Abstract: A wiring board electrically connected to a back side of an ultrasound transmitting/receiving section that transmits/receives ultrasound includes a rigid circuit board included in a stiff portion, and a wrapping portion extending out from the rigid circuit board (stiff portion), and a plurality of drive wirings electrically connected to the wiring board are inserted into a wiring insertion portion of a housing with the plurality of drive wirings wrapped and bundled by the wrapping portion.

Abstract: Devices and systems are disclosed that are associated with ultrasound sound devices. In one embodiment, a diaphragm for an ultrasound device comprises a housing configured with a receiving cavity defined by one or more sidewalls, wherein the receiving cavity is configured to hold a conductive medium. A connector formed in the housing is configured to connect the diaphragm to an ultrasound device.

Abstract: Provided is a medical image diagnostic apparatus, including: an internal image acquiring unit for acquiring a plurality of internal images different in time phase by irradiating a body part of a subject with X-rays; an outer appearance image acquiring unit for acquiring an outer appearance image by photographing the body part of the subject; an analysis unit for analyzing the outer appearance image to acquire first shape information indicating a shape of the body part of the subject and analyzing each of the plurality of internal images to acquire second shape information indicating a shape of the body part of the subject; and a display control unit for displaying the outer appearance image and the each of the plurality of internal images by superimposing one on another so that the body part of the subject included in the outer appearance image and the body part of the subject included in the each of the plurality of internal images are located in the same position based on the first shape information and the

Abstract: A method for determining a patient-specific contrast medium impulse response function includes providing patient-specific test bolus contrast medium behavior data and a number of basic impulse response functions on the basis of a defined test bolus input function. Simulated test bolus contrast medium behavior functions are generated by combining the basic impulse response functions with the test bolus input function. The simulated functions and the patient-specific data are fitted to one another by varying a number of fitting parameters to obtain optimum fitting parameter values, and the patient-specific contrast medium impulse response function is then created based on the basic impulse response functions and the optimum fitting parameter values. A method for predicting a likely contrast medium behavior and a method for controlling a medical imaging system are also described. Additionally a corresponding apparatus, a control device and an imaging system having such a control device are also described.

Abstract: Medical imaging is carried out by transmitting X-ray emissions through a subject, generating a first set of temporally separated images of an area of interest in the subject from the transmitted X-ray emissions, generating a second set of temporally separated images from the area of interest from a second source, and combining the sets to produce combined images of the area of interest. The method is further carried out by blocking the X-ray emissions from reaching the subject, updating the second set, combining the first set with the updated second set to produce updated combined images, displaying the updated combined images, and when a predetermined condition is satisfied, iterating updating the second set, combining the first set with the updated second set, and displaying the updated combined images.

Abstract: A medical image system includes: a storage unit which stores a first medical image; a selection unit which selects a medical image to be associated with a second medical image; a designation unit which designates an abnormal shadow candidate; a reception unit which receives the second medical image newly created; a determination unit which determines whether or not the first medical image selected is an image suited for association, and the abnormal shadow candidate designated and the second medical image received satisfy a predetermined condition; an association unit which stores the second medical image in association with the abnormal shadow candidate; and a monitoring unit which monitors the association, outputs a warning, and stores the abnormal shadow candidate or the second medical image in association with information indicating there is no second medical image or abnormal shadow candidate to be associated, respectively.

Abstract: An X-ray diagnostic system according to an embodiment includes: an X-ray tube for radiating an X-ray to the subject on the basis of a tube current for taking a scanogram of a subject; an X-ray detector for detecting the X-ray radiated by the X-ray tube and transmitted through the subject; a data collector for collecting X-ray dose distribution data, which shows the dose distribution of the X-ray; an image processor for creating the scanogram from the X-ray dose distribution data; a genuine data generator for generating genuine data showing the dose distribution of the X-ray, from the scanogram; a threshold value setting section for setting a threshold value for the genuine data; and a tube current adjustor for adjusting a tube current for taking a tomographic image of the subject in accordance with a comparison between the X-ray dose in the genuine data and the threshold value.

Abstract: An X-ray imaging apparatus has an electronic cassette, in which an FPD device receives X-rays applied by an X-ray source to a body, and stores charge according to a radiation dose of the X-rays, to create an image. A control unit controls the FPD device. A radiation sensor detects the radiation dose to be used for controlling the FPD device. A magnet as fastening device secures the radiation sensor removably in a radiation path between the X-ray source and the body. Also, an evaluation unit recognizes a start and end of application of the X-rays according to a dose signal from the radiation sensor, for the control unit to control the FPD device. A flexible support arm is disposed between the radiation sensor and the magnet, for keeping the radiation sensor in a changeable position relative to the magnet.

Abstract: An X-ray imaging system that allows X-ray images to be acquired from a desired direction by considering the tilt of a tabletop. The X-ray imaging system includes a support unit that holds an X-ray imaging unit that performs X-ray imaging of a subject. The subject is placed on the tabletop. A memory stores in advance imaging angle information from previous imaging. A tilt detector detects the tilt angle of the tabletop. A calculator calculates a correction angle for correcting the imaging angle information based on the imaging angle information and on the tilt angle. A drive unit moves the support unit to a position based on the imaging angle information and the correction angle.

Abstract: Embodiments described herein relate to health monitoring apparatuses, systems and methods that allow a user to passively monitor her/his health. Embodiments include acquiring chemical substances from a subject's skin (e.g., in sweat and/or sweat vapor or oil excretions) using a sample capture system located on a mounting portion in a fixed location. Embodiments also include analyzing chemical substance(s) acquiring from the subject's skin to generate raw data. Embodiments further include analyzing the raw data to generate health status data for a particular subject.

Abstract: A handle for a tool is provided that is formed of a core positioned within a sleeve of a temperature resistant material to form a handle with a space between the core and the sleeve. The core can be formed by machining a metal material while the sleeve and an optional skin positioned on the sleeve can be molded. The materials forming the sleeve and skin, and the space formed between the core and sleeve, create a handle that can be adapted to form a variety of different tools with different mechanisms located in the core that also has improved heat transfer characteristics for sterilization purposes.

Abstract: Stored information comprising product use information for each of a plurality of mechanical implants is maintained. Data identifying a mechanical implant is received, during a medical procedure. Suitability of the mechanical implant is determined, during the medical procedure, based on the data and the stored information.

Abstract: Systems for engaging a bodily tissue and methods of using the same. In at least one embodiment of an exemplary system for use with a vacuum source for engaging a tissue of the present disclosure, the system comprises an engagement catheter comprising a proximal end, a distal end, first and second lumens extending between the proximal end and the distal end, and a skirt operatively connected to the distal end, an inducer sheath having a proximal portion, a distal portion, and a lumen extending therethrough, the inducer sheath configured so that it is capable of insertion into the second lumen of the engagement catheter, a dilator comprising a tapered tip at a distal end and a hollow channel extending therethrough, the dilator sized and shaped for insertion into the lumen of the inducer sheath, and a vacuum port located at the proximal end of the engagement catheter, the vacuum port being operatively connected to the first lumen of the engagement catheter and capable of operative connection to a vacuum source.

Abstract: A device for the repair of tissue and methods of use and manufacturing thereof are described herein. Applications for the use of the device include, e.g., repair of atrial septal defects (ASD), patent foramen ovale (PFO), left atrial appendage closure and stent graft fixation among other applications throughout the anatomy. The implant portion of the device is available in a variety of sizes and configurations to accommodate the vast complexity of the target anatomy.

Abstract: A device for closing at least one opening leading to an anatomical cavity is delivered via a catheter positioned in a first opening leading to the anatomical cavity. An orientation control unit, positioned within the anatomical cavity, an orientation of a portion of a tissue surface within the anatomical cavity that is skewed with respect to the first opening and orients a closure member of the device with the tissue surface. An occluding member and a constricting unit are positioned within the anatomical cavity, the occluding member blocking a portion of an opening that is constricted by the constricting unit. An intermediate member of the device is positioned within the anatomical cavity and a closure unit employing at least one piercing element pierces through the intermediate member into a tissue wall surrounding the anatomical cavity.

Abstract: A device for delivering a percutaneous nephrostomy plug is provided. The device comprises a tubular member configured for insertion into a biological body. The device further comprises a handle coupled to a proximal end of the tubular member. The handle comprises a pusher element, an actuation element, and a transmission. The pusher element is disposed within the tubular member, and is configured to deliver a plug through a distal end of the tubular member. The transmission is coupled to the tubular member and the actuation element, and the transmission is configured to cause a retraction of the tubular member relative to the pusher element in response to a depression of the actuation element. A first depression of the actuation element toward the tubular member urges a partial exposure of the plug. A second depression of the actuation element urges a further exposure of the plug.

Abstract: An apparatus for placement into an opening formed in a wall of a body lumen to deploy a closure element. The apparatus comprising a housing having a handle portion formed at a distal end, the handle portion configured to be engaged by a user when advancing the housing to deploy the closure element. A locator assembly and a carrier assembly are at least partially received in the housing. The locator assembly can have one or more expansion members that can selectably contact the wall of the body lumen and a proximal end configured to cooperate with a portion of a locator control system operable to expand the one or more expansion members. A triggering system cooperates with the locator assembly and is moveable toward the one or more expansion members of the locator assembly upon the locator control system being operated to expand the one or more expansion members.

Abstract: The present invention provides a medical system, including a catheter defining an injection lumen, a chamber in fluid communication with the injection lumen, and an exhaust lumen in fluid communication with the chamber; a first temperature sensor positioned in the exhaust lumen proximal to the chamber; a second temperature sensor positioned in the chamber; and a console in electrical communication with the first and second temperature sensors, the controller modifying coolant flow through the medical device based at least in part upon a signal received from the first and second temperature sensor. The system may further include a thermally-conductive element circumscribing a substantial portion of the exhaust lumen proximal to the chamber, where the first temperature sensor is mounted to the thermally-conductive element, and the thermally-conductive element may include at least one of a braid, coil, and band.

Abstract: Certain embodiments disclosed herein relate to compositions, methods, devices, systems, and products regarding frozen particles. In certain embodiments, the frozen particles include materials at low temperatures. In certain embodiments, the frozen particles provide vehicles for delivery of particular agents. In certain embodiments, the frozen particles are administered to at least one biological tissue.

Abstract: An instrument for taking a tissue sample includes a tissue receiving element with a distal end and a proximal end and at least partly has a spiral or helix that has an outer surface and a central longitudinal axis (X-X?). The spiral or helix has at least has one zone where the distance (dd) from the outer surface to the central longitudinal axis (X-X?) is smaller than at a more proximally located part of the spiral or helix.

Abstract: A cryoprobe for use in cryosurgery and other applications comprising a rigid outer tube, an inner coolant inlet tube. a short rigid penetrating segment extending distally from the distal end of the outer tube and a helical-shaped baffle having a heating element disposed about the outer surface of the inlet tube. The baffle is adapted to produce turbulent fluid flow improving heat transfer and is able to warm target tissue during rapid freezing and thawing cycles.

Abstract: A cryogenic ablation catheter includes a catheter shaft, a balloon and a connector respectively at the catheter shaft proximal and distal ends, a refrigerant delivery tube assembly including a refrigerant delivery tube rotatable within the catheter shaft lumen, and a refrigerant delivery element with an outlet located inside the balloon which directs refrigerant outwardly against the balloon at different rotary positions as it rotates. A cryogenic balloon ablation system includes the cryogenic ablation catheter, a catheter coupler mating with the connector, a motor including a rotatable hollow motor shaft, and a delivery line fluidly coupled to a cryogenic gas source for supplying cryogenic gas to the refrigerant delivery tube. At least one of the refrigerant delivery tube and the delivery line passes at least partway through the hollow motor shaft. The coupling tip of the connector and the refrigerant delivery tube rotate with the motor shaft.

Abstract: Improved systems, devices, and methods for delivering cryogenic cooling fluid to cryosurgical probes such as cryosurgical endovascular balloon catheters take advantage of the transients during the initiation and termination of cryogenic fluid flow to moderate the treatment temperatures of tissues engaged by the probe. A flow limiting element along a cryogenic fluid path intermittently interrupts the flow of cooling fluid, often cycling both the fluid flow and treatment temperature. This can maintain the tissue treatment temperature within a predetermined range which is above the treatment temperature provided by a steady flow of cryogenic fluid. In another aspect, room temperature single-use cooling fluid cartridges are filled with a sufficient quantity of cryosurgical fluid to effect a desired endovascular cryosurgical treatment.

Abstract: A cryosurgical instrument including: a shaft having a closed distal end defining an expansion chamber and an open proximal end adapted and configured to receive an inflow of cryogen and to exhaust a flow of expanded cryogen; and a heat exchanger. The heat exchanger includes: a plurality of cryogen delivery tubes that spiral around a longitudinal axis thereof; and a diffuser having a plurality of branches, each of the branches supplying received cryogen to a respective one of the delivery tubes. The cryogen delivery tubes, where they spiral, are spaced from each other and in fluid tight contact with the inner surface of the shaft so as to form spiraling cryogen exhaust pathways that extend along a portion of a length of the cryosurgical instrument from the distal end of the shaft.

Abstract: This invention relates to the treatment of a patient's lung, for example, a lung exhibiting chronic obstructive pulmonary disease (COPD) and in particular to methods and devices for affecting lung volume reduction, preferably for achieving acute or immediate lung volume reduction following treatment. The lung volume reduction is effected by delivering a condensable vapor at a temperature above body temperature to the desired regions of the patient's lung to damage tissue therein. Blood flow and air flow to the damaged tissue region is essentially terminated, rendering the target region non-functional. Alternative energy sources may be used to effect the thermal damage to the lung tissue.

Abstract: The present disclosure relates to a suture anchor inserter. The suture anchor inserter includes a handle having a proximal component, a central component coupled to the proximal component, and a distal component coupled to the proximal component and the central component, the central component capable of rotating relative to the proximal component; and a shaft comprising a proximal end and a distal end, the proximal end coupled to the handle. A method of inserting a suture anchor into bone is also disclosed.

Abstract: The present invention discloses a minimally invasive multipoint fixation device adapted to laparoscopically locally reposition body tissues. The device comprises: a distal anchor, a proximal anchor and an elongated connecting element, adapted to interconnect between the distal anchor and the proximal anchor. The distal and the proximal anchors are characterized by two configurations: (i) a FOLDED CONFIGURATION; and, (ii) a DEPLOYED CONFIGURATION. The fixation device further comprises deployment means adapted to deploy the distal and the proximal anchors by reconfiguring the same from the FOLDED CONFIGURATION to the DEPLOYED CONFIGURATION.

Abstract: Suture anchors and methods for using the suture anchors for attaching soft tissue, such as ligaments, tendons, and muscles, to bone are disclosed herein. A suture anchor for attaching soft tissue to bone includes a catheter having an elongated shaft with a proximal end, a distal end, and a longitudinal axis therebetween, wherein the catheter has at least one inner lumen capable of allowing a light curable adhesive to pass therethrough; a balloon portion engaging the distal end of the catheter, wherein the balloon portion expands from a deflated state to an inflated state when a light curable adhesive is delivered to the balloon portion; and at least one suture material for passing through soft tissue to attach the soft tissue to a bone.

Abstract: A multi-functional element suitable for performing at least two surgical/therapeutic interventions, for example, the injection and cutting of tissue, with an anti-carbonization device to prevent the carbonization of tissue upon plasma coagulation by way of a suitable surgical instrument, where the surgical instrument has a feed line for an oxidizing agent, a feed line for a gas and an electrode for generating a plasma. A gas oxidizing agent mixture for producing a gas oxidizing agent plasma is provided by the anti-carbonization device.

Abstract: An anti carbonization device to prevent the carbonization of tissue upon plasma coagulation by a suitable surgical instrument, wherein the surgical instrument has a feed line for an oxidizing agent, a feed line for a gas and an electrode for generating a plasma. A gas-oxidizing agent mixture for generating a gas oxidizing agent plasma is provided by the anti-carbonization device.

Abstract: A compound barb medical device is provided which includes an elongated body having at least one barb formed along the length of the body, the barb defining an inner surface with a first portion disposed at a first orientation relative to a longitudinal axis of the elongated body, and a second portion disposed at a second orientation relative to the longitudinal axis. Optionally, the barb defines a third portion disposed at a third orientation relative to the longitudinal axis. A method for forming a compound barb on a medical device is also provided.

Abstract: A surgical cutting and fastening instrument that is motorized. The instrument comprises in one embodiment a charge accumulator device, separate from a battery, that provides additional power to the motor under certain conditions. In addition, the motor may comprise multiple windings.

Abstract: A staple cartridge for use with a surgical stapler can comprise a cartridge deck and a plurality of staples at least partially positioned within the cartridge deck. In various embodiments, the staples can comprise legs which extend upwardly from the deck wherein the deck can further include supports, or guides, which are configured to hold the staple legs in a particular alignment. In at least one such embodiment, the staple legs can extend upwardly from the supports into a tissue thickness compensator.

Abstract: Medical lens assemblies and sterile drapes with a lens assembly are presented herein. In one embodiment, a lens assembly includes an annular lens housing that is attachable to a medical drape. The lens housing is configured to releasably attach to a medical device, such as a surgical microscope. An annular lens cover holder is removably attachable to the lens housing. A lens cover for shielding the objective lens is pivotably hinged to the lens cover holder. In another embodiment, a drape assembly includes a flexible body sized to cover an optical device. A lens housing attached to the drape body is engageable with the optical device to attach proximate an objective lens thereof. A lens cover holder is removably attached to the lens housing to rotate about a first axis. A lens cover is mounted to the lens cover holder to pivot about a second, different axis.

Abstract: An apparatus for closing a surgical incision comprises left and right base panels, a plurality of closure components, and a plurality of left and right axial supports coupled to the respective base panels. The closure components couple the left and right base panels to each other laterally and have left and right ends coupled to the respective base panels. The closure components are positioned laterally across the left and right panels, the left axial supports are disposed between pairs of left closure component ends, the right axial supports are disposed between pairs of right closure component ends, and the left and right axial supports are offset from one another such that a serpentine arrangement of consecutive closure components and axial supports is formed. The apparatus can be made of antimicrobial materials or materials impregnated with antimicrobial agents. A flexible adhesive cover can be provided over the apparatus when in use.

Abstract: Apparatus and methods are provided for use in sealing a vascular puncture site. The invention comprises an integrated vascular device having a sheath with a closure component and puncture sealant. The closure component is disposed on and advanceable over the exterior of the sheath and may comprise any of a variety of apparatus suited for closing a vascular puncture. Once the closure component has been actuated to close the puncture, sealant is introduced to seal the puncture. The sheath and closure component are then removed from the patient.

Abstract: The invention relates to an anastomosis ring and to an anastomosis ring assembly for connecting hollow organs made from human or animal tissue. The anastomosis ring includes a first support ring and a second support ring, which can be coupled with the first support ring for fixating the tissue, so that the support rings are essentially disposed fixated relative to one another. The anastomosis ring is at least partially made form a biofragmentable material which disintegrates after a predetermined time period in a human or animal body. In order to facilitate better tissue connection the anastomosis ring includes at least one energy delivery element connectable with an energy source. The energy delivery element is configured to fuse the tissue at least partially through delivering energy during operations.

Abstract: An electrosurgical system and method for transmitting, monitoring, and controlling electrosurgical energy and tissue parameter quality at the tissue site. The electrosurgical system includes a generator adapted to generate electrosurgical energy for treating tissue. The generator includes one or more active output terminals which supply energy to the tissue. The active output terminals are operatively connected to one or more active leads. The generator also includes one or more return output terminal which returns energy from the tissue. The return output terminals are operatively connected to at least one return lead. The system also includes an electrosurgical instrument operatively connected to the one or more active leads and one or more return electrodes operatively connected to one or more return leads. The system further includes an electrosurgical cable including one or more active leads and one or more return leads.

Abstract: A device and method for facilitating access to a perimeter surface of a body structure is provided. The device includes an elongate flexible member configured to be positioned adjacent the perimeter surface of the body structure, an atraumatic tip positioned at a distal end of the elongate flexible member, and an elongate body. The elongate body has a surface positioned to guide the elongate flexible member and to permit longitudinal movement of the flexible member with respect to the elongate body. The body also has a curved distal portion and a distal end for releasably engaging the atraumatic tip.

Abstract: Various endograft assemblies and methods for using the same. In at least one embodiment of an endograft assembly of the present disclosure, the endograft assembly comprises an endograft and a tube defining one or more tube openings coupled to said endograft. In another embodiment of an endograft assembly of the present disclosure, the endograft assembly comprises an endograft, a sponge sheath coupled to the endograft, and a reservoir bag coupled to the sponge sheath, said reservoir bag capable of receiving fluid from the sponge sheath.

Abstract: Coils, such as embolic coils, and related methods, devices, and compositions, are disclosed.

Abstract: In accordance with various embodiments, methods to control electrical power provided to tissue via first and second electrodes may comprise providing a drive signal to the tissue via the first and second electrodes and modulating a power provided to the tissue via the drive signal based on a sensed tissue impedance according to a first power curve. The first power curve may define, for each of a plurality of potential sensed tissue impedances, a first corresponding power. The methods may also comprise monitoring a total energy provided to the tissue via the first and second electrodes. When the total energy reaches a first energy threshold, the methods may comprise determining whether an impedance of the tissue has reached a first impedance threshold.

Abstract: The volume of a hyperinflated lung compartment is reduced by sealing a distal end of the catheter in an airway feeding the lung compartment. Air passes out of the lung compartment through a passage in the catheter while the patient exhales. A one-way flow element associated with the catheter prevents air from re-entering the lung compartment as the patient inhales. Over time, the pressure of regions surrounding the lung compartment cause it to collapse as the volume of air diminishes. Residual volume reduction effectively results in functional lung volume expansion. Optionally, the lung compartment may be sealed in order to permanently prevent air from re-entering the lung compartment. The invention further discloses a catheter with a transparent occlusion element at its tip that enables examination of the lung passageway through a viewing scope.

Abstract: The invention relates to a medical implant in the form of an elongated helix wherein at least one part of the helix is preformed in such a manner that it has a secondary structure of identically sized loops which it assumes during implantation at the placement site, with said structure in turn forming at the placement site during implantation a polyhedral tertiary structure, and the polyhedron being provided with at least one additional loop.

Abstract: A tourniquet cuff has minimal flow restrictions within its pneumatic passageway under normal operating conditions, has a substantially reduced likelihood of partial or complete obstructions or interruptions of the pneumatic passageway under foreseeable operating conditions, can indicate exposure of the cuff to external agents that are capable of affecting the integrity of the pneumatic passageway before use, and can be manufactured economically.

Abstract: A method and device for single-point identification of neural tissue during endoscopic spinal surgery including the use of an electrical switch that accepts separate inputs from a bipolar generator and an electrical nerve stimulator.

Abstract: A cordless cautery and cutting surgical device includes a modular battery and a surgical handle. The battery has a cordless radio-frequency-signal-generation assembly generating an output radio-frequency signal and a first selectively removable connector part. The surgical handle has a first handle body portion with a bipolar cautery and cutting end effector. The end effector has jaws with bipolar contacts and a cutting blade disposed between the jaws. The handle has a second body portion connected to the first body portion, defines therein an aseptically sealable battery-holding compartment selectively exposed to the environment and removably holding therein the battery, and a second selectively removable connector part operable to removably hold the first connector part thereto.

Abstract: A surgical jaw instrument having two jaw pieces mounted at the distal end section of a shaft for relative reciprocal displacement, whereby at each displaced jaw piece a sliding rod is fastened at an incline to the axis of the shaft, to which a displaceable sliding element can be connected parallel to the axis of the shaft in such a way that upon displacement of the sliding element, the jaw pieces are relatively reciprocally displaced wherein a second sliding element is mounted at the first sliding element, diametrically opposed relative to the sliding rod.

Abstract: An apparatus for operating on tissue includes a body, a lip in communication with the body, and at least one electrode also in communication with the body. The body is able to mechanically couple with a portion of an end effector, which may be controlled by a user through a handpiece. The lip is configured to grip a portion of the end effector. The at least one electrode is configured to provide sufficient electrical energy to weld at least a portion of tissue. In some versions, a temperature sensitive material may be positioned on a portion of the end effector. Additionally, in some versions, the handpiece of the end effector may comprise feedback features able to convey information to the user.

Abstract: Surgical tools are disclosed that include a first handle having a first recess, a second handle having a second recess, a first tip disposed in the first recess and extending distally, and a second tip disposed in the second recess and extending distally. The first tip has a first external surface and a first internal surface. The second tip has a second external surface and a second internal surface. The surgical tool has a first configuration wherein the surgical tool operates as forceps. The surgical tool has a second configuration wherein the surgical tool operates as scissors. The first internal surface can be moved adjacent to the second internal surface to permit rotation of the first tip relative to the first recess and permit rotation of the second tip relative to the second recess. The rotation of the first tip and the second tip transitions the surgical tool between the first configuration and the second configuration.