Abstract: Disclosed herein are improved methods and apparatuses for providing hemostasis within a cavity defined by an internal surface of a bleeding tissue space. A catheter comprising a proximal end and a distal end may be advanced into the cavity through a proximal opening of the tissue space into the cavity. A distal balloon coupled to the catheter may be expanded, and the catheter tensioned to apply pressure to the internal surface of the tissue space to inhibit bleeding of the tissue space.

Abstract: Flush syringe assemblies are described herein. Such flush syringe assembly may include a barrel including a side wall defining a chamber, an open proximal end, a distal end having a distal wall with an elongate tip extending distally therefrom having a passageway therethrough in fluid communication with said chamber. A collar may be mounted on the distal wall of the barrel and surrounding the elongate tip. A disinfectant-loaded swab may be disposed in the collar. The flush syringe assembly may also include a removable cap.

Abstract: A device for automatically disinfecting a portion of a medical implement. The device includes a reservoir chamber having a top external opening, a medical implement protruded through a bottom part of the reservoir chamber with the portion to be disinfected exposed inside the reservoir chamber and below the top external opening, two disinfecting pads, and a resilient device. Each disinfecting pad is connected to the reservoir chamber through a mounting member, which permits displacement of the disinfecting pads relative to the reservoir chamber in substantially opposite directions thereby creating a gap between each pad and the portion to be disinfected. The resilient device biases the disinfecting pads such that when the disinfecting pads are displaced from a rest position, wherein they are contacting the portion to be disinfected, to an engaged position, the disinfecting pads are urged to return toward the portion to be disinfected to contact and disinfect the portion.

Abstract: A fluid control valve for use in a fluid delivery system for delivering fluid to a patient includes a valve body defining an internal chamber, a first inlet port for receiving a first inlet tube, a second inlet port for receiving a second inlet tube, an outlet port, and a sliding valve member slidably disposed in the internal chamber. The first inlet tube defines a first inlet lumen axially aligned with the internal chamber. The second inlet tube defines a second inlet lumen axially aligned with the internal chamber. The sliding valve member includes a first sealing end and second sealing end. The sliding valve member is positionable in a first operating state, a second operating state, and a third operating state based on a flow differential between the first inlet lumen and the second inlet lumen.

Abstract: The invention relates to a valve, in particular for a device for administering a liquid medicament, with a valve body (1) which has an interior (2) for receiving a liquid (20), wherein the valve body (1) has a liquid inlet (3) and an opposite liquid outlet (4) which both open into the interior (2), wherein the interior (2) accommodates a large number of micro channels (5) which extend in connection direction (x) between the liquid inlet (3) and the liquid outlet (4). A corresponding device for administering a liquid medicament is also described.

Abstract: A collapsible valve for use in a needleless access connector to reduce the priming volume of the needleless access connector. A needleless access connector with a small priming volume. A method of connecting a first medical device to a second medical device with a needleless access connector with a small priming volume.

Abstract: A needleless connector includes a body having a fluid path, a vent path, and a male fitting. The needleless connector also includes a valve disposed within the male fitting. The valve is configured to move between a first configuration, in which the fluid path is blocked, and a second configuration, in which the fluid path is open. The needleless connector further includes a seal disposed around the valve. The seal is configured to separate the fluid path from the vent path in the first and second configurations. Moving the valve from the first configuration to the second configuration also opens the vent path. The seal maintains the separation between the fluid path and the vent path when the valve moves from the first configuration to the second configuration.

Abstract: A therapy electrode system comprises a garment configured to be worn about a torso of a patient, a therapy electrode disposed in the garment and configured to deliver one or more electrical shocks to a body of the patient, a replaceable gel cartridge disposed on the therapy electrode and configured to release a conductive gel onto the patient's skin at an interface between the therapy electrode and the patient's skin prior to the delivery of the one or more electrical shocks to the body of the patient at the interface between the therapy electrode and the patient's skin, and a fluid pump in fluid communication with the replaceable gel cartridge.

Abstract: Presented herein are systems, methods, and devices that provide for stimulation of nerves and/or targets such as mechanoreceptors, tissue regions, mechanoresponsive proteins, and vascular targets through generation and delivery of mechanical vibrational waves. In certain embodiments, the approaches described herein utilize a stimulation device (e.g., a wearable device) for generation and delivery of the mechanical vibrational waves. As described herein, the delivered vibrational waves can be tailored based on particular targets (e.g., nerves, mechanoreceptors, vascular targets, tissue regions) to stimulate and/or to elicited particular desired responses in a subject.

Abstract: Presented herein are systems, methods, and devices that provide for stimulation of nerves and/or targets such as mechanoreceptors, tissue regions, mechanoresponsive proteins, and vascular targets through generation and delivery of mechanical vibrational waves. In certain embodiments, the approaches described herein utilize a stimulation device (e.g., a wearable device) for generation and delivery of the mechanical vibrational waves. As described herein, the delivered vibrational waves can be tailored based on particular targets (e.g., nerves, mechanoreceptors, vascular targets, tissue regions) to stimulate and/or to elicited particular desired responses in a subject. As described herein, in certain embodiments, the delivery of mechanical stimulation to a subject provides for treatment of anxiety.

Abstract: This disclosure describes the methods, devices, and systems of treating diseased tissue with integrated nanosecond pulse irreversible electroporation. Methods and systems as disclosed provide MRI compatible shielded electrodes and electrode leads to prevent emanating radiofrequency noise and improve image quality, disconnecting the electrode from the cable linkage to the pulse generator reduce electromagnetic interference and image artifacts, placing electrodes strategically within a guide cannula to minimize distortion from heterogeneities or maximize ablation within the tissue, utilizing conductive fluids, innate or external, such as cerebral spinal fluid or grounding pads to provide a pathway for current return, and for timing of the electrical waveforms with inherent brain electrical activity.

Abstract: In accordance with some embodiments of the disclosed subject matter, mechanisms (which can, for example, include systems, methods, and media) for directional coordinated reset deep brain stimulation are provided. In some embodiments, a method is provided, comprising: implanting a lead with segmented electrodes into an anatomical structure; selecting a first subset of the electrodes corresponding to the anatomical structure as active electrodes; causing electrical pulses at a first stimulation level to be applied at the active electrodes in a first sequence; causing electrical pulses at a second stimulation level that is lower than the first stimulation level to be applied at the active electrodes in a second sequence during a second time period; and inhibiting electrical pulses from being applied at inactive electrodes during the second time period.

Abstract: Described herein are microelectrode devices to provide localized neural recording or neural stimulation to a neurological target. The device includes a plurality of electrodes disposed along the shafts of deployable flexible pins. The deployable flexible pins are enclosed within an elongated probe shaft and can be expanded from their enclosure. Additionally, a specifically manufactured outer housing can be coupled to at least a portion of the elongated probe shaft. During deployment of the flexible pins the outer housing of the microelectrode device reduces friction between the flexible pins and the probe shaft and reduces delamination of the flexible pins during deployment.

Abstract: Apparatus is provided including an intraocular device which is implanted entirely in an eye of a subject and includes photosensors which detect photons representing an image in a gaze direction of the subject, and stimulating electrodes which apply currents to the retina. The apparatus further includes an extraocular device including an imaging device which captures a wide-field image. The apparatus further includes processing circuitry which (i) receives the wide-field image from the imaging device of the extraocular device, (ii) receives a signal from the photosensors of the intraocular device, (iii) based on the signal from the photosensors, process the wide-field image from the imaging device to generate image data representative of a sub-portion of the wide-field image, and (iv) cause the electrodes to apply currents to the retina based on the image data. Other applications are also described.

Abstract: The present invention relates to a method and apparatus for facilitating artificial vision using retinal electrical neuro-stimulation. Retinal ganglion cells are stimulated at two different sites in order to elicit better visual percepts. Primary stimulation is implemented at first site on the retina. Secondary stimulation is applied in the vicinity of the optic disc or optic nerve. The secondary stimulation modulates the signals elicited by the primary stimulation.

Abstract: An implantable medical lead having an elongated lead body extending from a proximal end to a distal end, at least one conductor extending within the lead body from the proximal end to the distal end, and a fixation member having a proximal end and a distal end, the proximal end of the electrode configured to be electrically coupled to the distal end of the lead body.

Abstract: A system for inducing emotional response through craniofacial stimulation, comprising an emotion enhancement device that selects a stimulation configuration and directs the operation of a plurality of stimulation transducers based on the selected stimulation configuration. In some aspects the emotion enhancement device is configured to be worn on the head of a human user, and in some aspects the stimulation configuration is selected based on input cues from hardware sensors.

Abstract: Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

Abstract: This disclosure describes, among other embodiments, a catheter. The catheter may include an outer layer defining a plurality of apertures therethrough, and a body defining at least one longitudinal lumen therein. The body may be within the outer layer, and the apertures may be radially outward of the lumen. The catheter may also include a plurality of electrodes positioned in or on the catheter, with each electrode being electrically exposed through an aperture of the plurality of apertures. A ribbon cable may extend through the lumen and include a plurality of leads, with the plurality of leads being electrically connected to the plurality of electrodes. The plurality of leads and electrodes may be formed by the deposition of conductive inks or paints, or by the electrodeposition of copper or other conductive metals or materials.

Abstract: A method includes: transmitting a first set of radio-frequency (RF) pulses to an implantable wireless stimulator device such that electric currents are created from the first set of RF pulses and flown through a calibrated internal load on the implantable wireless stimulator device; in response to the electric currents flown through a calibrated internal load, recording a first set of RF reflection measurements; transmitting a second set of radio-frequency (RF) pulses to the implantable wireless stimulator device such that stimulation currents are created from the second set of RF pulses and flown through an electrode of the implantable wireless stimulator device to tissue surrounding the electrode; in response to the stimulation currents flown through the electrode to the surrounding tissue, recording a second set of RF reflection measurements; and characterizing an electrode-tissue impedance by comparing the second set of RF reflection measurements with the first set of RF reflections measurements.

Abstract: Delivery of peripheral nerve field stimulation (PNFS) in combination with one or more other therapies is described. The other therapy delivered in combination with PNFS may be, for example, a different type of neurostimulation, such as spinal cord stimulation (SCS), or a drug. PNFS and the other therapy may be delivered simultaneously, in an alternating fashion, according to a schedule, and/or selectively, e.g., in response to a request received from a patient or clinician. A combination therapy that includes PNFS may be able to more completely address complex or multifocal pain than would be possible through delivery of either PNFS or other therapies alone. Further, the combination of PNFS with one or more other therapies may reduce the likelihood that neural accommodation will impair the perceived effectiveness PNFS or the other therapies.

Abstract: In one aspect, methods of treating major depressive disorder (MDD) employing transcranial alternating current stimulation are described herein. A method of treating MDD in a patient comprises reducing alpha oscillations in one or more frontal brain regions of the patient via administering transcranial alternating current stimulation (tACS) to the patient at a frequency within the alpha frequency band.

Abstract: This neural oscillation frequency modulation device changes a frequency of neural oscillation and includes an amplitude modulation unit which generates a modulation signal obtained by amplitude-modulating a carrier signal having a higher frequency than a target frequency band of the neural oscillation on the basis of a prescribed frequency in the target frequency band and an electric stimulation output unit which outputs, as an electric stimulus, an electric stimulus signal based on the modulation signal generated by the amplitude modulation unit to an electrode unit connectable to the head of a subject.

Abstract: Systems, methods and devices for promoting recovery from a stroke induced loss of motor function in a subject. In certain aspects, the system includes at least one electrode, and an operations system in electrical communication with at least one electrode, wherein the at least one electrode is constructed and arranged to apply current across the brain of the subject and to record low frequency oscillations from a perilesional region of the subject. In certain aspects, provided is a method comprising placing at least one recording electrode in electrical communication in a perilesional region of the subject; placing at least one stimulation electrode in electrical communication with the brain of the subject; recording low frequency oscillations from the perilesional region of the subject; and delivering current stimulation to the brain of the subject.

Abstract: Disclosed and described here are an adapter for a neuromonitoring system for placement of an electrode in a subject and a method for confirming placement of an electrode on an appropriate nerve fiber of a dorsal root ganglion during a dorsal root ganglion stimulation procedure.

Abstract: A system and method that includes receiving data from sensors such as electroencephalography, heart rate, accelerometer, blood oxygen saturation, pressure, temperature, and galvanic skin response sensors; determining user physiological information such as brain activity patterns during sleep, quantity of movement during sleep, breathing depth and rate, blood pressure, heart rate and stroke volume, heart rate variability, perspiration level and stress level based, at least in part, on sensor data; evaluating the physiological information to determine at least one of sleep quality, sleep apnea potential, quality of physical activity, and need for stress management for a user; and providing to user based, at least in part, on the evaluation, at least one recommendation such as timing, intensity, level, and type of physical activity to improve sleep quality, time and type of food consumption to improve sleep quality, relaxation techniques to reduce stress level, and nutritional supplements to improve sleep qualit

Abstract: Systems and methods for the efficient use of an implantable pulse generator (IPG) battery are disclosed. A representative system for adjusting an electrical signal of an IPG associated with delivering therapy to a patient comprises a computer readable medium having instructions that cause the IPG to deliver a supply voltage at a first value, adjust the supply voltage from the first value until a threshold break occurs, and, based at least in part of the threshold break, increase the supply voltage from the second value to a third value. As therapy is delivered to the patient, the system iteratively adjusts the supply voltage to approach and reflect a variable minimum voltage needed to provide the requested current to the IPG.

Abstract: Systems and methods for monitoring chronic over-pacing (COP) to the heart are discussed herein. In an embodiment, a system includes a receiver circuit to receive information about pacing rates of a plurality of paced heart beats, and a pacing analyzer circuit to generate a pacing rate distribution using pacing rates of the plurality of the paced heart beats. The pacing rate distribution includes a pacing rate histogram. The pacing analyzer circuit may recognize a morphological pattern from the pacing rate distribution, and detect a COP indication using the extracted feature. A programmer circuit adjusts one or more therapy parameters in response to the detected. COP indication.

Abstract: Methods and devices are provided for implantable medical devices. The device comprises a device housing that has an electronics module, an electrode, an antenna, and a header that has a main body. The main body is formed of a ceramic material that includes side walls, a distal end and a proximal mounting end. The main body has an electrode retention region and an antenna retention platform. The antenna extends along the antenna retention platform. The electrode is provided at the electrode retention region. The mounting end includes electrode and antenna connectors. The main body includes a first plated trace formed through the ceramic material to be electrically coupled to the electronics module in the device housing. Between the antenna and the antenna connector, the main body includes a second plated trace formed through the ceramic material between the electrode and the electrode connector.

Abstract: Systems and methods for managing machine-generated alert notifications of medical events detected from one or more patients are described herein. An embodiment of a data management system may receive an adjudication of a medical event episode including an episode characterization. A storage unit stores an association between one or more episode characterizations and corresponding detection algorithms for detecting a medical event having respective episode characterizations. An episode management circuit may detect from a subsequent episode, using the stored association, a medical event having an episode characterization of at least one medical event episode presented for adjudication, and schedule presenting at least a portion of the subsequent episode based on the detection.

Abstract: Systems and methods of limiting activation of a single use automated external defibrillator (AED). The method comprises using an event monitoring module to sense an activation of the AED, monitor the AED's use state, generate a notification and request a deactivation command if the AED's use state satisfies at least one deactivation criterion, and deactivating the AED when a deactivation command is received. The AED device comprises an energy source, a pair of electrodes, an alert module, a wireless communication module, and an event monitoring module.

Abstract: A method and medical device for adjusting a blanking period that includes sensing cardiac signals from a plurality of electrodes, the plurality of electrodes forming a plurality of sensing vectors, determining whether to adjust a blanking period during a first operating state, advancing from the first operating state to a second operating state in response to the sensed cardiac signals, determining, while in the second operating state, whether the blanking period was adjusted while in the first operating state, and adjusting the blanking period while in the second operating state in response to the blanking period being adjusted while in the first operating state.

Abstract: A defibrillator such as an automated external defibrillator (AED) includes a manual override feature which enables the AED to reduce the power consumption and owner annoyance after a self-testing fault. The AED, upon sensing a press of a manual override button or a receipt of an acknowledgement signal from a remote service provider, defers one or both of an alarm output and a subsequent self-test for a predetermined correction period. The deferral allows the user to correct the self-test fault during the correction period without further annoyance.

Abstract: A gel deployment device for use with an electrotherapy system includes a substrate and a conductive surface mechanically coupled to the substrate. The device includes one or more gel reservoirs disposed on the substrate, each surrounding an open center portion, and a fluid pressure source in fluid communication with the one or more gel reservoirs. At least one frangible seal is disposed within the open center portion and configured to release a volume of conductive gel from the one or more gel reservoirs to the conductive surface.

Abstract: A medical system for sensing a physiological state requiring defibrillation in a patient. The system comprising: a low power sensor, a physiological parameter measuring device, and a processor. The low power sensor generating a baseline signal relating to a physiological status of said patient. The physiological parameter measuring device comprising at least one higher power sensor configured to output at least one physiological parameter signal indicative of at least one physiological parameter of said patient. The processor assessing the baseline signal and determining if the physiological status is outside predetermined threshold boundaries.

Abstract: The invention relates to a device (10) for generating a plasma jet (P) comprising a first conduit (11) inside a second conduit (12), a first electrode (17) and a second electrode (18) for generating an electric field in a feed gas flow (F) provided in a first flow channel (15) to generate a plasma jet (P), and adapted to provide a curtain gas flow (C) in the space between the first and second conduit (11,12), wherein the first electrode (17) is positioned radially outside of the first flow channel (15), and wherein the radial distance of the second electrode (18) from a longitudinal axis (I) is larger than the radial distance of the first electrode (17) from said longitudinal axis (I). The invention further relates to an endoscope comprising a device (10), a method for generating a plasma jet (P), a method and a use of the device (10) for manipulating a cavity.

Abstract: This invention presents methods for targeting and killing types of cells or organisms using Magneto-Electric Nano-Particles under the control of an external magnetic field. A method was also presented for using Magneto-Electric Nano-Particles to stimulate or rejuvenate cells under an external magnetic field.

Abstract: Physiotherapeutic equipment covered by a plurality of interconnected bipartite enclosures formed by superior covers and inferior covers, being two terminals and three central, in a way that if one terminal is projected to the power cable, has a LED installed indicator of a device that is on and compartment of fusible of safety, in a way that such covers are articulated among them. Internally said device is provided a pair of parallel windings, passing the solenoid in the iron nucleus where five pairs of these are reunited, in an ordinated position in a way that the respective solenoids pass through the alternated current to generate the magnetic field.

Abstract: A far infrared film structure and a method of manufacturing the same are provided in this disclosure. The far infrared film structure includes a substrate, an oxide thin film, and an electrothermal film. The substrate has a metallic foil sheet and a plastic film overlappingly combined with each other. The oxide thin film is combined onto the metallic foil sheet and consists of an oxide gel formed by mixing an oxide powder and a sol. The electrothermal film is combined onto the plastic film, and the electrothermal film, the oxide thin film, and the substrate together constitute a flexible thin plate. Thus, the far infrared film structure is bendable to conform closely to the contours of a human body and also has a high content of the oxide powder. Therefore, the far infrared film structure is convenient to use and has a good far infrared emission rate.

Abstract: A method and apparatus irradiates a surface with at least one pulsed light beam emitted from an emission surface of an optical element. The at least one pulsed light beam comprises a plurality of pulses having a temporal pulsewidth in a range between about 0.1 millisecond and about 150 seconds. The at least one pulsed light beam has a beam cross-sectional area at the emission surface greater than about 2 cm2 and a time-averaged irradiance in a range between about 1 mW/cm2 and about 100W/cm2.

Abstract: Embodiments of the present disclosure are directed to a wearable phototherapy eye device. In an example, phototherapy can be controlled by varying an emission property of light emitted from the wearable phototherapy eye device to a user eye. In particular, the wearable phototherapy eye device includes a light source oriented to emit the light towards the user eye. The wearable phototherapy eye device also includes controls, such as electrical, mechanical, and/or electro-mechanical controls, to vary the emission property of the light based on an emission target associated with a sleep phase.

Abstract: Provided is a swallowable capsule for providing phototherapy to a patient's gastrointestinal (GI) tract, the capsule including a power supply, one or more phototherapeutic light sources, a speed determination unit for calculating speed of movement of the capsule in the GI tract, and a controller unit for activating one or more of the one or more light sources for delivering a therapeutic illumination dose to a target site in the GI tract, based, at least in part, on a determined speed. Related apparatus and methods are also described.

Abstract: The present invention refers to a skin or hair treatment device for emitting intense light radiation with an integrated sensor. The device has a housing; a treatment light source, wherein the treatment light source comprises an array of a plurality of light emitting elements arranged on a substrate; a sensor system, said sensor system has at least one sensing light source for emitting sensing light and at least one light sensor for detecting the sensing light, wherein the at least one sensing light source and the at least one light sensor are directed towards a device treatment window; and a control circuit having a processor. The device further has a circular polarizer interposed between the device treatment window and the at least one sensing light source and the at least one light sensor; and a shielding interposed between the at least one sensing light source and the at least one light sensor.

Abstract: A phototherapy device for treating neonatal hyperbilirubinemia comprises a plurality of LEDs coupled to a support structure configured to absorb and dissipate heat generated by the LEDs without requiring a fan. The LEDs provide a uniform dose of radiation on a treatment surface of the subject over a distance range of 20 cm to 45 cm. The support structure can comprise a heat-conductive metal plate. The LEDs have an emission range of 400 nm to 520 and a light output intensity of at least 30 ?W/cm2/nm and at most 65 ?W/cm2/nm at the treatment surface. The device can be adjustably coupled to a mounting structure. Power supplied to the LEDs is adjustable based on the total number of hours of use of the LEDs, the intensity of the LED radiation, the distance between the LEDs and the treatment surface, and/or the tilt or orientation of the phototherapy device.

Abstract: A phototherapy treatment apparatus and methods are provided. In particular, the present disclosure provides a phototherapy treatment apparatus configured to diffusely transmit light emitted from a light source to a patient.

Abstract: Probes include a probe body configured to penetrate biological tissue. High-efficiency light sources are positioned within the probe body. Each high-efficiency light source has a sufficiently intense light output to trigger a light-sensitive reaction in neighboring tissues and has a sufficiently low power output such that a combined heat output of multiple light sources does cause a disruptive temperature increase in the neighboring tissues.

Abstract: A device for feeding a line through the skin of a patient, wherein the line contains a photodynamic substance that releases highly reactive oxygen derivatives when irradiated. Thus, disinfection/sterilization can be achieved in the region of a feed-through both on the outside of the skin and in the feed-through region by irradiating the feed-through.

Abstract: To provide an accelerator that easily provides a space for placing equipment incorporated into an accelerator magnet, and that has a dense region with small turn separations of beams and a sparse region with large turn separations of the beams in different positions in the beam orbit direction. A pair of magnetic poles (8, 9) has a depression structure of a plurality of depression and projection structures, in a position intersecting with a vertical plane (3). A boundary surface (41, 44, 45, 48) between the depression structure (21, 23) placed in a position intersecting with the vertical plane (3) and a projection structure (31, 32, 33, 34) adjacent to the depression structure has unanimously either a projection shape or a depression shape with respect to the vertical plane (3).

Abstract: Disclosed is a spacer for radiotherapy that can be easily compressed into a reduced thickness, and has a high capacity to reconstitute itself from a compressed state back to its initial thickness after removal of external force. The spacer for radiotherapy is a flexible structure having front and back main faces and thickness therebetween, and composed of strands of biocompatible and biodegradable synthetic fibers, wherein the spacer consists of (a) a pair of main face portions opposing each other with a gap therebetween and respectively defining the main faces of the structure, and (b) a linker portion linking between the pair of main face portions, (c) wherein the main face portions comprise a knitted-fabric structure or a weave structure made of the strands, and (d) wherein the linker portion is composed as a collection of linker strands formed of the said strands and respectively extending in the thickness direction of the spacer and linking the pair of main face portions with each other.

Abstract: An apparatus includes: one or more input communicatively coupled to one or more medium storing current treatment plan data and a current image of a patient, the one or more input configured to obtain the current treatment plan data and the current image of the patient, wherein the current treatment plan data is for processing by a treatment machine; and a re-planning decision processor configured to determine a re-plan information based at least in part on the current treatment plan data, the current image, and a re-plan triggering model, the re-plan triggering model based on previous treatment plan data and previous image(s), wherein the re-plan information indicates a recommendation regarding treatment re-planning; wherein the re-planning decision processor is configured to output the re-plan information for reducing a burden, or for obviating a need, for a user of the apparatus to manually decide whether the treatment re-planning is desirable or not.