Abstract: An X-ray apparatus includes an X-ray radiator configured to radiate X-rays to an object and a controller configured to acquire orientation information indicating an orientation of the X-ray radiator and motion information indicating a movement of an X-ray detector configured to detect the X-rays radiated by the X-ray radiator and select the X-ray detector based on the orientation information and the motion information.

Abstract: A medical imaging device with a contactless data transmission device that registers interference fields acting thereon is provided. The device includes a bit error registration unit of the data transmission apparatus. The bit error registration unit is embodied and programmed to establish the bit error rate of the data transmission apparatus caused by the interference fields, and to output a warning signal when a predeterminable threshold of the bit error rate is exceeded.

Abstract: A method of testing waterproof performance of a radiological imaging apparatus including: a sensor panel including a plurality of radiation detecting elements two-dimensionally arranged; a housing containing the sensor panel; and an air pressure measuring unit configured to measure an air pressure in the housing having a vent hole allowing the air to flow into and out of the housing, includes: a load application step of continuing to apply a load to the housing; an air pressure measurement step of measuring the air pressure in the housing with the air pressure measuring unit, the air pressure changing while the load is being applied to the housing; and a waterproof performance determination step of determining whether the waterproof performance of the radiological imaging apparatus is normal based on a pattern of change in the measured air pressure in the housing.

Abstract: The present disclosure provides a medical/healthcare system which comprises an electronic stethoscope and a medical host under a medical/healthcare environment. The electronic stethoscope comprises an auscultation module for recording a sound from internal body of a patient to form an auscultation data, a reader for obtaining a patient information from the patient, a processor module to receive and associate the patient information to the auscultation data to form an auscultation file, a storage for storing the auscultation file, a display module to display the auscultation file for selection, a control input interface for selecting the auscultation file for playback, an output module for playing the auscultation file by outputting the sound corresponding to the auscultation file when selected, and a power module to provide electricity to all the others.

Abstract: A method includes obtaining first and second ultrasound image data and computing a coarse transverse flow field by applying an optical flow technique to compare the second ultrasound image data to the first ultrasound image data at a coarse scale. The method further includes computing a fine transverse flow field by applying optical flow technique to compare the second ultrasound image data to the first ultrasound image data at a scale that is finer than the coarse scale and superimposing the fine transverse flow field onto the coarse transverse flow field to form a first combined flow field.

Abstract: An interactive visual guidance tool for an imaging acquisition and display system and configured for user navigation with respect to a blockage of a field of view (216) detects, and spatially defines, the blockage. It also integrates, with the image for joint visualization, an indicium (244) that visually represents the definition. The indicium is moved dynamically according to movement, relative to the blockage, of the field of view. The indicium can be shaped like a line segment, or two indicia (244, 248) can be joined in a “V” shape to frame a region of non-blockage. The defining maybe based on determining whether ultrasound beams in respective directions are blocked. Included, for deriving the image, in some embodiments are imaging channels for receiving image data for which a metric of coherence, i.e., similarity among channel data, is computed. The determination for a direction is based on the metric for locations in that direction.

Abstract: The invention relates to an imaging apparatus (24) for imaging an introduction element (17) like a needle or a catheter for performing a biopsy or a brachytherapy. The introduction element (17) comprises at least one ultrasound receiver (21) arranged at a known location thereof. An ultrasound probe (12) for being inserted into a living being (2) emits ultrasound signals for acquiring ultrasound data of an inner part (19) of the living being (2). A first tracking unit (3) tracks the location of the introduction element (17) based on a reception of the emitted ultrasound signals by the at least one ultrasound receiver (21), an imaging unit (4) generates an indicator image showing the inner part (19) and an indicator of the introduction element (17) based on the tracked location, and a display (5) displays the indicator image. This allows receiving a feedback about the location of the introduction element (17).

Abstract: A catheter includes a sheath that is inserted into a lumen; a drive shaft that transmits mechanical drive force; a hub that moves the drive shaft; an outer tube that is provided in the sheath on a proximal side and comprises a first connector at a proximal portion; an inner tube that can move inside the outer tube; a second connector that can be connected to and disconnected from the first connector and can receive the inner tube; a sheath connection portion that connects the sheath and the outer tube; and a protective tube that protrudes toward a distal side further than the inner tube, accommodates the drive shaft, can be inserted into the outer tube and the sheath, and can be pulled out of the outer tube together with the hub and the inner tube as the second connector is disconnected from the first connector.

Abstract: Ultrasound adaptive imaging methods and/or systems provide for modification of waveform generation to drive a plurality of transducer elements. The modification may be based on at least one of contrast ratio or signal to noise ratio as determined with respect to control points in a region of interest. Further, image reconstruction may be performed upon separating, from pulse echo data received, at least a portion thereof received at each ultrasound transducer element from the region of interest in response to the delivered ultrasound energy corresponding to a single frequency of one or more image frequencies within a transducer apparatus bandwidth. The image reconstructed from the separated pulse-echo data corresponding to the single frequency of the one or more image frequencies may be used alone or combined with like image data (e.g., to provide an image representative of one or more properties in the region of interest).

Abstract: The present invention relates to a detachably joined ultrasonic probe device, including modular ultrasonic probe and a case for detachably joining with the modular ultrasonic probes, which enables the user to select a suitable ultrasonic probe according to desired performance and diagnosis frequency region. The device according to the present invention includes: a plurality of ultrasonic probe modules horizontally arranged in the direction of generating an ultrasonic wave; a case consisting of an outer housing with one open side for receiving and enclosing the plurality of ultrasonic probe modules, and a separation housing provided between the plurality of ultrasonic probe modules for separating the ultrasonic modules from one another, so as to detachably join with the ultrasonic modules; and a control module installed in the case for controlling the plurality of ultrasonic probe modules.

Abstract: An ultrasonic probe having a plurality of arrays connected in a parallel structure and an ultrasonic image diagnosing apparatus including the same are disclosed. The ultrasonic probe according to one embodiment of the present invention comprises: a first array; a second array connected in parallel to the first array in the elevation direction of the first array and having a focal distance different from that of the first array by having width different from that of the first array in the elevation direction; and a switch or a multiplexer for selecting an array to be activated.

Abstract: The assessment assistance device assists FAST by displaying and updating an assessment assistance screen. On the assessment assistance screen, 6 sites to be assessed through FAST are shown using hatching which is added to a schema image. In addition, execution situation display sections corresponding to these 6 sites are provided in the assessment assistance screen and are connected to the corresponding sites using indicators of arrows. A message indicating that no assessment is performed is displayed on the execution situation display sections in a state in which the corresponding sites are not assessed.

Abstract: The present invention relates to an ultrasound elastography system (10) for providing an elastography measurement result of an anatomical site (32) a corresponding method. The system (10) is configured to visualize a suitability for shear wave elastography of the region of interest (33) to the user within the ultrasound image (52) and/or to recommend an elastography acquisition plane (48, 50) for conducting shear wave elastography to the user. By this, proper selection of a location for an elastography measurement may be supported.

Abstract: The present invention relates to an ultrasound elastography system (10) for providing a shear wave elastography measurement result of an anatomical site (32), wherein the ultrasound signal and image processing assembly (16) is further configured to determine a location (94, 95, 96) of a shear wave elastography measurement result within the three-dimensional image (98) of the anatomical site (32) and to display the location (94, 95, 96) of a shear wave elastography measurement result to the user. Further, a corresponding method is provided.

Abstract: A method for rendering an image from ultrasound image data includes dividing the ultrasound image data into at least a first group of voxels and a second group of voxels, based on comparing voxel echo intensity to a threshold value. The method further includes processing the first group of voxels according to a first protocol and processing the second group of voxels according to a second protocol. The method further includes generating an image that includes both the first group of processed voxels and the second group of processed voxels to enhance realism of the rendered image.

Abstract: Disclosed herein is an ultrasound imaging apparatus and a controlling method thereof. The ultrasound imaging apparatus includes a controller configured to generate a control signal to control an operation of a probe, and a transceiver configured to transmit the control signal to the probe and to receive a signal transmitted from the probe. The controller may control the operation of the probe so that the probe may irradiate focused ultrasound energy when contrast agents composed of a silica nanostructure are injected into an object, and the controller may control the operation of the probe so that the probe may irradiate diagnostic ultrasound energy when the focused ultrasound energy is irradiated.

Abstract: An ultrasonic probe according to a present embodiment includes: at least one first transducer functioning as a transducer for excitation for executing excitation by an acoustic radiation pressure in an elastography mode; and second transducers functioning as transducers for detection for detecting a shear wave generated by the excitation in the elastography mode.

Abstract: The remote indication support system includes an in-vehicle device which is mounted on an ambulance; and a remote indication device which is installed in a hospital. The in-vehicle device transmits a photographed image which has been photographed by a photographing unit, to the remote indication device through a communication network. The photographed image is displayed on a display, and an operating unit receives position designation of the inspection site of a patient within the photographed image. The remote indication device transmits an indication based on this position designation, to the in-vehicle device. The light pointer displaces the irradiation position of light based on the indication relating to the inspection site which has been received from the remote indication device.

Abstract: Guidance in acquiring ultrasound imaging of a subject to achieve a target view, such as a standard view, entails emitting ultrasound to the subject and receiving, in response, a current ultrasound view (502);matching the received image to a pre-existing image, such as a three-dimensional reference image (503); and, for user assistance, generating, based on the matching, feedback (514-528) for the guidance. The reference image may be a statistical atlas or it may be derived from patient-specific CT or MR scans. The pre-existing image may instead stead be a database image corresponding to a state in a state space. The feedback can be an image derived from the reference image;a graphic indication (508) of a plane of the target view; the received view fused (512) to an image derived from the reference image; or the received view and an image derived from said reference image, the derived image appearing concurrently and enhanced to spatially indicate where the received view registers to the reference image.

Abstract: An ultrasonic diagnostic apparatus according to the embodiment includes a memory, a display, an input interface unit and a control unit. The memory stores a plurality of body marks that are classified for each region of a subject. The display displays the plurality of body marks stored in the memory. The input interface unit instructs selection of any one of the plurality of body marks displayed on the display.

Abstract: Various embodiments include a system and method that provide support for acquiring secondary ultrasound image snapshots with primary real-time ultrasound image data. The method can include acquiring first image data at an ultrasound system in a primary acquisition mode based on primary acquisition mode imaging parameters. The method may include receiving a trigger to switch from the primary acquisition mode to a secondary acquisition mode. The method can include acquiring second image data at the ultrasound system in a secondary acquisition mode based on secondary acquisition mode imaging parameters in response to the trigger. The method may include displaying a replay cine sequence that includes the first image data and the second image data. The replay cine sequence can include a tag identifying the second image data in the replay cine sequence.

Abstract: A method and apparatus for determining at least one representative temperature value for a female human user for an extended period includes receiving at least a first, a second and a third plurality of temperature measurements obtained from a female human user during at least first, second and third respective extended periods, wherein each extended period includes at least one hour and wherein the start of each extended period is separated by at least 8 hours. At least one representative temperature value is calculated for the second extended period. The representative temperature value is calculated using at least one first temperature value obtained from a plurality of measurements taken during the first extended period, at least one second temperature value obtained from a plurality of measurements taken during the second extended period and at least one third temperature value obtained from a plurality of measurements taken during the third extended period.

Abstract: A non-invasive endometrial sample collector has an outer body of absorbent material configured for insertion into a vaginal cavity of a patient such that a distal end of the body is positioned proximate a uterine cervix of the patient. The collector has an internal collection assembly disposed within the outer body of absorbent material. The internal collection assembly includes a funnel having an opening at the distal end of the outer body configured to face the uterine cervix when the outer body is positioned in the vaginal cavity, and a reservoir in fluid communication with the funnel. During a menstruation cycle of the patient when endometrial tissue cells are shed within menstrual fluid that passes through the uterine cervix, or during any type of normal or abnormal bleeding episode, at least a portion of said fluid is directed to the reservoir via the funnel under the force of gravity.

Abstract: A biopsy device may be used to obtain and store multiple tissue samples. The device permits the tissue samples to be stored in a sequenced fashion within a generally transparent tissue storage chamber disposed at a proximal end of the biopsy device. The tissue samples can be stored on flexible tissue sample strips arranged around the circumference of a rotating vacuum manifold disposed within the chamber.

Abstract: An articulated tool positioning apparatus comprising a base member, an intermediate member, an end member and a first tool holder arranged in succession, each of the base member, intermediate member, end member and tool holder having a respective central opening. A first plurality of coupled guides id positioned between the base member and the intermediate member and a second plurality of coupled guides is positioned between the intermediate member and the end member. A third plurality of coupled guides is diposed between the end member and the tool holder. The base member, intermediate member, end member, first tool holder and first second and third pluralities of coupled guides all have a central opening and guide openings or securing points for securing pluralities of flexible control links to the base member or to an object separated from the base member.

Abstract: A surgical tissue connector system for moving a first internal body tissue to a position away from a second internal body tissue and then holding the first internal body tissue in the position. Tissue connectors are secured to cords such that the length of cord between the tissue connectors can be easily adjusted in a laparoscopic work space.

Abstract: The invention concerns a perfected device for the transosseous insertion of suture threads. This device comprises a main body (1) supporting a protruding cannula (3) provided with an active end (30); the device comprises a flexible threadlike element (4), on which there are fashioned a sharp tip (40) and an opening (41) that serves for the threading of at least one suture thread (5), said element (4) being housed in a coaxially sliding manner inside said cannula (3) and, on command, exiting from the active end (30) of the cannula, assuming a curved position; the device comprises first means for producing the coaxial movement of the threadlike element (4) in the two directions with respect to the cannula (3) and second means for producing a coaxial movement of the threadlike element in the exiting direction from the cannula (3); for a short tract, the movement produced by the second means is disengaged from the advancement of the threadlike element produced by the first means.

Abstract: Methods and apparatus for providing transapical access to a heart chamber for performing an intra cardiac procedure are described. The apparatus include a helical needle driver, a dilator, a straight access needle, and optionally a guidewire. After entering the heart chamber with the straight access needle, the helical needle driver is used to place a helical suture within the myocardium. After removing the needle driver, the dilator is advanced through the pre-placed helical suture, dilating both a passage and the circumscribing suture. After performing procedure, the pre-placed suture may be closed by proximally retracting an external end of the suture.

Abstract: A surgical fastener for anchoring medical devices to tissue includes first and second legs lying in a first plane, and third and fourth legs lying in a second plane that is orthogonal with the first plane. A bridge interconnects proximal ends of the four legs for forming a closed end of the surgical fastener. Each leg has a proximal end, a distal end, and an insertion tip with a distal point located at the distal end of the leg. Each leg has an insertion tool alignment guide that extends between the proximal and distal ends of the leg and along a longitudinal axis that is aligned with the distal point of the insertion tip.

Abstract: A method for surgical wound closure includes providing a pre-stressed elastomeric membrane having an aperture enclosed by at least a portion of the membrane; adhering the pre-stressed membrane to dermal tissue of a patient at a surgical procedure site; creating an incision through dermal tissue of a patient at the surgical procedure site at a location defined at least in part by the aperture of the membrane; and contracting the membrane and adhered dermal tissue, such that the aperture and incision created during the surgical procedure are at least partially closed. A kit of parts for adhered contractional wound closure including an unstressed elastomeric membrane, at least one retaining frame configured to apply a stressing force for pre-stressing the membrane, and an adhesive configured to attach the pre-stressed elastomeric membrane to dermal tissue of a patient, is also disclosed herein.

Abstract: A side-to-end vascular anastomosis device comprising a diversion conduit coupled to a lower flange which is inserted into the vessel and an upper flange located on the outside of the vessel designed to clamp together to seal the incision into which the lower flange of the device is inserted.

Abstract: A system is described for performing vascular anastomosis without the use of sutures. The system includes a connector comprised of memory material and an incision seal. The connector has one end configured to securely engage a graft vessel and another end with wings and barbs. The wings are configured to securely engage an inner wall of a main vessel and the barbs are configured to lock with the incision seal. Once locked, the incision seal and the connector apply a clamping force that secures the graft vessel with the main vessel.

Abstract: An apparatus for cleaning a surgical instrument includes an elongate member having a first end and a second end configured for disposal within a cavity of a surgical instrument. The elongate member defines a longitudinal channel and a plurality of apertures extending transversely through the elongate member. The apertures are in communication with the longitudinal channel. The first end of the elongate member is configured to be coupled to a source of fluid such that fluid passes through the longitudinal channel and out of the elongate member through the plurality of apertures.

Abstract: The present invention provides a surgical clamp comprising a temperature sensitive shape memory material, the clamp capable of taking up a first form in which the clamp (6) is shaped to at least partially encircle a tubular structure (14); a second form shaped to substantially completely encircle the tubular structure (14) and constrict it, the clamp changing from the first form to the second form above the transition temperature of the shape memory material; and a third form derived from the first form by resilient deformation of the clamp in its first form. The present invention also provides applicators for delivering the clamps and kits comprising the clamps.

Abstract: This disclosure provides design, material, manufacturing method, and use alternatives for medical devices. An example medical device may include a medical device for delivery of a surgical closure member. The medical device includes an elongate tubular member having a proximal end, a distal end and a lumen extending therein. The elongate tubular member is adapted to be delivered through the working channel of an endoscope and the lumen is adapted to receive a surgical closure member. The medical device also includes a tissue support extending from the distal end of the elongate tubular member. The tissue support includes a support surface and the support surface is adapted to support tissue as a surgical closure member engages the tissue thereon.

Abstract: Medical device used to cause hemostasis of blood vessels using a clip arrangement delivered to a target region through an endoscope. Method for using the device to cause hemostasis of a blood vessel through an endoscope. Medical device including a reversibly closeable clip, a locking arrangement, a control wire, a sheath, and a handle with an actuating trigger. Through the endoscope, hemostatic clipping device that is fully reversible and lockable. Hemostatic clip that reversibly targets and clips bleeding ulcers.

Abstract: An improved catheter and method of using the same is described. The catheter has at least one anchoring element at its distal tip region which is used to secure the catheter to a pre-implanted medical device, such as a stent, during the filling of an aneurysm. Such action prevents a buildup of pressure or of material from forcing the distal tip of the catheter to be forced from the aneurysm before the procedure is complete.

Abstract: Occlusive plugs are provided which comprise a single elongate member that is insertable into and through a microcatheter and assumes a space-occupying shape when deployed into a vascular structure. The elongate member optionally includes one or more polymer fibers, one or more polymer sleeves to secure the polymer fibers to the elongate member, and/or a radiopaque marker band.

Abstract: An applicator device, system and method for use with an exsanguination tourniquet are disclosed. The applicator device includes a body with a proximal end and a distal end, a first opening at the proximal end, and a conduit connecting the proximal end and the distal end. The system includes the applicator device and an exsanguination device. The method of applying an exsanguination tourniquet over a patient's limb, includes selecting an applicator device and correspondingly sized exsanguination tourniquet, placing the exsanguination tourniquet over the applicator device, placing the applicator device over the patient's limb, and rolling the exsanguination tourniquet over the applicator device and a portion of the patient's limb from the distal end of the limb.

Abstract: A probe which is configured to treat a bone by ultrasonic vibration, includes: a treatment section which is arranged on a distal end side of a vibration transmitting section, to which the ultrasonic vibration is transmitted through the vibration transmitting section. The treatment section includes: a cutting blade that includes a treatment surface, and cuts and treats the bone by the treatment surface; a protrusion that is provided at a position different from the cutting blade, protrudes in a direction different from the protruding direction of the treatment surface of the cutting blade, marks the bone, and defines a position of the bone to be treated with the cutting blade; and a regulation surface that is formed at a position where the protrusion is provided, and regulates entrance of the protrusion into the bone beyond a predetermined level.

Abstract: An orthopaedic reamer includes a drive train having a drive shaft, a reamer head connector driven by the drive shaft and a locking structure surrounding at least a portion of the drive shaft; and a handle assembly configured to detachably connect to the locking structure. The handle assembly includes a grip; a connecting structure connected to the grip that is configured to slide over the locking structure; a bridge connecting the grip to the connecting structure; a stop having a first interface feature connected to the bridge between the grip and the connecting structure; and a knob assembly at least partly surrounding the bridge having a second interface feature that is mateable to the first interface feature. The knob assembly is configured to prevent detachment of the handle assembly from the locking structure unless the second interface feature is mated with the first interface feature.

Abstract: Surgical systems and tools are disclosed including a surgical tool that has a shroud and a drive mechanism. The drive mechanism can have a distal end configured to connect to a surgical cutting instrument. The shroud can be configured to be disposed adjacent the distal end of the drive mechanism and can be adapted to be disposed between the drive mechanism and tissue of a patient.

Abstract: In a first embodiment, an instrument guide includes an elongate guide body extending between a proximal end and a distal end, wherein a portion of the guide body extending proximally from the distal end is generally arcuate. The instrument guide further includes a rigid tip extending generally linearly from the distal end of the guide body. The rigid guide further includes a cannulation formed in the guide body and extending continuously from the proximal end of the guide body to a distal terminus of the tip. The cannulation can be approximately uniform in diameter. The instrument guide further includes a cut-out region, different from the guide body cannulation, extending along at least a portion of an inner radial surface of the arcuate body portion and intersecting the guide body cannulation.

Abstract: The medical device disclosed here is configured to remove a plurality of objects at a time from an interior of a living body by restricting the objects from dropping out from an interior of a basket and is capable of treating objects in a body tissues having different structures efficiently with the same device. A treatment portion of a medical device includes an outer basket and an inner basket. A plurality of outer leg portions of the outer basket and a plurality of inner leg portions of the inner basket are arranged so as to be staggered in a circumferential direction. The medical device may be used by being switched between a mode of using only the outer basket and a mode of using both of the outer basket and the inner basket.

Abstract: A clot retrieval device for removal of occlusive clot from a blood vessel comprises a clot engaging element 700 having a constrained delivery configuration and an expanded deployed configuration. In the expanded configuration peripheral portions are laterally spaced-apart and the clot engaging section 700 extends between the peripheral portions. The device 700 may have two superimposed wave patterns provided by a large amplitude curve 723 and shorter pitch sinusoidal patterns 721, 722. A wave shape varies the contact pressure between a clot and the device along the length of the device, reducing the compression of the clot by the device at some locations. The device can elongate when placed under tension which aids elongation of the clot during dislodgement.

Abstract: A skin tag removal device for removing skin tags from a user's body. The skin tag removal device includes a clamp having a first arm and a second arm pivotally affixed to one another by a resistance element. The resistance element helps to bias the arms in a closed configuration. In operation, the user can squeeze the second end of the arms which serve as handles in order to separate the first ends of the arms. The first ends of the arms include projections thereon that are in contact with one another when the clamp is in the closed configuration. The clamp can be secured to the stalk of a skin tag wherein the projections contact opposing sides of the base of the skin tag in order to cut off blood supply to the skin tag, causing the skin tag to fall off.

Abstract: Methods for dissecting tissues are provided. The methods comprise selecting a tissue site comprising dermis and subdermal fat connected to the dermis, and applying ultrasonic energy to the tissue to remove at least a portion of the subdermal fat from the dermis, wherein the ultrasonic energy is applied to minimize damage to the dermis.

Abstract: Current invention relates to a combined system developed for the purpose of use in the treatment of anorectal fistulas. Fistulectomy Set is a system consisting of fistulectomy units which functions fully controlled and transmitting the pivoted movement which comes from the movement providing and transmitting part to the cutting edge by moving it on a central guide with the help of a motion carrier flexible shaft consisting of hexahedron spheroid parts. It consists of a cannulation apparatus which provides a simultaneous rotation, vibration and reciprocating movement and which detects the fistula trace fully and accurately. With this cutting edge, a channel surrounded by living tissue is obtained by cutting around the fistula trace cylindrically with suitable thickness, and thus cutting the secretory mucosa, dead tissues and fibrotic structures. With the developed system, it is believed that important progress will be made in the treatment of anorectal fistula; an important social and medical problem.

Abstract: A surgical apparatus comprises a body, a shaft assembly, a rotation input assembly, and an end effector. The shaft assembly defines a longitudinal axis and a first fluid passageway. The rotation input assembly is operable to rotate the shaft assembly about the longitudinal axis. The rotation input assembly defines a second fluid passageway. The second fluid passageway is in fluid communication with the first fluid passageway. The end effector is located at a distal end of the shaft assembly. The end effector comprises an ultrasonic blade. The end effector is in fluid communication with the first fluid passageway such that the end effector is configured to receive fluid communicated through the first and second fluid passageways.

Abstract: A surgical apparatus comprises a body, a user input feature, a shaft assembly, an end effector, and a blade cooling system. The end effector comprises a clamp arm and an ultrasonic blade that may be coupled with an ultrasonic transducer. The clamp arm is configured to pivot toward and away from the ultrasonic blade. The cooling system is operable to deliver liquid coolant to the ultrasonic blade to thereby cool the ultrasonic blade. The user input feature is operable to both actuate the clamp arm and actuate the cooling system.