Abstract: A medical image diagnostic apparatus of embodiments includes processing circuitry configured to: calculate an index value in a region of interest of a subject based on tissue property data collected by scanning on the subject; and determine display characteristics of the region of interest based on the index value.

Abstract: An ultrasonic measurement apparatus extracts, from a reception signal, a plurality of partial reception signals according to overlap periods that are set by shifting the time so as to overlap partially. Then, scattering attenuation correction using a scattering attenuation correction value is performed for a frequency domain signal obtained by performing a Fourier transform of each of the plurality of partial reception signals, and an inverse Fourier transform of a corrected frequency correction signal is performed. Then, partial correction signals corresponding to the respective partial reception signals are obtained by performing an inverse Fourier transform. Then, a signal obtained by combining the partial correction signals is set as a reception correction signal after correcting the reception signal. The scattering attenuation correction value is calculated from the signal strength of incident ultrasonic waves and a sum value of the signal strength of the reception signal at each time.

Abstract: Methods and systems managing protected health information (PHI) on a medical display are provided. The systems and methods detect a plurality of communication links between a medical device and a plurality of remote system and display the medical device and the plurality of remote system as corresponding graphical icons on a display. The systems and methods further determine encryption levels for the plurality of communication links and display connection graphics representing the plurality of communication links. Each connection graphic is positioned between the medical device and one of the remote systems having a visual feature corresponding to an encryption level of a communication link between the medical device and the one of the remote systems.

Abstract: Various embodiments include systems and methods for optimizing utilization of bandwidth between ultrasound probes and display units. Data transfer limits for a connection between an ultrasound probe and a corresponding display-and-control unit may be determined. Based on the data transfer limits, one or more functions in the ultrasound probe may be controlled. The one or more functions relate to acquiring of ultrasound image data via the ultrasound probe, processing of the acquired ultrasound image data, and/or communication of the acquired ultrasound image data. Further, the controlling is adapted to reduce amount of data acquired and/or transferred, between the ultrasound probe and the display-and-control unit, during ultrasound imaging, to meet the data transfer limits for the connection.

Abstract: An ultrasound diagnosis apparatus according to an embodiment includes an ultrasound prove and transmitter circuitry. The ultrasound probe is connected to a body through a cable and includes an ultrasound transducer element to transmit and receive an ultrasound wave. The transmitter circuitry generates transmission waveform data, generates, from the generated transmission waveform data, transmission signals that the ultrasound probe uses for transmitting ultrasound waves, and outputs the generated transmission signals to the ultrasound probe. When causing the ultrasound probe to transmit a plurality of ultrasound waves with different phases successively depending on a transmission condition, the transmitter circuitry generates transmission waveform data based on which a sum component of the ultrasound waves transmitted successively is within a certain range, by using the transmission signals detected between the cable and the ultrasound transducer element.

Abstract: Medical devices and methods are disclosed in the present application. In one illustrative example a tissue removal device may comprise an elongate shaft defining a lumen and having a proximal end and a distal end, wherein a proximal portion of the elongate shaft has a first diameter and a distal portion of the elongate shaft has a second diameter, and wherein the first diameter is less than the second diameter and an elongate member disposed at least partially within the elongate shaft, the elongate member having a proximal end and a distal end, the distal end of the elongate member comprising a cap. In some further embodiments, the elongate member may be axially translatable between a proximal position and a distal position, and the cap may form a closed receptacle with the distal portion of the elongate shaft when the elongate member is in the proximal position.

Abstract: An improved flexible endoscopic instrument to precisely and efficiently obtains samples of flat polyps and multiple polyps from a patient by debriding one or more polyps and retrieving the debrided polyps without having to alternate between using a separate cutting tool and a separate sample retrieving tool and may be used with an endoscope. In one aspect, the cutting tool is coupled to a flexible torque coil or torque rope that is configured to transfer rotational energy from a powered actuator through the length of the endoscope onto the cutting tool.

Abstract: A biopsy system includes an endoscope which includes an insertion portion having a channel, and a bendable portion provided in a distal end portion of the insertion portion; a needle tube which includes a distal end region, and a proximal end region having a higher bending rigidity than that of the distal end region; a sheath which can be inserted into the channel and inserted through by the needle tube; an attachment adapter which is provided on a proximal end side of the sheath and is capable of being mounted at the endoscope; and a connection member which connects the distal end region and the proximal end region, wherein the connection member can move within only a range of the insertion portion more proximal than a proximal end of the bendable portion and more distal than a proximal end of a follow-bending region.

Abstract: To provide a surgical instrument for performing incision that enables surgery to be performed safely and easily, with minimal invasiveness and a reduced risk of damaging a tissue, such as a tendon, nerve, or blood vessel. The surgical instrument for performing incision includes incision reception means that receives an incision portion of a tendon sheath and an aponeurotic membrane, guide fixture means that fixes the incision reception means outside a body, and incision means that performs incision under guidance of the guide fixture means, the instrument being configured to incise a tendon sheath and an aponeurotic membrane by pressing and moving the incision means against the incision reception means. This surgical instrument for performing incision enables a tendon sheath and an aponeurotic membrane to be incised safely without significantly incising the skin or subcutaneous tissue, and makes it possible to conduct surgery percutaneously at an extremely low level of invasion.

Abstract: The present disclosure relates to a vascular closure device adapted for use in closing a puncture in a blood vessel after e.g. a percutaneous interventional procedure. The disclosure also relates to a method for vascular closure using such a vascular closure device.

Abstract: An anchor assembly configured to locate and anchor body tissue surrounding an opening in the body tissue. The anchor assembly can include a plurality of anchor elements. Each anchor element can include an elongate portion and an anchor portion extending from the elongate portion. The elongate portion can be configured to be manipulated by a user. The anchor portion can have a contracted configuration capable of passing through the opening in the body tissue and can have an expanded configuration capable of anchoring the body tissue surrounding the opening. The anchor portion and the elongate portion can be integrally formed from a single wire.

Abstract: A vascular closure device comprised of a sheath-delivered cincture or noose-like device or knot comprised of suture, wire, or other suitable materials, that is placed on the external surface of a puncture wound, and closed. The vascular closure cincture is delivered by a sheath, and after closing is left resident on the external surface of a tissue puncture wound.

Abstract: The present disclosure relates to a vascular closure device adapted for use in closing a puncture in a blood vessel after e.g. a percutaneous interventional procedure. The disclosure also relates to a method for vascular closure using such a vascular closure device.

Abstract: Described are medical graft products, systems, and methods for treating fistulae. Certain products of the invention are configured to have portions residing in and around a primary fistula opening, e.g., one occurring in a wall of the alimentary canal. One such product includes a biocompatible graft body which is configured to block at least the primary opening. The graft body includes a capping member, which is configured to contact portions of the alimentary canal wall adjacent to the primary opening, and an elongate plug member extending from the capping member, which is configured to extend into at least a portion of the fistula. In certain embodiments, a graft body component has the capacity to expand or otherwise change form to provide a suitable capping arrangement. Such a component can include a resilient wire frame, e.g., one that is self-expandable or one that requires at least some manipulation in order to expand.

Abstract: A surgical retrieval apparatus includes a tube assembly, a cartridge assembly, and a plunger assembly. The cartridge assembly is releasably engagable with the tube assembly and includes an end effector assembly disposed therein. The end effector assembly includes a specimen retrieval bag releasably coupled thereto at a distal end thereof and a first engagement member disposed at a proximal end thereof. The plunger assembly is configured for insertion through the tube assembly and into the cartridge assembly. The plunger assembly includes a second engagement member configured for releasably engaging the first engagement member. When the first and second engagement members are engaged with one another, the plunger assembly is movable between a more proximal position, wherein the end effector assembly and specimen retrieval bag are retracted within the cartridge assembly, and a more distal position, wherein the end effector assembly and specimen retrieval bag are deployed from the cartridge assembly.

Abstract: Applicators for storing, sterilizing, and dispensing adhesives are provided. The applicators comprise a porous tip, a body, and a container containing a polymerizable cyanoacrylate monomer adhesive. The applicators are sterilized by radiation, and following sterilization, the adhesive remains substantially unpolymerized for about twenty four months.

Abstract: A spray assembly for dispensing a mixture is provided. The spray assembly includes a connector configured for operable engagement with a first and second source of component and a source of pressurized fluid, and a tip operably connected to the connector. The tip includes an opening and defines a mixing chamber between the connector and the opening of the tip, and an insert member configured to be received in the mixing chamber. The insert member includes a plurality of radially extending slots on at least one end of the insert. The plurality of radially extending slots is configured to mix the first and second components prior to the mixture exiting the opening in the tip.

Abstract: Technology disclosed herein relates to retractors and methods of use for surgical procedures, and in particular, spinal surgical procedures. In one embodiment, a surgical retractor includes a pair of pivotable armatures and a translatable armature. A body for supporting the armatures is provided, with a handle connected thereto. The handle includes a first rotary actuator, wherein a rotation of the first rotary actuator moves the pair of pivotable armatures in opposite arcuate directions, and a second rotary actuator, wherein a rotation of the second rotary actuator translates the translatable armature in a linear direction.

Abstract: Devices and methods for positioning a surgical instrument are described herein. In one embodiment, a positioning device can include a base that can be placed against tissue and a shuttle including a lumen that can receive a surgical instrument. The lumen can be translated in at least two directions relative to the base and an orientation of the lumen relative to the base can be polyaxially adjusted. Further, the device can include a locking mechanism that, upon actuation, prevents both translational movement and polyaxial movement of the lumen relative to the base.

Abstract: A system for implanting an anchor into bone, the system comprising a curved cannulated guide for percutaneous insertion, having a proximal end and a distal end; a flexible drill insertable through the curved guide from the proximal end to the distal end, the flexible drill having a shaft having a flexible portion; and a flexible inserter for inserting a suture anchor into a bore at the anatomical site formed by the flexible drill, the flexible inserter having a shaft having a flexible portion, wherein the flexible portions of both the flexible drill and flexible inserter include a series of discrete, interlocking segments.

Abstract: Devices and methods for cleaning a surgical device, and or end effectors associated with the device, are provided. In one exemplary embodiment, a surgical device includes a housing, a plurality of shafts extending distally from the housing, a port disposed at a proximal end of the shafts to form a proximal compartment and an end effector receiver disposed at a distal end of the shafts to form a distal compartment. A fluid and/or a vacuum source can be supplied at the port, through the proximal compartment and shafts, and to the distal compartment. The supplied fluid or vacuum source can be effective to remove fluid and/or tissue from the distal compartment. A plurality of seals can be provided on an outer-most shaft in the compartments to seal fluid from the compartments from entering a housing and/or an outside environment. Other devices and exemplary methods are also provided.

Abstract: A method for coupling tissue with a flexible member including a tail and a self-locking construct coupled to the tail. The self-locking construct includes an adjustable first loop and an adjustable second loop coupled thereto. The method includes implanting an anchor in bone, the anchor slidably mounted to the tail. The tail is positioned relative to the tissue. An end of the tail is inserted through the first loop. The tail is passed through the first loop, the second loop is pulled into the anchor, and the self-locking construct is positioned relative to the tissue. The self-locking construct is tightened against the tissue by pulling on an end of the self-locking construct. The first loop is tightened onto the second loop.

Abstract: A suture cinch, cinch applicator, and cinch loader for loading the cinch into the cinch applicator are provided and permit re-use of the applicator with multiple cinches during an endoscopic procedure. The applicator can be loaded with a first cinch, apply the first cinch onto a portion of suture to fix the portion of suture relative to anatomical tissue, reloaded with a second cinch optionally using the loader, and subsequently used to apply the second cinch to fix another portion of suture to fix the other portion of suture relative to anatomical tissue. The cinch is a tubular member through which the suture can be advanced when the cinch is loaded within the applicator. The cinch defines multiple ribs and cutter defined in a wall thereof. Operation of the applicator deforms the ribs inward to retain the cinch on the suture, and displaces the cutter to sever the suture.

Abstract: A suture cinch, cinch applicator, and cinch loader for loading the cinch into the applicator are provided and permit re-use of the applicator with multiple cinches during an endoscopic procedure. The applicator can be loaded with a first cinch, apply the first cinch onto a portion of suture to fix the portion of suture relative to anatomical tissue, reloaded with a second cinch optionally using the loader, and subsequently used to apply the second cinch to fix another portion of suture to fix the other portion of suture relative to anatomical tissue. The cinch is a unitary tubular member through which the suture can be advanced when the cinch is loaded within the applicator. The cinch defines multiple ribs and a cutter in a wall thereof. Operation of the applicator deforms the ribs inward to retain the cinch on the suture and displaces the cutter to sever the suture.

Abstract: A tissue closure device includes a needle and a suture extending therefrom, a proximal head including a proximal slot and a proximal locking mechanism for releasably engaging a first end of the needle in the proximal slot in a first configuration, and a distal head movably coupled to the proximal head so that the proximal and distal heads are movable relative to one another between an open configuration, in which a target tissue is received therebetween, and a closed configuration, in which the target tissue gripped therebetween. The distal head includes a distal slot and a distal locking mechanism for releasably engaging a second end of the needle in the distal slot in a second configuration, the needle movable between the first and second configurations by rotating the needle, the needle alternatingly passed between the proximal and distal heads to thread the suture through the target tissue.

Abstract: An apparatus and a method for surgical suturing with thread management. An apparatus for tissue suturing comprising a cartridge having a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis; a pusher assembly comprising a cartridge holder having a needle rotation drive capable of releasably engaging the cartridge and rotating the suturing needle about the axis; and an actuator capable of releasably engaging the needle rotation drive to rotate the needle rotation drive. A method for suturing tissue comprising placing a suturing device having a cartridge containing a suturing needle to span separated tissue segments; activating an actuator to cause rotational movement of the suturing needle through the separated tissue segments; and deactivating the actuator to stop an advancing movement of the suturing needle to cause a suturing material to be pulled through the separated tissue segments forming a stitch.

Abstract: An apparatus and a method for surgical suturing with thread management. An apparatus for tissue suturing comprising a cartridge having a suturing needle having a pointed end and a blunt end, the suturing needle capable of rotating about an axis; a pusher assembly comprising a cartridge holder having a needle rotation drive capable of releasably engaging the cartridge and rotating the suturing needle about the axis; and an actuator capable of releasably engaging the needle rotation drive to rotate the needle rotation drive. A method for suturing tissue comprising placing a suturing device having a cartridge containing a suturing needle to span separated tissue segments; activating an actuator to cause rotational movement of the suturing needle through the separated tissue segments; and deactivating the actuator to stop an advancing movement of the suturing needle to cause a suturing material to be pulled through the separated tissue segments forming a stitch.

Abstract: An apparatus includes a staple cartridge. The staple cartridge includes staples, a deck, and a buttress. The deck defines a plurality of openings. Each opening of the plurality of openings is associated with a corresponding staple of the plurality of staples, such that each staple is configured to pass through a corresponding opening of the plurality of openings. The buttress is configured to detach from the staple deck in response to the staples being driven through the corresponding openings of the deck. The buttress is resiliently biased to transition from a first configuration while attached to the deck to a second configuration when detached from the deck. The buttress has a first length in the first configuration and a second length in the second configuration. The first length is longer than the second length.

Abstract: A surgical instrument includes a shaft assembly, a handle assembly, and a latch system configured to operatively couple the shaft and handle assemblies. The latch system includes shaft and a handle lock members respectively connected to the shaft and handle assemblies for inhibiting operative uncoupling of the shaft and handle assemblies. The latch member has a cam surface and a latch member. The latch member is configured to selectively move from a locked position to a released position such that movement of the latch member causes the shaft and handle lock members to disengage and uncouple the shaft and handle assemblies. The latch member is further configured to selectively move from the released position to a removal position such that further movement of the latch member causes the cam surface of the latch member to engage the cam base and urge the shaft assembly in a removal direction.

Abstract: Endoscopic surgery clips are dispensed out of an endoscopic catheter that has restriction provisions that cooperate with spring-biased jaw-clenching provision(s) that are provided to the clips. The cooperation between the restrictions of the catheter and spring-biased jaw-clenching provisions of the clips cooperate to facilitate reversal of the lead clip to-be-ejected, prior anytime before full ejection past the dispensing end of the endoscopic catheter, and at least partially reversed back into the lumen therefor in the endoscopic catheter.

Abstract: An apparatus includes a locking portion, a flexible pulling portion, a flexible body, and a plurality of barb features extending laterally from the body. The locking portion is configured to receive the pulling portion. The pulling portion is configured to engage and translate relative to the locking portion after the locking portion has received the pulling portion. The flexible body extends from the locking portion to the pulling portion. The flexible body is configured to form a loop when the pulling portion engages the locking portion. The loop is configured to decrease in size in response to pulling of the pulling portion relative to the locking portion. The barb features are configured to engage a tubular region of tissue and thereby form pleats in the tubular region of tissue.

Abstract: A surgical instrument includes a shaft assembly, a handle assembly including a battery dock, and a battery unit. The battery unit is configured to be received by the battery dock such that the battery unit is in electrical communication with at least one of the shaft assembly or the handle assembly. The battery unit includes a casing, an anode contact and a cathode contact within the casing, and a discharge drain. The discharge drain includes a controller, a switch element, and a resistor element operatively connected between the cathode contact and the anode contact. The controller is configured to selectively direct the switch element to close such that the resistor element is in electrical communication with the anode contact and the cathode contact. Thereby, the resistor element is configured to drain a remaining electrical power from the at least one battery connected to the anode contact and the cathode contact.

Abstract: A compressible adjunct for use with a surgical instrument including a staple cartridge includes a biocompatible layer and a plurality of biocompatible looping members. The biocompatible looping members protrude from the biocompatible layer. Each biocompatible looping member includes a first end portion attached to the biocompatible layer, a second end portion attached to the biocompatible layer, and an intermediate curved portion extending between the first end portion and the second end portion, wherein the intermediate curved portion is further away from the biocompatible layer than the first end portion and the second end portion.

Abstract: A surgical instrument for surgically joining tissue is disclosed. The instrument comprises a handle assembly, an elongated portion, an end effector, and an articulation mechanism. The elongated portion extends distally from the handle assembly. The end effector is disposed adjacent a distal portion of the elongated portion. The articulation mechanism is disposed in mechanical cooperation with the end effector for articulating the end effector. The articulation mechanism comprises a lever, a knob, a plate and a lower clutch. The plate is disposed at least partially within a portion of the knob. The lower clutch is disposed in mechanical engagement with the plate. The plate is disposed at least partially between the lower clutch and the knob. The lower clutch is keyed to the plate to limit rotation therebetween. The lower clutch is keyed to the knob to limit rotation therebetween.

Abstract: A compressible adjunct for use with a surgical instrument including a staple cartridge includes a first biocompatible layer, a second biocompatible layer spaced apart from the first biocompatible layer, and a plurality of supporting pillars extending between the first biocompatible layer and the second biocompatible layer.

Abstract: A motor-driven surgical cutting and fastening instrument that comprises an end effector, an electric motor, and a motor control circuit. The motor control circuit is for monitoring a parameter of the electric motor that is indicative of movement of a moveable member of the end effector, and for adjustably controlling the electric motor based on the monitored parameter to thereby adjustably control movement of the moveable member of the end effector during forward rotation of the electric motor.

Abstract: Surgical end effectors and fastener cartridges having firing lockout arrangements for preventing or limit a firing stroke when a cartridge has not been operably installed in the end effector or a spent cartridge has not been replaced.

Abstract: A compressible adjunct is used with a surgical instrument. The compressible adjunct includes a hollow fibrous construct and a core fibrous construct housed within the hollow fibrous construct, wherein the hollow fibrous construct comprises at least one biocompatible material that has experienced at least one transition from a more ordered phase to a less ordered phase in response to heating the hollow fibrous construct to a predetermined temperature.

Abstract: An apparatus includes an end effector including an anvil and lower jaw. The anvil is pivotable toward the lower jaw to capture tissue. The apparatus further includes a stapling and severing assembly configured to sever and staple tissue clamped between the anvil and the lower jaw. A staple cartridge is coupled with the lower jaw. The staple cartridge includes a deck facing the anvil, a plurality of staples positioned in a plurality of staple openings formed through the deck, and a magnetic feature configured to be coupled to tissue in response to activation of the stapling and severing mechanism. The magnetic feature is configured to be coupled to tissue in response to actuation of the staple cartridge, wherein the magnetic feature is configured to retain at least one outer portion of stapled tissue in an inwardly folded position relative to an inner portion of stapled tissue.

Abstract: Methods and devices are provided for performing robotic surgery. In general, a surgical system is provided including an electromechanical tool with a first mode of operation in which the electromechanical tool mimics movement of a controller, and a second mode of operation in which the tool mirrors movement of the controller. A hybrid surgical device is also provided including an adapter matable to a handle assembly such that the adapter is electronically coupled to a motor of the handle assembly and is configured to communicate with the motor. A robotic laparoscopic surgical device is also provided including a motion sensor configured to sense movement of an electromechanical tool and an electromechanical arm that assists movement of the tool. A robotic surgical device is also provided including an electromechanical driver associated with a trocar and being configured to rotate and to translate a tool disposed through a passageway.

Abstract: A surgical stapling instrument including staples and an implantable layer is disclosed. The implantable layer comprises fibers which have undergone a kinking process. The kinked fibers, once interwoven together, create a resilient body that can dynamically adapt to the thickness of the tissue captured within the staples.

Abstract: A staple cartridge assembly is disclosed which comprises a cartridge body and an implantable layer. The implantable layer includes fibers comprised of a first material and a second material. The first material and the second material have different glass transition temperatures. After the fibers comprised of the first material and the second material have been intermixed or interwoven, the layer is exposed to a temperature which exceeds the lower of the two glass transition temperatures. This heating process causes the layer to constrict and increase in thickness. The layer, when implanted, can compensate for variations in tissue thickness within the staples.

Abstract: A staple cartridge assembly for use with a surgical stapling instrument includes a staple cartridge including a plurality of staples and a cartridge deck. The staple cartridge assembly also includes a compressible adjunct positionable against the cartridge deck, wherein the staples are deployable into tissue captured against the compressible adjunct, and wherein the compressible adjunct comprises a first biocompatible layer comprising a first portion, a second biocompatible layer comprising a second portion, and crossed spacer fibers extending between the first portion and the second portion.

Abstract: A staple cartridge assembly comprising an implantable adjunct or layer assembly is disclosed. The implantable adjunct comprises a plurality of layers, wherein at least one of the layers has been melted to bond with one or more of the other layers of the implantable adjunct.

Abstract: A staple cartridge assembly comprising an implantable layer is disclosed. The implantable layer comprises a top portion, a bottom portion, and structural walls interwoven between the top portion and the bottom portion.

Abstract: A staple cartridge assembly is used with a surgical stapler. The staple cartridge assembly includes a staple cartridge including a cartridge body, a cartridge deck, and a plurality of staples deployable from the cartridge body through the cartridge deck. The staple cartridge assembly includes a compressible adjunct positionable against the cartridge deck. The compressible adjunct includes a plurality of unaltered fibers and a plurality of altered fibers that are melted and resolidified. The unaltered fibers include a first fiber including a first fiber portion and a second fiber including a second fiber portion extending over the first fiber portion. The compressible adjunct further includes a node which comprises the first fiber portion, the second fiber portion, and at least a portion of the plurality of altered fibers, wherein the at least a portion of the plurality of altered fibers affixes the first fiber portion and the second fiber portion.

Abstract: A compressible adjunct has a first portion, a second portion, and a middle portion. The middle portion is disposed between the first portion and the second portion. The middle portion comprises a first pillar, a second pillar, and an interconnecting member. The first pillar and the second pillar extend substantially between the first portion and the second portion. The interconnecting member is configured to engage at least the first pillar and the second pillar. When the compressible adjunct is compressed by a force, the first pillar is configured to deflect a first deflection and the second pillar is configured to deflect a second deflection. The first deflection differs from the second deflection.

Abstract: Methods for forming an implantable layer onto a staple cartridge are disclosed.

Abstract: A compressible adjunct is used with a surgical instrument including a staple cartridge deck. The compressible adjunct includes a first biocompatible material, a second biocompatible material with a lower melting temperature than the first biocompatible material, and a body including a face positionable against a length of the staple cartridge deck. The face includes a plurality of attachment regions spaced apart from one another, wherein the plurality of attachment regions include the second biocompatible material, wherein the face is selectively attachable to the staple cartridge deck at said plurality of attachment regions, and a plurality of non-attachment regions extending between the plurality of attachment regions, wherein the second biocompatible material is selectively disposed outside said non-attachment regions.

Abstract: A staple cartridge assembly is disclosed comprising, one, a plurality of staples removably stored within a surgical staple cartridge and, two, an implantable adjunct. The implantable adjunct is configured to be progressively released from the surgical staple cartridge during a firing progression of a firing assembly configured to travel through the surgical staple cartridge.