection of the projection may be heat treated, or undergo a similar process, such that the point of connection is formed so that the projection may transition into a closed position. In yet a further embodiment, the body, point of connection, and projection may all be formed from one material or separate materials but at least one may include an additional reinforcing material to harden the material or raise the durometer, or alternatively have an embedded metal or metal alloy therein, or a flexible material, or a combination of a flexible material and reinforcing material. In yet an additional embodiment the body, point of connection, and the projection may all include an additional reinforcing material, a flexible material, or a combination of a reinforcing material or a flexible material.
[0044] The catheter body may further comprise at least one aperture. While there may be more or less apertures, the catheter body may generally contain at least 1 aperture, such as at least about 2, such as at least about 3, such as at least about 4, such as at least about 5, such as at least about 7 such as at least about 10 apertures. The catheter body may also comprise less than about 20, such as less than about 18, such as less than about 15, such as less than about 13 apertures.
[0045] The apertures may be spaced apart radially as generally shown in
[0046] The apertures may have a diameter such as about 1 millimeter or less, such as about 900 micrometers or less, such as about 800 micrometers or less, such as about 700 micrometers or less, such as about 600 micrometers or less, such as about 500 micrometers or less, such as about 400 micrometers or less, such as about 300 micrometers or less, such as about 100 micrometers or greater, such as about 200 micrometers or greater, such as about 300 micrometers or greater, such as about 400 micrometers or greater, such as about 500 micrometers or greater, such as about 600 micrometers or greater in diameter. In a further embodiment, some of the apertures may have a fairly large diameter and some of the apertures may have a fairly small diameter. In an embodiment with apertures that have a mixture of diameters, the ratio of the diameter types may be fairly even, or in an alternate embodiment there may be more large diameter apertures, such as twice as many large, such as three times as many large, such as five times as many large diameter apertures. Alternatively, there may be more small diameter apertures such as twice as many small, such as three times as many small, such as five times as many small diameter apertures.
[0047] The arrangement of the apertures, number of apertures, and diameter of the apertures may be selected based upon the target area, the type of drug or anesthesia to be delivered, or the desired rate of delivery, to name a few considerations. For example, a larger number of apertures or apertures with a larger diameter, or both, may be selected when a greater rate of delivery is desired. Alternatively, arrangements of apertures may be selected based upon the location and orientation of the target area. For example, if a small target area is desired, all of the apertures may be located fairly close together either radially or axially. In an additional embodiment for example, if a target area may only be located on one side of a catheter, then the apertures may mainly be located on a single side of the catheter body such that the apertures are all located on generally the same side, area, or radius. Alternatively, if a more central location is chosen for the catheter, the apertures may extend radially around the catheter body such that an aperture is located on several different radii around the catheter body.
[0048] In one embodiment, the rate of delivery of a drug or anesthetic using a catheter assembly according to the present disclosure may be at least about 0.01 mL/hr, such as about 0.05 milliliters(mL)/hr or greater, such as about 0.1 mL/hr or greater, such as about 0.5 mL/hr or greater, such as about 1 mL/hr or greater, such as about 3 mL/hr or greater, such as about 5 mL/hr or greater, such as about 7.5 mL/hr or greater, such as about 10 mL/hr or greater, such as about 12.5 mL/hr or greater, such as about 15 mL/hr or greater, such as about 17.5 mL/hr or greater, such as about 20 mL/hr or greater, such as about 22.5 mL/hr or greater, such as about 25 mL/hr or greater, such as about 27.5 mL/hr or greater, such as about 30 mL/hr or greater, such as about 35 mL/hr or greater, such as about 40 mL/hr or less, such as about 37.5 mL/hr or less, such as about 35 mL/hr or less, such as about 32.5 mL/hr or less, such as about 30 mL/hr or less, such as about 27.5 mL/hr or less, such as about 25 mL/hr or less, such as about 22.5 mL/hr or less, such as about 20 mL/hr or less, such as about 17.5 mL/hr or less, such as about 15 mL/hr or less, such as about 12.5 mL/hr or less, such as a rate of delivery of about 10 mL/hr or less.
[0049] The OTN catheter assembly of the present disclosure may also generally include a needle. The needle shape and size may be selected based upon the desired target area or based upon the size of catheter desired and the lumen diameter of the catheter. Alternatively, other instruments may be used to pierce a surface of the skin and guide the OTN catheter assembly, such as a tunneler or a guidewire. In a further embodiment, a curved needle may be used, and in such a case a catheter formed from a flexible material capable of holding a shape may be used so as to maintain the shape after a needle is removed from the catheter assembly. A needle of the present disclosure may also be made of an echogenic material, or may include other materials based upon the target area and placement thereof. The needle, the needle tip size, and the needle tip shape may be selected to correspond with a projection of the catheter body of the present disclosure, or a standard sized and shaped needle may be used.
[0050] The needle may generally have a length or be inserted into the catheter lumen at a location such that the tip of the needle may extend through the opening in the distal end of the catheter. Only a small portion of the needle may extend through the opening in the distal end or a large portion may extend through the opening in the distal end. In one embodiment, only the tip of the needle may extend through the opening in the distal end such that the catheter is largely in the desired target area when the needle is removed. Alternatively, a longer portion of the needle may extend through the opening in the distal end, and optionally, the catheter's positioning may be adjusted after the needle is removed. The needle may also be configured so as to remain in the lumen in a retracted position such that the needle still allows for the delivery of a drug or anesthesia but is completely contained within the lumen when the projection is in a closed position.
[0051] Generally, the OTN catheter assembly of the present disclosure may have a projection that is configured to interact with a needle that may be contained in the catheter lumen such that the projection is in an open position when a needle extends through an opening in the distal end of the catheter, and transitions into a closed position when the needle is withdrawn into the catheter lumen. The projection may close automatically when the needle is withdrawn; for example, the projection may have a treated section (e.g. heat treated) at the point of attachment to the catheter body that transitions the projection into a closed position when the needle is no longer applying pressure or support to the projection. The projection may be releasably or permanently held in the closed position by the portion of the open distal end opposite the projection. This may be accomplished by an additional adhesive, tacky, or textured material on the portion of the open distal end opposite the projection or, alternatively, point of attachment may have a treated section that maintains the projection in a closed position unless acted upon by internal forces such as a needle.
[0052] In an embodiment wherein the flap is releasably held in a closed position, a needle may be reinserted through the distal end of the catheter, transitioning the projection into the open position. This may allow a catheter to be repositioned, or may allow the delivery of a bolus or larger single dose of a drug or anesthetic before resuming the continuous flow of the catheter.
[0053] In yet a further embodiment, the OTN catheter assembly may also include a needle hub releasably or permanently attached or configured at the proximal end of the catheter. The present disclosure may include both a needle hub and a catheter hub, or may include a singular hub suitable to interact with both a needle and a catheter. Regardless of the type and number of hubs, the hub or hubs may be configured to maintain the needle within the lumen of the catheter until it is desired to remove the needle. Alternatively, the hub may comprise a durable material, such as a rigid plastic in one embodiment, or alternatively a polyethylene polymer or copolymer and/or polypropylene polymer or copolymer, so as to not become disconnected from the catheter and needle when the OTN catheter assembly is placed within a target area. In yet a further embodiment, the hub or hubs may provide a convenient place to hold and/or guide the OTN catheter assembly. Additionally or alternatively, the hub may be provided with ports for administering a drug or anesthesia through the catheter, needle, or both, or may provide a connection to the needle or catheter such as a nerve stimulator device.
[0054] The present disclosure may further be generally directed to a method for administering a bolus or continuous flow of a drug or anesthetic to a patient. The method may include piercing a surface of skin with an OTN catheter. The OTN catheter may generally have the form of the OTN catheter assembly as discussed above. After piercing the skin, the distal end of the OTN catheter assembly may be positioned near a target area. The OTN catheter assembly may be fully positioned before withdrawing or removing the needle, or alternatively the OTN catheter assembly may only be partially inserted before withdrawing or removing the needle, and may then be further positioned after withdrawing or removing the needle.
[0055] The OTN catheter assembly may further be used to administer a drug or anesthesia to a patient or a target area of a patient. The target area may be a nerve or nerve bundle, or alternatively may be used for other or more general targets. Administration of the drug or anesthesia may begin while the needle is still extended through the opening in the distal end of the catheter or may not begin until the needle has been either withdrawn into the lumen or withdrawn from the lumen such that the projection is in a closed position. The OTN catheter assembly may thus be used to administer a bolus or a continuous flow of a drug or anesthesia. In one embodiment, no drug or anesthesia may be administered through the opening in the distal end and instead is only administered through the at least one aperture. As previously discussed, the shape and size of the catheter, and the shape, size and orientation of the apertures may be selected based upon the amount or type of drug or anesthesia, or based upon the desired rate of delivery, to name a few considerations.
[0056] While embodiments of the present disclosure have been generally discussed, various embodiments of the present disclosure will now be described in more detail. Referring now to the drawings,
[0057] As shown in
[0058] The OTN catheter assembly, such as illustrated in
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[0067] These and other modifications and variations to the present invention may be practiced by those of ordinary skill in the art, without departing from the spirit and scope of the present invention, which is more particularly set forth in the appended claims. In addition, it should be understood that aspects of the various embodiments may be interchanged both in whole or in part. Furthermore, those of ordinary skill in the art will appreciate that the foregoing description is by way of example only, and is not intended to limit the invention so further described in such appended claims.