glass-epoxy resin diaphragm member with an overmolded silicone flexible acoustic surround which permitted increased excursion of the diaphragm member in a Z-axis with respect to the plane of the sound collecting area. The left shift to a lower resonant frequency increases the volume of some low frequency sounds due to the longer waves propagated by the increased excursion of the hard diaphragm member suspended in the concentric accountic surround. Conversely, restricting excursion of the diaphragm by pressing the stethoscope diaphragm surface firmly against the anatomical area overlying the physiological sounds of interest, the acoustic surround could also be used to dampen excursion of the diaphragm in response to "z"-axis pressure against a concentric fret. This raises the frequency bias by shortening the wavelength to auscultate a higher range of physiological sounds. In 1999, Richard Deslauriers patented the first external noise reducing stethoscope, the DRG Puretone. It featured two parallel lumens containing two steel coils which dissipated infiltrating noise as inaudible heat energy. The steel coil "insulation" added .30 lb to each stethoscope. In 2005, DRG's diagnostics division was acquired by TRIMLINE Medical Products. Current practice Stethoscopes are a symbol of healthcare professionals. Healthcare providers are often seen or depicted wearing a stethoscope around the neck. A 2012 research paper claimed that the stethoscope, when compared to other medical equipment, had the highest positive impact on the perceived trustworthiness of the practitioner seen with it. Prevailing opinions on the utility of the stethoscope in current clinical practice vary depending on the medical specialty. Studies have shown that auscultation skill (i.e., the ability to make a diagnosis based on what is heard through a stethoscope) has been in decline for some time, such that some medical educators are working to re-establish it. In general practice, traditional blood pressure measurement using a mechanical sphygmomanometer with inflatable cuff and stethoscope is gradually being replaced with automated blood pressure monitors. Types Acoustic Acoustic stethoscopes operate on the transmission of sound from the chest piece, via air-filled hollow tubes, to the listener's ears. The chestpiece usually consists of two sides that can be placed against the patient for sensing sound: a diaphragm (plastic disc) or bell (hollow cup). If the diaphragm is placed on the patient, body sounds vibrate the diaphragm, creating acoustic pressure waves which travel up the tubing to the listener's ears. If the bell is placed on the patient, the vibrations of the