Abstract: This invention can help a person in bed to avoid decubitus ulcers. This device has a flexible body support structure (such as a sheet or blanket) which is automatically moved from a first configuration which is flat to a second configuration which enfolds and/or wraps around a person's body. The device turns a person from lying on their first side to lying on their opposite side by: enfolding the person in the support structure; rotating or pivoting the support structure; and then releasing the person by unfolding the support structure.

Abstract: A robotic operating table according to one or more embodiments may include: a patient placement table; a robotic arm comprising a plurality of joints, and having a first end supported on a base and a second end supporting the table; a light emitter provided to the table; and an operation device including a move operation unit that receives, from a user, a move operation to move the table. In one or more embodiments, while the move operation unit is receiving the move operation to move the table, the light emitter may emit light.

Abstract: An adjustable bed includes a plank assembly, a support assembly, a frame and a power unit. The plank assembly includes a first waist plank and a second waist plank. The power unit is pivotally connected to the frame. The support assembly includes a waist-lifting unit that includes a first lifting element pivotally connected to a portion of the frame, a second lifting element pivotally connected to another portion of the frame, and a transmission unit operatively connected to the first and second lifting elements.

Abstract: A movable sanitary station for use with a hospital bed includes a cabinet with a front side, a back side, a right side, a left side, a bottom and a top. The back side of the cabinet has a concave shape forming a semi-cylindrical cavity having an axis extending laterally along the back side of the cabinet, permitting a mattress of the bed to protrude forward into the semi-cylindrical cavity. The top extends over the mattress of the bed to cover a gap between a foot of the mattress and the back side of the cabinet. The movable sanitary station also includes a set of wheels for supporting and moving the cabinet and a toilet seat integrated in a central portion of the top of the cabinet and surrounding a first aperture formed through the top of the cabinet.

Abstract: A gas turbine engine rotor includes a hub having a slot. A blade includes a root received in the slot. An under-root area is provided between the root and the fan hub in the slot. A spacer includes first and second portions that cooperate with one another to provide an adjustment feature with discrete height settings. The adjustment feature provides different radial heights of the spacer. The spacer is arranged in the under-root area beneath the root.

Abstract: The present invention is a portable device for administering spinal decompression therapy. The device features a compact size and an innovative tension control mechanism to facilitate, in particular, a therapy for imbibition. The use of fabric for a sling and a platform adds comfort features while reducing weight.

Abstract: A transformable bed for examinations in pediatric ophthalmology, especially suitable for the use of general anesthesia when conducting eye examinations, is provided. The bed may include a fixed bed board, a movable bed board, a movable seat, a movable support, a securing strap, and a main frame. The bed may be fixedly connected to the top of the main frame, the movable bed board may be rotationally connected to the top of the main frame, and the movable seat may be rotationally connected to the top of the main frame. The securing strap may be disposed on the movable bed board, in which one end of the movable support may be removably connected to the movable bed board, and another end may be removably connected to the main frame. The transformable bed may function both as an anesthesia bed and a handcart, and may be quickly switched therebetween.

Abstract: An articulating bed incorporating a frame having side frame members and a rigid cross frame member extending between the side frame members employs a flexible support member secured to the rigid cross frame member. Support arms engage an upper body portion of the flexible support member with lubricious support and are rotatable through a range of motion from an aligned position with the side frame members to a fully elevated position angularly supporting the upper body portion in a raised position. A leg portion adjustment member engages the flexible support member at a knee position intermediate a thigh portion and a leg portion of the flexible support member. The leg portion adjustment member is rotatable through a range of motion from an aligned position with the side frame members to a fully elevated position placing the knee position at an elevated location with angular positioning of the thigh portion and leg portion.

Abstract: A new and useful portable pelvic exam device is provided, which is lightweight for convenient transport or storage, and is readily used atop existing surfaces in the environment such as a bed and maintains a patient in a dorsal or modified lithotic position for a pelvic examination or procedure. The device comprises a substantially wedge shaped prismatic base with a concave semispherical well along the front surface, over which a patient orients her vulva to create a theatre in which the examiner may observe the anatomy, operate ancillary tools and perform an indicated procedure or exam. Stirrup assemblies may be utilized in concert with the device to support the patient's feet and keep her knees spaced apart from each other and legs in an abducted position. Additionally, the device has a drawer moveably attached into an aperature in the device, which can be opened or closed and houses therein ancillary tools.

Abstract: A bed for nursing care comprises a mat unit including a hip receiving portion for supporting a hip portion of a care-dependent person, an upper half body receiving portion for supporting an upper half body portion that is upper than the hip portion, and a lower half body portion for supporting a lower half body portion that is lower than the hip portion; a bed frame unit for supporting the mat unit; and a toilet unit moveable to an opening portion formed when the hip receiving portion is stored in a lower portion. The lower half body portion comprises a thigh receiving portion that supports thigh portions of the care-dependent person, wherein the thigh portion is lifted with rising of the thigh receiving portions.

Abstract: Methods and devices are provided for maintaining a patient in a position in which the patient's torso can be moved during surgery, for example by which the sternum can be closed after open chest surgery. The device has two contact members for contacting a respective scapula and support structures for maintaining the contact members in a grip position. In use, each contact member imparts a force on the respective scapula to close the patient's sternum.

Abstract: A disposable gel pad for cushioning the plate of an operating table's patient support apparatus is a block of gel with one face of the block adapted to locate the pad on the plate. Usually the pad will be enclosed in a film envelope. A pocket in the envelope allows the pad to engage the plate. Stick on patches which provide a pocket and sacroiliac pads axe variants. Sacroiliac pads can be cast with a soft gel front for patient contact joined to a hard gel rear for screw or bayonet fixing to the patient support apparatus.

Abstract: A system to cause instability for a person supported by a person support surface is disclosed. The system is configured to cause the person supported by the person support surface to compensate for the instability caused by the system in order to exercise their core or trunk region.

Abstract: A hospital bed with conveyor mattress that includes a loop mattress disposed overlying and attached to a conveyor belt disposed in operational communication with a plurality of transverse rollers horizontally disposed within a mattress frame, wherein the loop mattress is moveable in each of a first direction and a second direction and a plurality of hydraulic jacks enable inclinations of specific sections of the mattress relative each other to comfortably position a patient disposed upon the bed, as desired, and extant electronics and medical accoutrements are supportable, powerable, and securable proximal a patient disposed in the bed, whereby a patient is moveable upon the mattress at the press of a button and able to control peripheral electronics while in bed.

Abstract: An articulating bed incorporates a support frame having an upper body support section. A lumbar actuation lever extends from a rotatable torque tube with angle arms extending from the torque tube to a lumbar support element. The lumbar support element is retracted against the upper body support section creating minimal deflection in a lumbar region of a mattress. The torque tube is rotated with to elevate the lumbar support element. A head support bracket is mounted to a neck angle adjustment section. The neck angle adjustment section is aligned with the upper body support section. or rotated about hinge elements to provide an angled head and neck position with respect to the upper body support section.

Abstract: An apparatus for moving a limb of a bedridden person having a pulley secured above said bedridden person, a cable supported and arranged for movement about the pulley, and a substantially “T” shaped member consisting of a first longitudinally arranged member having a first end and a second end, where the first end is removably secured to the cable, and a second laterally arranged member secured transversely to the second end of the first member, where the first longitudinally arranged member is arranged perpendicularly to the second laterally arranged member.

Abstract: A hospital bed includes a base, an upper frame supported above the base, and a deck supported on the upper frame. The deck has head, seat, thigh, and foot sections. The deck is movable between a horizontal position to support a patient in a supine position and a chair egress position to support the patient in a sitting position. The hospital bed further has a seat section actuator to articulate the seat section relative to the upper frame about an axis located adjacent a foot end of the seat section such that a head end of the seat section lifts upwardly relative to the upper frame to facilitate egress of the patient from the deck when the deck is in the chair egress position.

Abstract: A bed and chair with commode for a patient is disclosed. The bed and chair with commode includes a rectangular main frame, which stands on at least four legs, four frames fitted on the main frame, patient's body over it when patient is lifted up off the bed, side guards being fixed on both sides of main frame for supporting the straps or nets over it and for avoiding the patient from falling down a lifting means for lifting the body of patient over the straps or nets, and a commode pan or pot being fitted under the middle frame with the help of hinge and linkage arrangement. The sliding back of the bed moves upwards and downwards by a mechanism when the back support frame is raised to chair position or lowered to bed position.

Abstract: An apparatus and method for preventing decubitus ulcerations including a frame having a pair of frame supports spaced from each other. A mattress is supported on the frame between the frame supports. A pliable support material extends between the supports. The material is adapted to support an individual thereon in a generally recumbent position. A lift mechanism is disposed on the frame and operably connected to the support material. The lift mechanism adjusts the tension of the material so that the support has a first position resting on the mattress and a second position wherein the support is raised above the mattress.

Abstract: A motorized bed includes a bed body and a driving device. The bed body includes a base frame, a fixed frame, and a movable frame. The driving device includes a drive unit mounted on the fixed frame, a guide tube mounted on the drive unit, a threaded rod mounted in the guide tube, an extension tube mounted in the guide tube and having a first end provided with a push portion and a second end connected with the movable frame, and a threaded mover moved by the threaded rod and movable to abut the push portion. Thus, when a human body is disposed between the movable frame and the base frame, the human body only needs to overcome the weight of the movable frame to detach the extension tube from the mover, so that the movable frame stops moving immediately.

Abstract: A health mat (2) and a health bed (10) with the health mat (2) are provided. The health mat (2) includes a fixed bar unit (3), a movable bar unit (4) that can move relatively to the fixed bar unit (3), and a mat body unit (5) that is on the movable bar unit (4) and can move with it. The reciprocation of the movable bar unit (4) makes the mat body unit (5) move and makes the mat body unit (5) do reciprocative movement.

Abstract: A mattress for use on a bed frame has a lower body section 42 and a upper body section 40. The mattress upper body section is orientation adjustable in as a function of the orientation of the upper body section of the frame upon which the mattress rests. At least part 60 of the mattress lower body section is profile adjustable as a function of the orientation of the mattress upper body section without being dependent on profile adjustment of the lower body section of the frame. A mattress replacement system includes a mattress having an orientation adjustable upper body section and a lower body section. The mattress replacement system also includes an angular orientation sensor 58 for determining the orientation of the upper body section. At least part 60 of the mattress lower body section is profile adjustable in response to the determined orientation of the mattress upper body section.

Abstract: A body support is provided utilizing a cushion formed in rectangular segments in which the segments alternately pivot to change pressure points on the surface of the user's skin. The body support can be used as a wheelchair seat cushion to prevent non-ambulatory patients from developing bedsores and other ailments. Electrical circuitry provided includes a timer to adjust the length of time between activation cycles thereby changing the pressure points at desired intervals.

Abstract: An operating table includes a base, a support post standing on the base, and a bed. The bed has a head section, a back section, a hip section and a foot section. The back section and the foot section respectively connect with ends of the hip section through pivot joints and are pivotable relative to the hip section upward and downward. The foot section has a rear section and a front section connecting with each other, and is pivotable either upward to an angle of less than 135 degree with respect to the hip section. The rear section is detachable separately, and an angle of the front section with respect to the hip section is adjustable via a pivot joint. The foot section can be shortened to support downward weight of the patient reliably. Moreover, a surgeon can adjust angles between the patient's legs and hip easily during the operation.

Abstract: Stimulation actuators that exert any desired movements on the underspringing arrangement. The underspringing arrangement has lifting members (11) that are mounted elastically by means of elastic elements (14). The elastic elements (14) are arranged such that at least a main direction of work extends at an angle with respect to the direction of the movement of the lifting member. In this way, the lifting member (11) can have a particularly low overall height. The supporting surface of the underspringing arrangement can be moved up and down by the lifting member (11) and the elastic element (14), thereby permitting an individual stimulation and movement of a person lying on the mattress.

Abstract: A system and procedure for preventing and enhancing healing of Decubiti ulcers on patients, comprising the steps of placing the patient on a web adapted to support the patient, the web having a patient contacting portion and a non-patient contacting portion, the web having an opening through the web, positioned so that the opening surrounds the ulcer and prevents contact of the web with the ulcer, and using a web support system adapted to support the web by attachment only to the non-patient contacting portion, to solely support the web with a patient on it. The procedure may also include a step wherein a rocking device is used that acts through the web support system to selectively tilt the web and thereby to tilt the patient on the patient contact portion of the web, so that the pressure between the patient and the web is cyclically altered.

Abstract: An adjustable bed comprises a patient support surface supported by a patient support framework that adjusts vertices along the perimeter of the patient support surface. Through adjustments that raise and contract the perimeter of the patient support surface on either side of the lower torso and/or hip-area of the patient, the framework is operable to cradle a patient's waist and hips. This mechanism not only distributes the patient's weight across a larger surface area, reducing the need for lateral rotation, but also helps to maintain a patient in place when the patient is rotated from side to side.

Abstract: An examination table for use in the medical field comprising integral adjustment mechanisms for raising, lowering, and tilting a head cushion portion, is herein disclosed. The adjustment mechanisms further comprise an internal hydraulic moving means. The height adjustment mechanism would allow the tabletop to vary in height from approximately eighteen (18) to thirty-six (36) inches. In this manner, the table would allow a patient to simply sit down and then be elevated to a suitable height for a doctor or other medical personnel to perform needed medical procedures. Such a feature is envisioned as being invaluable to those who are handicapped, elderly, or small in stature.

Abstract: A breast-board system, components and methods of use therefore. A generally U-shaped wrist support with a flattened bottom and rounded post like tops that may be used as either a cupping-support or as a grasping-post is mounted on a post atop a tiltable breast-board. A second support having a generally U-shaped cross section mounted on a supporting framework extends from a base, which is rotatably mounted to the tiltable breast-board near the edge thereof. The base includes a portion extending over the edge of the breast-board, and, a slidable locking mechanism on the bottom surface, which may be retracted to slide the mechanism out of a recess located on the breast-board. The support may then be rotated to a desired position and the slidable locking mechanism actuated to engage with a desired recess on the breast-board.

Abstract: An adjustable bed comprises a patient support structure supporting a patient support surface that comprises separately adjustable torso and hip support structures. Lifting mechanisms are provided to elevate the torso and hip support structures to substantially reduce pressure on the sacral area of a patient resting on the patient support surface.

Abstract: The present invention relates generally to a device and method for providing a lateralization effect such as in a medical procedure. The lateralization device can have a supporting member, which can be adapted to be supported in a fixed position. A lateralization member can be provided to at least partially wrap around the supporting member and be mounted thereto to provide a lateralization effect. The lateralization member can be formed and/or adjusted to provide a variable lateralization. For example, the lateralization member can comprise a cylindrical member with an eccentric cut-out portion adapted to fit over the supporting member. The inter wall of the cut-out portion and the outer wall of the supporting member can be formed with interference fittings so that the lateralization member can rotate in relation to the supporting member to provide a variable lateralization.

Abstract: It is depicted a rotating therapeutic bed which comprises: a structural base including in turn wheels located on its lower portion to allow moving the bed from one place to another; a first removable stretcher with a first mattress to support the patient laying on his back; a second removable stretcher with a second mattress being placed in a reversed fashion and over the first stretcher and the patient, who is supported between the mattresses of both stretchers; the second stretcher supporting the patient laying face down when stretchers are rotated by 180° on a rotation axis crossing along the patient; front and rear stretcher mounting and rotation members rotationally mounted on the structural base; the first and second stretchers being longitudinally mounted with a vertical spacing between them in such stretcher mounting and rotation means, which allow also their rotation; and side barriers coupled to the longitudinal sides of the first stretcher, as well as of the second stretcher, such barriers covering

Abstract: A system for transferring medical patients utilizes the concept of creating a “hollow space” between the patient and the surface on which he or she is supported. A patient support material mounted to a rigid frame positioned about a bed or other hospital furniture can have slots or openings extending laterally inward from at least one side of the patient support material and oriented substantially perpendicular to a line running from the head of the bed to the foot of the bed. The slots allow respective tines of a transport device, or straps from a patient transfer chair or device, to be inserted beneath a patient lying on the patient support material such that the tines or straps (or other elongated patient support/transfer components) can be lifted above through the slots and thus transfer the patient from the patient support material to the tines or straps of the patient transfer/transport device.

Abstract: A lying surface for a bed, especially for a healthcare and/or hospital bed, comprises support elements (22) and at least one electro-mechanic lifting unit (20) for lifting and lowering one of the support elements (22) relative to a bearing element (62) of the support element (22). The at least one lifting unit (20) comprises a housing (24) with an electromotor (32) having a drive shaft (34), a transmission (38) and a lifting member (50) supported at the bearing element (62) of said one support element (22). The lifting member (50) is adapted to be rotated by the transmission (38) and to be moved both up and down during a rotary movement of 360°.

Abstract: A support base for a bed mattress having at least two planar portions with at least one rotatable planar portion able to rotate relative an adjacent planar portion with a planar flexible continuous mattress able to extend over both the rotatable planar portion and the adjacent planar portion, and the support base further including an adjustable support means at least partially mounted on the rotatable planar portion and selectively able to adjust a portion of the mattress resting on the rotatable planar portion out of the plane of extension of the adjacent remainder of the mattress wherein the support base allows for adjustment from a continuous linear formation to a backrest formation with the adjustable support means providing localized support.

Abstract: Disclosed is a device that attaches to a standard bed and prevents or treats bedsores by using electro-mechanical means to rotate a person from side to side in a bed without human assistance. In one embodiment, a controller that is attached to at least one linear actuator and at least one electric motor is used to rotate a person in bed at regular intervals without human assistance and without disturbing any medical equipment to which the person may be attached.

Abstract: A therapeutic method and apparatus intended for enhancing blood circulation, and lymph and neural fluid flow throughout a person's body. The person is placed supinely on a longitudinally pivoting support member or bed operated by a motor driven drive mechanism. In addition, an overhead pulley mounted towline is attached to the bed and affixed to the person's hands such that his or her upper extremities move in opposition to the upper end of the bed. The bed tilts cyclically like a seesaw to alternatively raise the person's upper torso and head above the upper and lower extremities, and vice-versa.

Abstract: A therapeutic treatment table includes a frame and a table section for supporting at least a portion of the body of a patient. The table section includes a body support and a drop mechanism that is mounted between the frame and the body support and adapted to drop the body support from an upper position to a lower position. A fluid actuator is mounted between the frame and the body support and adapted to raise the body support from the lower position to the upper position, and a mechanism is provided for controlling the flow of fluid to the fluid actuator in order to control the rate by which the fluid actuator raises the body support from the lower position to the upper position.

Abstract: A nursing bed is provided that has a height adjustable base, in which a rotary hinge is attached in a substantially countersunk arrangement. The rotary hinge connects the base to an intermediate frame on which the actual reclining frame is installed. In this way, a bed framework is obtained, which, after subtracting the height of support feet, has a very small structural height, so that in the lowest position, the distance from top edge of the mattress from the floor corresponds to the length of a lower leg, while simultaneously there is still space underneath the base.

Abstract: The present invention provides a patient support apparatus for use during a medical procedure. The patient support apparatus is configured to receive and support a body of a patient on a base member. The base member includes a top surface having a plurality of adjustable members, wherein each of the adjustable members is configured to support a different portion the body of the patient. A plurality of actuation mechanisms are operably connected to both the base member and one each of the plurality of adjustable members, such that each of the plurality of adjustable members is separately, selectively positionable with respect to the base member. A control device operably connected to the actuation mechanism to selectively control the position of each of the adjustable members and the corresponding body portions.

Abstract: A rotating bed is provided that has a base with a mattress frame supported for rotation about a vertical axis. The mattress frame is divided into sections and can be converted into a chair-like configuration in one rotational position. In order to increase the stability of the arrangement in the chair position, at least one support leg is provided that either contacts the floor from the beginning or only makes contact with the floor when the stability limit without the support leg is exceeded.

Abstract: The invention relates to a patient bed having a frame (1) for supporting a mattress (3). To enable the insertion of an X-ray detector (9), it is proposed in accordance with the invention that a tensioning device (5a, 5b) is provided to secure a fabric-like carrier means (4) resting on a mattress (3) and a lifting device (6) is provided for lifting a patient (8) accommodated on the taut carrier means (4) from the mattress (3), so that an X-ray detector (9) can be inserted in a gap (10) formed between the lifted carrier means (4) and the mattress (3).

Abstract: An operating table including a patient support; a block for supporting a patient's lower back which is moveable in relation to the patient support between a retracted position and a deployed position; an actuator having a first end portion linked to the patient support; and at least one mechanism for adjusting the block between the retracted and deployed positions including a first connecting rod articulatable relative to the patient support, the connecting rod being connected to a second end portion of the actuator for angular displacement and to the block for displacement of the block between the retracted position and the deployed position, and wherein the adjustment mechanism essentially rectilinear displaces the block between the retracted position and the deployed position.

Abstract: An adjustable position shoulder arthroscopy chair for surgical operating tables consisting of a back supporting platform pivotally attachable to the end of the table and an externally powered position actuator mounted at the base of the platform nearest the table and pivotally mounted to the platform at a location spaced apart from the base. The actuator is extendable and retractable and may be powered either electrically, hydraulically, or by compressed air. The extension and retraction of the actuator is controlled by a suitable device within the actuator or remote from it.

Abstract: An operating table including a patient support; a block for supporting a patient's lower back which is moveable in relation to the patient support between a retracted position and a deployed position; an actuator having a first end portion linked to the patient support; and at least one mechanism for adjusting the block between the retracted and deployed positions including a first connecting rod articulatable relative to the patient support, the connecting rod being connected to a second end portion of the actuator for angular displacement and to the block for displacement of the block between the retracted position and the deployed position, and wherein the adjustment mechanism essentially rectilinear displaces the block between the retracted position and the deployed position.

Abstract: A bed assembly (1) for altering the position of a person supported thereon, includes a longitudinal support frame (5) having a support surface (23) for a person and a longitudinal cradle means (4) extending over the support surface. The cradle has a recess (10) extending along side portions of the cradle in the longitudinal direction. The recesses are adapted to receive and engage cradle support engaging means (7, 7a). These means are mounted to the support frame in close relation to the recess and adapted to be extendable and retractable in engaging relation within said recess so as to promote a change in configuration of the cradle. A first actuator (3) is disposed beneath the support frame and coupled to the engaging means for extending or retracting the engaging means. In a first condition the actuator causes the engaging means to extend towards and be received by the recess, causing the cradle means to move between a position of rest and a concave configuration about the central longitudinal axis.

Abstract: The invention refers to a bed with a mattress pad supported in a three-dimensionally movable manner and a bedstead with legs, which supports the mattress. The mattress pad is in springy or not springy, but yielding manner attached to the bedstead. Sensors are arranged spaced across the surface of the mattress pad, to detect the local lowering of the mattress pad during loading; and lifting means reacting to the local lowering also arranged spaced across the surface of the mattress pad between the mattress pad and the bedstead, to align the mattress pad in the horizontal disregarding the locally different loading. The sensors and the lifting means are formed as double-acting pressure cylinders, which are connected in cross-wise manner with regard to each other.

Abstract: A mattress support, in particular a bed lath grid with a neck support that can be raised with respect to an adjustable backrest has an adjustment mechanism that can be produced easily and economically and that ensures a direct support on the backrest. This is achieved with an adjustment mechanism which has an adjustment lever that is pivotally positioned on a rotational axis. The adjustment lever has a guidance arc that is guided in a restricted guidance fixed on a longitudinal or a transverse beam and a lever arm which is supported on the neck support, so that the adjustment lever can be pivoted around the rotational axis by guiding the guidance arc in the restricted guidance when raising the backrest, and so that the neck support, which moves together with the backrest through the use of the lever arm, can be raised.

Abstract: The present invention is directed to a pivotal operating room table having a main surface and an elongated support member. The main surface preferably lies generally in a first plane and is pivotal end to end such that the first plane can pass through a second generally vertical plane as the main surface pivots to end to end. A second plane is generally perpendicular to the first plane. The elongated support member is adjustably interconnected with the operating room table, and provides a support surface lying generally in a third plane which is generally perpendicular to the second plane when the elongated support member is interconnected with the table. In preferred embodiments the elongated support member is adjustably interconnectable with the table at any of a plurality of heights above the main surface and it further includes an elongated support bar and an inflatable bladder resting above the elongated support bar.

Abstract: A sickbed, comprising: a base frame; a main bed frame, having several tilting sections that are movable for having the patient sit up; a movable bed frame for lifting the body of the patient above the main bed frame, so as to relieve pressure from the main bed frame and to prevent bedsore; a left turning bed frame and a right turning bed frame for turning the body of the patient; a first link rod group, driving the tilting sections; a second link rod group, driving the movable bed frame; a power device, having a driving shaft, driving intermittent independent movements of the first and second link rod groups; a turning system driving the left and right turning bed frames; and a shaking device, generating an oscillatory movement of the left and right turning bed frames for massaging the patient.