The present disclosure generally relates to medical devices, systems and methods for imaging in biomedical and other medical and non-medical applications, and more particularly, to probes, systems and methods for generating an image in a multiple aperture, multiple modal optical system for Optical Coherence Tomography (OCT) imaging.
Various forms of imaging systems are used in healthcare to produce images of a patient. Often, an image of an internal cavity of a patient is required. These cavities can include areas of the digestive system and/or the respiratory system. Surgical incisions are also used to access internal cavities. When imaging tissue features of these systems, fiber optic endoscopy is often utilized.
One type of fiber optic endoscope is based on Optical Coherence Tomography (OCT) techniques. OCT provides structural information on tissue with high resolution. OCT can provide this information in real time and in a non-invasive manner. One example is disclosed in U.S. patent application Ser. No. 13/365,621, filed Feb. 3, 2012, entitled IMAGING SYSTEM PRODUCING MULTIPLE REGISTERED IMAGES OF A BODY LUMEN, the entire contents of which are herein incorporated by reference.
Many different lens types have been used to construct fiber optic endoscopes. These lenses include fiber lenses, ball lenses and GRadient INdex (GRIN) lenses. Lens materials can vary from glass to plastic to silicon. An optical probe must be specifically manufactured to conform to optical parameters required for a specific use.
In addition, many different energy types with proper probes are used in fiber optic endoscopy. For example, coherent laser light can be used for deep tissue scans, visible light for surface imaging, and ultrasound for intravascular imaging.
Light or energy from a source is focused onto or into the tissue. The tissue scatters the light or energy and the light or energy that is reflected back to the probe is received at a detector that converts the light to electrical signals. A processing system is used to analyze the detected light (i.e. the electrical signals) and produce images on a display. These images can be manipulated to produce variations for better diagnosis by a health care professional.
Esophageal imaging requires probes of specific design to properly image into surrounding tissue. Typical esophageal imaging systems include a prism to direct light off axis into the surrounding tissue. In order to produce a full image of an esophagus the probe must be rotated within the esophagus at a specific rotation rate and translated along the esophagus at a specific translation rate throughout the scanning process. If the rotation rate and/or the translation rate are too fast for a proper scanning, the image produced will be rendered useless. Whereas a slower rotation and/or translation rate increases the costs of imaging.
The typical optical imaging system consists of a single optical probe and a single energy (e.g. visible light) source. A particular optical probe has a set characteristics used for specific image requirements. Such characteristics can include, for example, depth of field, polarization, resolution, visible imaging, etc. Thus, if multiple characteristics are required, multiple scans using multiple probes must be performed.
If a multiple scan is performed, the multiple images must often be viewed individually due to scaling and alignment problems. If two images are to be viewed together as one composite image, they will be distorted and useless unless properly scaled and aligned.
This disclosure describes improvements over these prior art technologies.
Accordingly, a multiple modal optical system is provided. The system includes at least one optical component positioned at a first position about a longitudinal axis; and at least two light sources connectable to the at least one optical component, wherein the multiple modal optical system is configured to transmit light from the at least two light sources in at least one direction transverse to the longitudinal axis and receive reflected light, and wherein the at least one optical component is configured to rotate about the longitudinal axis and translate along the longitudinal axis when connected to the at least two light sources.
Accordingly, a multiple modal optical system is provided. The multiple modal optical system includes a first optical component positioned at a first position about a longitudinal axis, connectable to a first light source, and configured to transmit light from the first light source in a first direction transverse to the longitudinal axis and receive first reflected light; and a second optical component positioned about the longitudinal axis at a second position at or about the first position of the first optical component, connectable to a second light source, and configured to transmit light from the light source in a second direction transverse to the longitudinal axis and different from the first direction and receive second reflected light, wherein the first and second optical components are configured to rotate about the longitudinal axis and translate along the longitudinal axis when connected to the light source.
Accordingly, a multiple modal optical system is provided. The multiple modal optical system includes a first optical component positioned at a first position about a longitudinal axis, connectable to a light source, and configured to transmit light from the light source in a first direction transverse to the longitudinal axis and receive first reflected light; a second optical component positioned about the longitudinal axis at a second position at or about the first position of the first optical component, connectable to the light source, and configured to transmit light from the light source in a second direction transverse to the longitudinal axis and different from the first direction and receive second reflected light; a first detector to receive the first reflected light and convert the first detected light into a first signal; a second detector to receive the second reflected light and convert the second detected light into a second signal; and a processor effective to: receive first data and second data representative of the first signal and the second signal, respectively, said first data and said second data representative of a common tissue sample, identify a common feature in the first data and the second data, and modify the first data to at least one of register, align or scale an image produced by the first data to an image produced by the second data based on the common feature, wherein the first and second optical components are configured to rotate about the longitudinal axis and translate along the longitudinal axis when connected to the light source.
Accordingly, a multiple modal optical method is also provided. The method includes receiving first data and second data representative of a first signal produced by a first of at least two light sources and a second signal produced by a second of the at least two light sources, said first data and said second data representative of a common tissue sample; identifying a common feature in the first data and the second data; and modifying the first data to at least one of register, align or scale an image produced by the first data to an image produced by the second data based on the common feature.
Accordingly, a multiple modal optical method is also provided. The method includes generating first data from a tissue sample using an Optical Coherence Tomography (OCT) imaging mode and second data from the tissue sample using an Red-Green-Blue (RGB) imaging mode; transforming the first data into OCT lines of data by projecting along an axial dimension; representing each OCT line as one line in a final gray scale OCT image; transforming the second data into individual red, green and blue lines of data; combining each of the red, green and blue lines to form a single RGB image; and combining the Oct image and the RGB image to form a composite image.
Accordingly, a multiple modal optical method is also provided. The method includes acquiring at least two data sets from the optical system through at least two detectors; preprocessing the at least two data sets; registering the two data sets by determining a geometric transformation model to map voxel coordinates of the two data sets, comprising: identifying locations salient features in each data set; computing feature vectors for each identified location; determining feature vector pairs between the two data sets; and determining the geometric transformation model based on smoothness and plausibility and a minimization of the number of outliers in the matched pairs; selecting an optimal transformation model based on at least one of a number of outliers, closeness of feature positions and descriptors, regularity of the geometric transformation; applying the selected optimal transformation model to the data sets; combining data sets; and rendering images from the combined data sets.
The present disclosure will become more readily apparent from the specific description accompanied by the following drawings, in which:
Like reference numerals indicate similar parts throughout the figures.
The present disclosure may be understood more readily by reference to the following detailed description of the disclosure taken in connection with the accompanying drawing figures, which form a part of this disclosure. It is to be understood that this disclosure is not limited to the specific devices, methods, conditions or parameters described and/or shown herein, and that the terminology used herein is for the purpose of describing particular embodiments by way of example only and is not intended to be limiting of the claimed disclosure.
Also, as used in the specification and including the appended claims, the singular forms “a,” “an,” and “the” include the plural, and reference to a particular numerical value includes at least that particular value, unless the context clearly dictates otherwise. Ranges may be expressed herein as from “about” or “approximately” one particular value and/or to “about” or “approximately” another particular value. When such a range is expressed, another embodiment includes from the one particular value and/or to the other particular value. Similarly, when values are expressed as approximations, by use of the antecedent “about,” it will be understood that the particular value forms another embodiment. It is also understood that all spatial references, such as, for example, horizontal, vertical, top, upper, lower, bottom, left and right, are for illustrative purposes only and can be varied within the scope of the disclosure.
A multi-aperture probe has the significant advantage of co-registering all the different types of data on top of each other compared to a single aperture probe. Additional data is only as good as how well it is located with the OCT image. Characteristics of a multi-aperture probe include faster imaging, higher resolution radially and axially, increased depth of imaging, increased field of view, handle higher optical power (multimode fiber, GRIN fiber, and double clad fiber), white light imaging, and structural information based on polarization.
Multiple aperture, multiple modal optical systems and methods according to the present disclosure can increase the scanning area and/or speed without increasing the rotation rate or decreasing the pitch. The pitch of a pull-back is described the same way as the pitch on the threads of a screw. If the pitch is kept constant, then the resolution will be about double. If the pitch becomes twice as large, then imaging will take half the time and resolution will be maintained assuming 2 identical OCT apertures. Inversely, decreasing the pitch increases the scan time if rotation rate is maintained. Additionally, multiple aperture optical systems and methods according to the present disclosure can extend the depth of field for imaging while maintaining resolution by providing multiple apertures having separate working distances. Still further, multiple aperture optical systems and methods according to the present disclosure can significantly increase resolution by changing the direction of the spectral signal. In addition, multiple aperture optical systems and methods according to the present disclosure can gain additional polarization data by having multiple polarization states. Still yet further, multiple aperture optical systems and methods according to the present disclosure can include a visible imaging modality similar to a regular camera as one of the probe characteristics. Also, multiple aperture optical systems and methods according to the present disclosure can utilize a multimode fiber for a high power laser with a separate OCT channel.
Although many of the embodiments disclosed herein relate to systems having 2 or more distinct apertures, a single aperture configuration is contemplated. The single aperture configuration uses the single aperture to direct and focus at least 2 different energy (e.g. white light and coherent light) sources onto and/or into the surrounding tissue of interest and receive the reflected light back through the aperture. Once received, the processing of the signals is similar to the multiple aperture systems.
The multiple aperture optical systems and methods according to the present disclosure can be realized using a computer that receives signals from two or more optical probes assembled into one functional probe that utilizes multiple path lengths, carrier frequencies, types of fiber, polarizations and/or detectors to separate the image data from each optical probe. A computer receives signals representing images from the optical probe and scales and/or aligns the images to produce a composite image for display.
Reference will now be made in detail to the exemplary embodiments of the present disclosure, which are illustrated in the accompanying figures.
As shown in
A GRIN lens is described herein for illustrative purposes. Other lenses and lens structures are contemplated. For example, ball lenses, fiber optic lenses, and molded lenses (all of these may be made with or without a grating) can be utilized as the probe without departing from the scope of the present invention.
Probe 10 is typically contained within a sheath S. Sheath S containing probe 10 is inserted into a cavity of a patient to image into tissue T surrounding probe 10. Sheath S protects probe 10 and tissue T from damage.
Probe 10 is typically connected to a light source 19 at proximal end 12 of optical fiber 11 through a rotary junction 18 and optical components 17. Also included is a detector 20 to detect light reflected back from tissue T. The optical components 17 can include elements to direct light from light source 19 toward probe 10 and elements to direct light from probe 10 to detector 20. The energy from light source 19 can be, for example, coherent, visible, infrared (IR) or ultrasound; other energy sources are contemplated.
System 1 is shown connected to computer 30. Computer 30 can include a central processing unit (CPU) 31 for controlling the overall operation of the system, a memory 32 for storing programs upon which the system can operate and data, an input device 33 for receiving input commands from a user, and a display 34 for displaying processed or raw data for images or other information. Computer 30 provides control for the components of system 1. Computer 30 also provides image processing functions to produce images from light detected at detector 20. Input device 33 can include a keyboard and/or a mouse. Output device 34 can include a display for displaying, for example, instructions and/or images.
In operation, and also with reference to
In order to provide an image of a particular area of tissue T, probe 10 is translated along direction X and rotated about axis Z. The translation rate and rotation rate must be maintained at a predetermined and/or known rate to ensure a complete and accurate scan is performed. Anomalies can result if the translation and/or rotation rates are too high, too low or varies over time, a phenomenon referred to as Non-Uniform Rotational Distortion (NURD).
This translation and rotation directs light L into tissue T at an area of concern. In order to produce a complete radial scan of tissue T surrounding probe 10, probe 10 must be rotated 360 degrees to produce an image of a first slice of tissue T and then translated along direction X to produce an image of an adjacent slice of tissue T. This rotation/translation process continues along direction X until the area of concern of tissue T is completely scanned.
Referring to
An optical probe must be specifically manufactured to conform to required optical parameters. Esophageal imaging requires probes of specific design to properly image into surrounding tissue T. When using an optical probe for esophageal imaging, a long working distance with large confocal parameter is required. Generally in esophageal imaging the working distances from the center of the optical probe radially outward to the tissue ranges from 6 mm to 12.5 mm. The optic itself can be 1 mm in diameter, with a protective cover (not shown) in sheath S and with a balloon (not shown) on top, while still fitting through a 2.8 mm channel in an endoscope. With no tight turns required during the imaging of the esophagus (compared, for example, to the biliary system, digestive system or circulatory system), an optical probe can be as long as 13 mm in length without a interfering with surrounding tissue T. In attempts to manufacture an optical probe that conforms to these parameters, several designs have been utilized. Ball lenses, GRadient INdex (GRIN) lenses, and molded lenses may be used with or without an outer balloon structure can increase the working distance and achieve better imaging conditions.
A multiple aperture optical system in accordance with one embodiment of the present disclosure is illustrated in
Each probe 110a/110b is connected to an optical fiber 111a and 111b that connects a respective probe 110a/110b to at least one light source 119. A concept of the present disclosure is to provide each probe 110a/110b with light that when received back at detector 120 can be used during the image processing.
In one embodiment, each probe 110a/110b is connected to a distinct coherent light source that requires a multiple channel rotary junction 118 to handle the multiple light paths.
In another embodiment a single light source 119 can be utilized while employing an optical component 140 that functions to split light path through optical fiber 111 from light source 119 into 2 separate light paths, each having a fraction of the total power and each having a different path length. In this embodiment only a single channel rotary junction 118 would be required. As stated above, light source 119 can be any available energy source for different imaging requirements or imaging modes, e.g. coherent light or ultrasound.
A single aperture multimodal OCT optical system in accordance with another embodiment of the present disclosure is illustrated in
The single aperture optical system is similar to the multiple aperture system of
In yet another embodiment the light can be multiplexed to the multiple probes using Acoustic Optical Frequency (AOF) shifting. As shown in
In still yet another embodiment the light paths of differing path lengths can be used. As shown in
In still yet another embodiment the light travels down one or more stationary optical fibers to the distal end of the probe where a mechanism is employed to scan the tissue of interest. The scanning mechanism can result in moving the light beam in a linear pattern (X, Y or Z), raster pattern (X-Y, Z-Y), rotational pattern (theta) or combination thereof. Systems and/or methods of scanning could include MEMS mirror, linear or rotary motors, piezo elements or combinations thereof.
Other methods are contemplated. Whichever method is utilized, an object of the present disclosure is to provide light to the probe(s) to generate at least 2 reflections and to be able to distinguish between the reflected light for further image processing occurring in computer 130.
Additionally, the present disclosure is described as using a coherent light source as the at least one light source 119, but additional configurations are possible. Other configurations include a visible light source to provide a visual imaging mode or an ultrasound energy source to produce an ultrasound image. Several of these configurations will be discussed in further detail below.
Although a GRIN lens is described herein for illustrative purposes, other lenses and lens structures are contemplated. For example, ball lenses, fiber optic lenses, molded lenses, and molded multi-aperture probes (all of these may be made with or without a grating) can be utilized as the probe without departing from the scope of the present invention.
Probes 110a/110b are typically contained within a sheath S, which is insertable into a cavity of a patient to image into tissue T surrounding probes 110a/110b to protect probes 110a/110b and tissue T from irritation or damage.
Probes 110a/110b are connected to a coherent light source 119 through optical fiber 111, rotary junction 118 and optical components 117. Also included is detector 120 to detect light reflected back from tissue T. The optical components 117 can include elements to direct light from light source 119 toward probes 110a/110b and elements to direct light from probes 110a/110b to detector 120.
System 100 is shown connected to computer 130. Computer 130 provides control for the components of system 100. Computer 130 also provides image processing functions to produce images from light detected at detector 120. Computer can include CPU 131 and memory 132. Computer 130 can also include one or more input devices 133 such as a keyboard and/or a mouse. Computer 130 can also include one or more output devices 134 such as a display for displaying, for example, instructions and/or images.
With respect to the OCT imaging, the following energy/light sources are contemplated: Red-Green-Blue (RGB) laser diodes and combiner to provide the three channels needed to reproduce visible imaging and narrow-band imaging, and/or broad bandwidth source (such as a super continuum laser) for continuous visible imaging or hyper spectral imaging. Other sources are also contemplated. The detectors can include several individual detectors for different laser wavelengths and/or a spectrometer. The detection schemes that can be utilized can consist of a direct scheme (simply measure the intensity of backscattered light) and/or a lock in amplifier based theme (sinusoidaly modulate the light source and use a lock in amplifier in the detector electronics to boost sensitivity).
Turning again to
In operation, and also with reference to
In order to provide an image of a particular area of tissue T, probes 110a/110b undergo a similar translation along direction X and rotation about axis Z. The translation rate and rotation rate must be maintained at a predetermined rate to ensure a complete and accurate scan is performed. In the preset disclosure, if the same type of probe is used for both probe 110a and probe 110b, the rotation rate can be maintained while doubling pitch between translations as the image is ½ obtained by probe 110a and ½ obtained by probe 110b and then combined by computer 120 to form a complete rotational scan. A faster acquisition can be obtained thus saving cost and time of the imaging process. Computer 130 can utilize a type of interleaving process when combining images from the same types of probes, i.e. the same imaging modes. The interleaving process is also discussed below with respect to
As discussed above, multiple probes are utilized to provide multiple images from a single pass of an OCT imaging system according to the present disclosure. Different configurations of types of probes can be combined to produce varying imaging results. One configuration where two similar probes are used to reduce the acquisition time was described above. The following are illustrations of various configurations according to the present disclosure; other configurations are contemplated.
Another embodiment similar to that shown in
In a system having multiple probes (or one probe having multiple modes, e.g. see
In step s1 the data is acquired from the imaging system through the detectors as described above. As many different modes are available, all of the modes are contemplated and the system can easily be adapted to manage the varying datasets.
In step s2 preprocessing is performed. As will be described later, if images are to be produced to represent the raw (pre-processed) data, this step may be eliminated. If subject to preprocessing, the data of im1 and im2 is processed to obtain im11 and im21, respectively. Preprocessing can include processes to clean the images of known image artifacts (e.g. precession, saturation) and normalize them, that is, correct for other artifacts such as decentering and intensity variations. This step may also include, but is not limited to, background subtraction, shifting of data along axes to correct for precession and decentering, masking of saturated lines, and/or normalization by subtraction of a global or local mean and possible division by global or local measure of variability, e.g. standard deviation. In addition, cropping and/or resampling of data to a normalized, convenient size may also be performed.
In step s3 a registration of the 2 data sets is performed. This step can also include alignment and scaling of the data for the 2 images. It is in this step that a geometric transformation model is determined that will be used to map the voxel coordinates of im1 onto those of im2. Registration can include one or more of the following processes, or a combination thereof.
One registration technique is based on statistical methods, e.g. optical flow, Normalized Cross-Correlation (NCC), and Particle Imaging Velocimetry (PIV). These statistical methods for registration attempt to match regions of interest of a given size from one data set with regions of interest of the same size in the other data set. The process is performed by computing the statistical correlation between the pixel values of those two regions of interest or between a transformed set of pixel values of those two regions of interest. Other common registration techniques are contemplated. Other such registration techniques can include, for example, those disclosed in J. P. Lewis, Fast Normalized Cross-Correlation, Vision Interface (1995), pp. 120-123; Horn, Berthold K P, and Brian G. Schunck, Determining optical flow Artificial intelligence 17.1 (1981), pp. 185-203; Adrian, Ronald J. Particle-imaging techniques for experimental fluid mechanics, Annual review of fluid mechanics 23.1 (1991), pp. 261-304.
Other registration techniques are feature-based methods, e.g. using feature detectors and descriptors (e.g. Speed Up Robust Features (SURF), Scale-Invariant Feature Transform (SIFT), Local Binary Patterns, (LBP), Histogram of Gradients (HoG)) and finding the optimal feature pairs in the two datasets that satisfy a given transformation model (e.g. rigid body rotation, translation, scaling, affine transformation, etc. . . . ) First, salient feature locations are detected in datasets 1 and 2. These salient features represent voxel locations, in the datasets, where features of interest may be located: typically, blobs of significantly higher or lower intensity. At each of these locations, a feature vector is computed based on one of the vector models (e.g. SURF, SIFT, LBP, HoG) depending on the nature of the features to be determined. Next the feature vector pairs are determined (one from dataset 1 and one from dataset 2) that are nearest neighbors and that most resemble each other in feature space. Finally, based on all the nearest neighbor feature pairs detected between the two datasets, a geometric transformation model is determined that satisfies specific criteria of smoothness and plausibility, while minimizing the number of outliers in the matched pairs.
Additional methods for registration, alignment and/or scaling of the two datasets can include tracking of a known (existing or created) target to calibrate the offset and/or scaling between the multiple datasets. This process can be performed as a calibration step for each probe, or can be done in real time during image acquisition. For example, in the case of a balloon-based probe, a surface or surface marker of the (cylindrical) balloon can be tracked and used to match the two or more image sets based on the detected surface or marker, that is, a type of feature-based method. Tracking of the balloon surface would be much faster than any of the feature descriptors mentioned above. A real-time registration and merge rendering of multiple aperture datasets can be performed.
In step s4 an optimal transformation model is selected. The selection is based, at least in part, on criteria such as number of outliers, closeness of feature positions and descriptors, regularity of the geometric transformation, other a priori knowledge of the expected optical and mechanical geometry linking the two (or more) probes and their associated images. Following statistical and/or feature-based registration, the optimal transformation model is applied to image set im1, or im11 if preprocessing is performed. As discussed above, there is the option of working with either image set im1 or im11 or any other intermediate steps between a raw (i.e. unprocessed) dataset and a full processed dataset. The choice of at which stage of preprocessing the data ends up being used for displaying and rendering, depends on the accuracy and confidence in the preprocessing steps, and/or how close the user wants to remain to the unprocessed (i.e. raw) dataset.
In step s5 the merged data is rendered. The rendering of the data set is based on single channel (e.g. gray-scale intensity) or multi-channel (e.g. Red-Green-Blue (RGB), Hue-Saturation-Value (HSV) and/or Lightness A/B coordinate (LAB)) renderings of the two combined datasets. Combination can be linear or non-linear, additive or multiplicative and can once more involve a combination of various operations such as thresholding, masking and other forms of segmentation. One example is standard multi-channel image representation.
In addition, a user can be provided the ability to change the way the two datasets are merged or displayed (i.e. 3D vs. surface rendering), as well as change or choose which image, or combination of images, gets displayed, using the input device(s) (e.g. mouse, keyboard, joystick, display or other device). Further, the two data sets can be viewed on two different parts of a display or two different displays, if available. The ability to manually match features can be used to initialize the search for an optimal transformation model or to enforce a particular constraint.
It is noted that the data representation is not required to have the same dimensionality as the original dataset. For example, the combined or merged images could be on a surface (2 dimensional) image or enface image, while the original acquired datasets are 3 dimensional.
Several examples of the present disclosure are now provided.
As shown in
In order to correct for NURD artifacts, the following steps are performed. First, both images are acquired. Next, the angular encoder image is processed to track where each tooth or encoder was located in the image. Then, the non-rigid transformation that would transform the non-uniform encoder image into a regularly-spaced encoder image is computed. Finally, that same transformation is used to transform the actual image of the tissue of interest.
The components of the system can be fabricated from materials suitable for medical applications, including glasses, plastics, polished optics, metals, synthetic polymers and ceramics, and/or their composites, depending on the particular application. For example, the components of the system, individually or collectively, can be fabricated from materials such as polycarbonates such as Lexan 1130, Lexan HPS26, Makrolon 3158, or Makrolon 2458, such as polyether Imides such as Ultem 1010, and/or such as polyethersulfones such as RTP 1400.
Various components of the system may be fabricated from material composites, including the above materials, to achieve various desired characteristics such as strength, rigidity, elasticity, flexibility, compliance, biomechanical performance, durability and radiolucency or imaging preference. The components of the system, individually or collectively, may also be fabricated from a heterogeneous material such as a combination of two or more of the above-described materials. Although embodiments of the present disclosure have been illustrated as separate pieces attached together, the probes can also be constructed as a single element with multiple apertures.
The present disclosure has been described herein in connection with an optical imaging system including an OCT probe. Other applications are contemplated.
Where this application has listed the steps of a method or procedure in a specific order, it may be possible, or even expedient in certain circumstances, to change the order in which some steps are performed, and it is intended that the particular steps of the method or procedure claim set forth herebelow not be construed as being order-specific unless such order specificity is expressly stated in the claim.
While the preferred embodiments of the devices and methods have been described in reference to the environment in which they were developed, they are merely illustrative of the principles of the inventions. Modification or combinations of the above-described assemblies, other embodiments, configurations, and methods for carrying out the invention, and variations of aspects of the invention that are obvious to those of skill in the art are intended to be within the scope of the claims.
This application claims priority to U.S. provisional patent application Ser. No. 61/811,193, filed Apr. 12, 2013, entitled MULTIPLE APERTURE OPTICAL SYSTEM, the entire contents of which are herein incorporated by reference.
Number | Date | Country | |
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61811193 | Apr 2013 | US |