Abstract: The invention provides systems and methods for monitoring the wellbeing of a fetus by the non-invasive detection and analysis of fetal cardiac activity data.

Abstract: Aspects of the present disclosure are directed to detecting Atrial Fibrillation (AF). As may be implemented in accordance with one or more embodiments, a time series of inter-beat intervals is computed from a recording of activity of a beating heart. The time series is decomposed into subcomponents, and an envelope of at least one of the subcomponents is computed. The presence of atrial fibrillation (AF) is detected based upon characteristics of the envelope that are indicative of AF.

Abstract: A system comprises a cardiac signal sensing circuit and a processor circuit. To detect a QRS duration, the processor circuit determines an isoelectric amplitude value of the cardiac signal segment, identifies a time where the cardiac signal segment amplitude deviates from the first isoelectric amplitude value by a specified threshold deviation value as a Q time, determines an isoelectric value time after the determined maxima and minima times that the cardiac signal segment returns to the same or a different isoelectric amplitude value, identifies a time that follows both the determined maxima and minima times and precedes the isoelectric value time as an S time, wherein the cardiac signal segment amplitude at the identified S time satisfies a specified amplitude change criterion from an isoelectric amplitude value, and determines a time duration of the QRS complex in the cardiac signal segment using the identified Q and S times.

Abstract: A method of managing pain using neurophysiological data acquired from the brain of a subject is disclosed. The method comprises: identifying activity-related features in the data; parceling the data according to the activity-related features to define a plurality of capsules, each representing a spatiotemporal activity region in the brain; comparing at least some of the defined capsules to at least one reference capsule; and assessing the likelihood that the subject is experiencing pain responsively to the comparison.

Abstract: A heart-rate sensor for detecting artery blood-flow volume per unit length change in a human or animal subject, which comprises an antenna for sensing the instantaneous volume of blood in the artery of the subject, to be measured; a RADAR unit for transmitting microwave signals into a subject's body part or limb representing tissue targets.

Abstract: A method includes accepting a plurality of Magnetic Resonance Imaging (MRI) data points of a cardiac chamber, acquired over multiple phases of at least one cardiac cycle. A simulated surface of the cardiac chamber is constructed by processing the MRI data points. Measurements of a parameter, acquired at respective points on a surface of the cardiac chamber, are accepted from an intra-cardiac probe. The measurements are overlaid on the simulated surface constructed from the MRI data points, so as to produce a map of the parameter on the surface.

Abstract: A method of optimizing scan parameters for LGE-MRI. At least one cardiac MRI TI scout scan is performed by applying an inversion pulse every predetermined heart beat of a patient. An initial value of an inversion time TIinitial is determined by assessing a set of images generated from the scout scan. A first multiple of a duration between successive indicia of ventricular depolarization is selected, and a relaxation time T1 is determined based on the initial value Tinitial and the first multiple of duration. An optimized inversion time TIoptimal for LGE-MRI is determined based on the relaxation time T1 and a second multiple of a duration between successive indicia of ventricular depolarization. A correction factor is determined based on the optimized inversion time TIoptimal from the initial value of the inversion time TIinitial.

Abstract: Apparatus, systems, and methods are provided for localizing lesions within a patient's body, e.g., within a breast. The system includes a microwave antenna probe for transmitting and receiving electromagnetic signals to detect one or more markers that are implanted within or around the target tissue region. During use, the marker(s) are implanted into a target tissue region, and the microwave antenna probe is placed against the patient's skin to transmit a signal to the marker(s) and to receive the reflected signal from the marker(s) in order to determine the location of the marker(s). A tissue specimen, including the lesion and the marker(s), is then removed from the target tissue region based at least in part on the location information from the microwave antenna probe.

Abstract: A bi-directional flow sensor may be adapted for reducing pneumatic noise during pressure sensing with a flow passing through the flow sensor. The flow sensor may include a hollow, tubular member having a throat section disposed between a ventilator end and a patient end. A flow restrictor may be disposed in the throat section and may be adapted to measure differential pressure in the flow. A baffle may be mounted at the ventilator end and may be adapted to minimize non-axial flow at pressure taps located on opposing ends of the flow restrictor. The patient end may include a flow obstruction configured to promote uniform velocity across the flow at the pressure taps during exhalation flow from the patient end to the ventilator end. The flow sensor can minimize pneumatic noise to less than 0.1 LPM to allow accurate patient flow measurement and triggering of inhalation and exhalation phases at flow rates of 0.2 LPM.

Abstract: A system and method are provided for targeted training of a person walking on a powered backward moving surface. Kinematic information of motor performance, such as ankle position and velocity, is measured throughout one or more phases of a gait cycle with a detector. The gait phase is determined, and a resistive/assistive force is applied to the leg that differs depending upon the gait phase and the measured kinematic information.

Abstract: Presented herein is a modular analyte measurement system having a replaceable strip port module that releasably connects and operably couples with an analyte meter. Embodiments of the present invention also relate to modular components of the analyte measurement system. In one aspect, there is provided a replaceable strip port module having a strip port and electrical interface for removably and electrically coupling with an analyte meter. In another aspect, there is provided an analyte meter that includes a processor and electrical interface for removably and electrically coupling with replaceable strip port modules. Methods of configuring the analyte measurement system and methods of determining an analyte meter with the analyte measurement system are also provided.

Abstract: An optical rotation measurement method includes causing measurement light of a predetermined polarization to be incident on a subject from an incident direction that is a non-right angle to the subject, discriminating an optical rotation reflecting component of the predetermined polarization from reflected light that is reflected in a different direction to the incident direction of the subject, and measuring the optical rotation based on the discrimination result.

Abstract: Generally, embodiments of the invention relate to analyte determining methods and devices (e.g., electrochemical analyte monitoring systems) that have improved uniformity of distribution of one or more components of the sensor by inclusion of a low surface tension polymer leveling agent, where the components are disposed proximate to a working electrode of in vivo and/or in vitro analyte sensors, e.g., continuous and/or automatic in vivo monitoring using analyte sensors and/or test strips. Also provided are systems and methods of using the, for example electrochemical, analyte sensors in analyte monitoring.

Abstract: Novel membranes comprising various polymers containing heterocyclic nitrogen groups are described. These membranes are usefully employed in electrochemical sensors, such as amperometric biosensors. More particularly, these membranes effectively regulate a flux of analyte to a measurement electrode in an electrochemical sensor, thereby improving the functioning of the electrochemical sensor over a significant range of analyte concentrations. Electrochemical sensors equipped with such membranes are also described.

Abstract: A system for human-digital media interaction tracking. One example system includes a database that stores information regarding a user's activity history for various different cognitive tasks, and a computing device that receives user behavior information indicating usage by a user of an interactive software program, the interactive software program associated with at least one of the cognitive tasks. The computing device, in response to the receipt of user behavior information indicating usage by the user of the interactive software program, updates the database information regarding the user's activity history for the at least one of the cognitive tasks.

Abstract: A wearable resuscitation system is used for resuscitating a patient. The system comprises at least two defibrillation electrodes adapted to be worn by the patient for extended periods of time; circuitry for monitoring the an ECG of the patient; at least one processor configured for analyzing the ECG of the patient, and determining whether electrical therapy should be delivered to the at least two defibrillation electrodes; circuitry for providing defibrillation pulses to the at least two defibrillation electrodes; and circuitry for providing resuscitation prompts, wherein at least the circuitry for monitoring the ECG, the processor configured for analyzing the ECG, and the circuitry for providing resuscitation prompts are contained in one or more devices adapted to be worn by the patient.

Abstract: A hinge pin joint for facilitating precise separation of the jaws of a spring clip, including a base cylinder with a threaded bore, supports extending laterally out from the base cylinder, pin supports capable of pivoting, and stabilizing wings extending from the pin supports. In one embodiment, the capability of pivoting includes pins that are integral with the pin supports and which extend out laterally from the pin support. An alternate embodiment includes aligned opening in the pin supports into which pins may be inserted. At least one stopper may be disposed on at least one of the pin supports for supporting the upper shell. The stabilizing wings are configured as plates that are semi-rigidly secured in guide structures within the lower shell.

Abstract: The apparatus for the non-invasive glucose detection comprises an electrical detection device (2) for measuring the response of the tissue or blood to an electric field at low frequencies below 1 MHz and at high frequencies above 10 MHz. The former is primarily dominated by skin hydration and sweat, while the latter contains contributions from the current glucose level. Combining the two signals allows an increased degree of accuracy. The apparatus further comprises a force or acceleration sensor (4, 5), which allows to detect the pressure of the apparatus against the skin and/or quick movements. Further sensor modules, such as a temperature sensor (6) or alternative perfusion sensor (7), improve the accuracy of the measured result.

Abstract: A multimodal intravascular analysis uses a structural intravascular analysis modality to compensate for a chemical analysis modality. Examples of structural analysis are IVUS, OCT, including optical coherence domain Reflectometry (OCDR) and optical frequency domain imaging (OFDI), and/or sonar range finding. Examples of chemical or functional analysis are optical, NIR, Raman, fluorescence and spectroscopy, thermography and reflectometry. In one example, the structural analysis is used to characterize the environment structurally, such as catheter head-vessel wall distance. This information is then used to select from two or more algorithms which are depth specific (e.g. shallow vs. deep), to achieve improved accuracy in the chemical or functional analysis.

Abstract: The present invention allows a subject to hold breathing at any position, and it is confirmed whether or not the breath holding is really performed in the middle of imaging to reflect its result to the imaging sequence. An image 411 showing a temporal change of respiratory displacement of the subject is generated from nuclear magnetic resonance signals acquired by executing the navigator sequence 231 repeatedly on the subject. Upon accepting from an operator a confirming operation that the operator viewing the image confirms a state of breath holding, the navigator sequence 231 is switched to the real imaging sequence 211 and the real imaging sequence is executed for a predetermined period of time. Those operations are repeated more than once. It is also possible to determine whether or not the breath holding during the imaging sequence is successfully performed, based on a difference in respiratory displacement between immediately before and immediately after the real imaging sequence.

Abstract: The present disclosure relates to the iterative reconstruction of projection data. In certain embodiments, the iterative reconstruction is a multi-stage iterative reconstruction in which different feature are selectively emphasized at different stages. Selective emphasis at different stages may be accomplished by differentially handling two or more decompositions of an input image at certain iterations and/or by differently processing certain features with respect to each stage.

Abstract: An apparatus configured to generate for display a plurality of vasculature views alongside a live fluoroscopy image. The views are selected in such a way that they allow visualizing the 3D structure of the vasculature segment in which the device is currently navigating. The view is best relative to one or a weighted average of a plurality of goodness of view standards. As the device progresses and new fluoroscopy images are acquired, the views are updated accordingly.

Abstract: Identification of an optimal monochromatic energy for displaying monochromatic images is disclosed. In certain embodiments, determination of an optimal monochromatic energy may be performed by generating histograms for various monochromatic images generated based on a set of acquired multi-energy projections and by evaluating the histogram dispersion for the respective histograms.

Abstract: A physiologic transmitter manages multiple communications between physiologic data acquisition devices attached to the patient and a receiver attached to an MRI or CT scanner. The transmitter's processor is able to generate waveform data and trigger data based upon the acquired physiologic data and transmit the data to a physiologic receiver attached to the host scanner. The receiver then is able to deliver a trigger signal to the host scanner for imaging the patient during a selected time frame based upon cardiac and/or respiratory cycles of the patient.

Abstract: A computed tomography (CT) imaging modality includes a stator and a rotor that rotates relative to the stator. The CT imaging modality includes a radiation source and a detector array for detecting at least some of the radiation. A first data communication component is coupled to the stator or the rotor for transmitting data between the stator and the rotor. The first data communication component includes a first circuit board assembly including a first conductive layer and a first dielectric layer and a second circuit board assembly including a second conductive layer and a second dielectric layer. The second conductive layer of the second circuit board assembly faces the first conductive layer of the first circuit board assembly. An insulating layer is disposed between the first conductive layer of the first circuit board assembly and the second conductive layer of the second circuit board assembly.

Abstract: A system having an X-radiation generator; an X-radiation detector; and a portable computing device. The X-radiation detector has a first wireless communication module, and a non-volatile memory. The X-radiation detector is configured to: self-trigger acquisition of an X-radiation image, store the acquired X-radiation image, and transmit the X-radiation image (or a lower-resolution version) via the first wireless communication module. The portable computing device has a second wireless communication module, and a digital screen. The portable computing device is configured to receive the X-radiation image via the second wireless communication module that communicates with the first wireless communication module, display the X-radiation image on the digital screen, enable a user to select whether to discard the X-radiation image or to transmit the X-radiation image to a server, and responsive to the user selecting to transmit the X-radiation image to the server, transmit the X-radiation image to the server.

Abstract: An intravascular imaging system can include a catheter, a position sensor, and an intravascular imaging engine for receiving information from the catheter and the position sensor. The position sensor can include a reference element and a movable element, which can have a movable element position that is correlated to the position of an imaging transducer in the catheter. The relative position between the movable element and a reference element can be determined and can correspond to the relative movement of the transducer within a patient's vasculature. The imaging engine can receive position information from the position sensor and image information from the catheter and generate a display using the received information. Because relative movement of the transducer can be determined, spatial relationships between sets of imaging data can be determined, and image data from multiple transducer locations can be combined into one image.

Abstract: A groove portion depressed from an unit outer surface toward a first perpendicular direction extends over an entire length of a transmission unit in axially parallel directions, and in the transmission unit, a sectional of a first unit component perpendicular to a longitudinal axis is a first sectional shape and a sectional shape of a second unit component perpendicular to the longitudinal axis is a second sectional shape smaller in sectional area than the first sectional shape. The sectional area changing portion changes from the first sectional shape to the second sectional shape so that a gravity center position in a case where the longitudinal axis is a reference position is consistent over the entire length of the transmission unit in the axially parallel directions.

Abstract: An ultrasonic diagnostic imaging system is operated to acquire an ultrasound image of a region of the body containing suspect anatomy such as a suspected lesion. A body marker template (104, 106) of the region of the body is displayed on a touchscreen display of the imaging system. The operator records the location of the suspect anatomy by touching a corresponding point on the body marker template displayed on the touchscreen display. The mark (120a, 120b) on the template can be finely adjusted by one or more controls on the imaging system control panel. The body marker template can also record a graphic indicating (120c) the orientation of the ultrasound probe relative to the body when the suspect anatomy was imaged. A report generator produces a report containing both the ultrasound image of the suspect anatomy and the body marker template with the indicated location of the suspect anatomy.

Abstract: A method and system are provided for detection of localized hydrogen peroxide within tissue by introducing a catalase-containing material into at location of interest, positioning an ultrasound transducer over the location, and generating an ultrasound image to detect microbubbles, where the presence of microbubbles indicate the presence of localized hydrogen peroxide. The catalase-coated surface may be the inner surface of a microtube, on the surface of or incorporated within a nanosphere or microsphere, or an implantable device.

Abstract: Provided are an ultrasound system and method for providing change information of a target object by performing image registration on a reference image acquired before radiofrequency ablation (RFA) and an ultrasound image acquired during the RFA and comparing the reference image and the ultrasound image that have undergone the image registration with each other.

Abstract: A body fluid collection device comprises a longitudinal member having a lumen formed along a longitudinal axis and configured to be inserted through the channel, a flow path in which a suction is acted by the suction section of the endoscope, which is formed to bring the lumen of the longitudinal member in communication with the channel, an accommodating section which is formed in the flow path, and accumulate the the body fluid suctioned in the lumen by the suction section of the endoscope, and a sealing member configured to seal a space between the longitudinal member and the channel closer to a distal end of the longitudinal member than the suction port so that a fluid does not flow from the distal end side to a proximal end side of the longitudinal member.

Abstract: An apparatus for sealing a puncture includes a cartridge, a pusher member, a sealant, and a tamping device on a proximal end of the cartridge. During use, the cartridge, sealant, and pusher member are advanced over a positioning member and into the puncture by advancing a cartridge hub carrying the tamping device. When further distal advancement of the cartridge is limited, the cartridge hub is further advanced, activating the tamping device, and causing the pusher member to advance relative to the sealant to compress the sealant within the puncture.

Abstract: The present invention includes a method of assembling an anchor for use in tissue comprising an anchor body, a continuous closed suture loop and an insert, the method comprising positioning a portion of the continuous closed suture loop through an opening in the anchor body; positioning the insert adjacent the portion of the continuous closed suture loop which was passed through the opening; and securing the insert to the anchor body such that the continuous closed suture loop is secured to the anchor body by the insert.

Abstract: An anchor assembly can include at least one anchor member, such as a pair of anchor members that are configured to be implanted in a target anatomical location in a first configuration, and can subsequently be actuated to an expanded configuration that secures the anchor members in the target anatomy. The anchor assembly can further include a connector member that attaches the pair of anchor members together across a gap so as to approximate the anatomical defect.

Abstract: A surgical fastening assembly has a fastener delivery sub-assembly with a plurality of elongated tubular needle members rigidly affixed to one another about a longitudinal axis of the subassembly. The tubular needle members are positionable around an elongate trocar movably positionable inside a cannula. The cannula is coupled to the fastener delivery sub-assembly. Anchors or fasteners are disposed in the needle members and ejected at the same time by a pusher member.

Abstract: An adaptor for a powered surgical instrument includes a casing, a cam drum, a first linear driver, and a second linear driver. The cam drum defines and is translatable along a longitudinal axis of the adaptor between a retracted position and an advanced position. The cam drum is being supported for rotation about the longitudinal axis. The cam drum defines first and second radial cam grooves about an outer surface thereof. The first cam groove defines a first profile and the second cam groove defines a second profile. The first linear driver includes a first cam follower disposed in the first cam groove and the second linear driver includes a second cam follower disposed in the second cam groove. The first and second linear drivers are supported for movement between advanced and retracted positions in response to rotation of the cam drum.

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 method of deploying a surgical fastener into a patient by introducing the fastener into a body of a patient while the fastener is in a first shape having a first loop with a back span and an original size and shape. The method then involves moving end segments of the fastener away from each other substantially along an entire length thereof while keeping the back span in substantially its original size and shape. The method then involves forming the fastener into a second loop having a width greater than a width of the first loop.

Abstract: A surgical circular stapler has a handle assembly, a shaft, a stapling assembly, a motor, a drive assembly, and a firing assembly. The shaft extends distally from the handle assembly. The stapling assembly is secured to a distal end of the shaft. Longitudinal translation of the firing assembly causes the stapling assembly to drive a plurality of staples in a circular array to secure two lumens of tissue together. The stapling assembly may further drive a blade to sever any excess tissue interior of the circular array of staples. The motor is operable to rotate the drive assembly to thereby translate the firing assembly. A resilient member biases the firing assembly proximally. Through cooperation between the firing assembly and the resilient member, the firing assembly is driven distally and proximally to complete a firing stroke in response to rotation of the drive assembly through a single revolution.

Abstract: A dissecting tip is provided for use with a surgical stapler or instrument. In one embodiment, the dissecting tip is secured to the end effector of the surgical instrument, e.g., to the cartridge assembly. The dissecting tip extends distally from the end effector and is configured to dissect or separate target tissue from certain tissue, e.g., adherent, connective, joined or other tissue.

Abstract: A surgical fastener applier having a handle and a fastener housing extending from the handle. The housing contains at least one anvil movable within the staple housing, the anvil has a proximal position and a distal position. When in the distal position a distal end of the anvil extends distal to the distal end of the staple housing. The housing contains a plurality of surgical fasteners each of which in the shape of a loop. At least one of the fasteners is placed around a portion of the anvil when in the distal position. The applier has a first mechanism for moving the anvil distally after a fastener has been deployed, and a second mechanism for moving the anvil distally after a fastener has been deployed. The second means is independent of the first means.

Abstract: A mechanical system for bilaterally securing skin tissue preferably utilizes a tissue manipulator apparatus to approximate a portion of an interior surface of each of two pieces of living dermis tissue along a vertical interface below an exterior surface without overlapping either interior surface across the vertical interface. An applicator apparatus includes a driving head portion positioned in the vertical interface and at least partially below the exterior surface and a handle portion positioned at least partially above the exterior surface. The applicator apparatus bilaterally drives at least one portion of the fastener through each piece of the living dermis tissue behind the interior surface of that piece of tissue such that the fastener is positioned below the exterior surface and a portion of the fastener is positioned generally transverse to the vertical interface.

Abstract: A surgical instrument includes an end effector, an actuator coupled to the end effector and actuating it, a handle coupled to the end effector and having an electric motor disposed therein actuating the actuator when supplied with power, and a post-termination braking circuit including a power supply switch at the handle. The switch has a break-before-make configuration, a power-supplying state in which power is supplied to the motor, and a power-removed state in which power is not supplied to the motor. The braking circuit short-circuits power to the motor when the switch is in the power-removed state. A method for post-termination braking of the motor utilizes the permanent magnetic field to counteract inertia-induced over-stroke of the motor, drive train, and/or actuation assembly after powered operation by short-circuiting the still-spinning motor to create an electrically generated magnetic field in opposition to the permanent magnetic field upon ceasing supply of power.

Abstract: An endoscopic stapler comprises a first jaw and a second jaw. The first jaw includes structure for retaining a plurality of staples. The first jaw and second jaw are mounted to permit pivotal movement of the first and second jaws relative to one another. The endoscopic stapler also comprises at least one clamp member for clamping tissue and pulling the tissue into a position between the first jaw and the second jaw to facilitate inserting at least one staple of the plurality of staples into the tissue. A first handle is operably coupled with the first jaw such that movement of the first handle effects delivery of the at least one staple of the plurality of staples to the tissue. A second handle is operably coupled with the second jaw and the at least one clamp member such that movement of the second handle effects movement of the second jaw and movement of the at least one clamp member.

Abstract: An occlusive device for occluding a target area can include an elongate member having opposing first and second side edges extending longitudinally along the member and a member width. The member can have a collapsed configuration in which the first and second side edges are curled toward each other about a longitudinal axis of the member. Further the member can have an expanded configuration in which the member form a series of loops and the first and second side edges uncurl to be spaced apart from each other.

Abstract: A method of fabrication of a medical balloon, and a balloon device useful for various medical balloon procedures, such as gastrointestinal, vascular, reproductive system, urinary system and pulmonary applications. At least two layers of a thermoplastic film are sealed at their peripheral edges and heat sealed at one or more locations inside an area enclosed by the sealed edges at predetermined locations, in one implementation of the balloon device. Such configuration enables the balloon to articulate to a desired shape upon inflation, with the desired shape being selected to accommodate a specific medical application.

Abstract: The present disclosure relates to systems and methods for preparing a distal end of a femur for receiving a knee prosthesis. A method can include installing a valgus guide onto an intermedullary rod, coupling a drill guide with said valgus guide, resting a boom tip of said drill guide on a high part of the femur, drilling a hole into a distal portion of a medial condyle using a first drill hole of said drill guide and drilling a hole into a distal portion of a lateral condyle using a second drill hole of said drill guide, and, subsequent to drilling the first and second drill holes, resecting the distal portion of the medial condyle of the femur and the distal portion of the lateral condyle of the femur. A system can include a valgus guide, a drill guide, and a resection tower, among other things.

Abstract: A method of performing an orthopedic procedure in a sacroiliac region. At least a portion of an undercutting system is inserted at least partially into an aperture in at least one of an ilium and a sacrum. The undercutting system includes an insertion apparatus, a probe assembly and a cutting assembly. The probe assembly is moved with respect to the insertion apparatus from a retracted position to an extended position so that at least a portion of the probe assembly is between the ilium and the sacrum. The probe assembly is manipulated between the ilium and the sacrum. The cutting assembly is moved with respect to the insertion apparatus from a refracted position to an extended position so that at least a portion of the probe assembly is between the ilium and the sacrum. The cutting assembly is manipulated between the ilium and the sacrum to cut tissue between the ilium and the sacrum.

Abstract: A surgical instrument includes a housing and an elongated shaft extending distally therefrom. The elongated shaft includes a proximal portion, a distal portion and a flexible portion supported therebetween. The flexible portion permits pivotal movement of the distal portion of the elongated shaft and an end effector supported thereon. A locking mechanism is operatively associated with the flexible portion of the elongated shaft to selectively impede pivotal motion of the distal portion. The locking mechanism includes a locking coil disposed about an axis defined by the flexible portion of the elongated shaft. A distal end of the locking coil is coupled to the distal portion of the elongated shaft, and a proximal end of the locking coil is rotatable about the longitudinal axis to laterally approximate the locking coil to flexible portion, and thus frictionally engage the flexible portion of the elongated shaft to selectively impede articulating motion thereof.