CN109394184A - Pulse wave conduction speed measuring device and method based on two-way pulse wave - Google Patents
Pulse wave conduction speed measuring device and method based on two-way pulse wave Download PDFInfo
- Publication number
- CN109394184A CN109394184A CN201811380281.2A CN201811380281A CN109394184A CN 109394184 A CN109394184 A CN 109394184A CN 201811380281 A CN201811380281 A CN 201811380281A CN 109394184 A CN109394184 A CN 109394184A
- Authority
- CN
- China
- Prior art keywords
- pulse wave
- wave sensor
- way
- measuring device
- conduction speed
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6813—Specially adapted to be attached to a specific body part
- A61B5/6825—Hand
- A61B5/6826—Finger
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Medical Informatics (AREA)
- Biophysics (AREA)
- Pathology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Physics & Mathematics (AREA)
- Molecular Biology (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Cardiology (AREA)
- Physiology (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
Abstract
The present invention proposes a kind of pulse wave conduction speed measuring device and method based on two-way pulse wave.The present apparatus includes flexible bundling belt, ranging telescopic rod, pulse wave sensor and data processing module.Ranging telescopic rod includes interior bar and outer bar with a scale, and tester adjusts the length of ranging telescopic rod so that whole equipment can be bundled on tester's third finger, and two groups of flexibility bundling belts are separately fixed at one end of interior bar and outer bar.Two groups of pulse wave sensors being fixed on flexible bundling belt measure the pulse wave signal on tester's third finger on first knuckle and second knuckle respectively, and are sent to data processing module.Data processing module amplifies data, be filtered after switch to be sent to smart machine by Type-c interface after digital signal.Smart machine calculates the delay time PTT of two-way pulse wave signal, calculates pulse wave conduction speed using the scale in apparatus of the present invention.
Description
Technical field
The present invention relates to technical field of medical equipment more particularly to a kind of pulse wave conduction speeds based on two-way pulse wave
Measuring device and method.
Background technique
Blood pressure is the important parameter for reacting Human Physiology information, has with human health status and closely contacts, therefore
Accurate, stable, convenient and fast blood pressure measurement device is needed in actual application.Traditional cuff type survey meter of blood pressure has many lack
Point, due to needing to be bundled on tester's arm several minutes, the inflation extruding of cuff can bring sense of discomfort to tester, test
Time is longer, and is unable to get continuous real time data.Currently, being had become using pulse wave conduction speed to calculate blood pressure
A kind of relatively common noninvasive continuous blood pressure monitoring method is avoided complicated test operation by such method, can use one
Convenient, small and exquisite equipment is planted to obtain the real-time blood pressure data of tester.
Currently, the method for measuring blood pressure using pulse wave velocity, that is, PWV or pulse wave translation time, that is, PTT is mainly advantageous
With electrocardiosignal mark pilot and single channel pulse wave calculate pulse wave velocity by obtain the method for blood pressure and using two-way pulse wave in terms of
The method for calculating pulse wave velocity PWV and pulse wave translation time PTT to obtain blood pressure.First method is due to needing to measure two kinds
Signal, synchronizes relatively difficult, and is easier to be interfered, therefore second method is now mostly used to calculate arteries and veins using two-way pulse wave
It fights wave velocity, and then obtains the blood pressure of tester by blood pressure model.
Entitled " a kind of noninvasive blood pressure measurement by shooting based on double pulse waves that domestic applications number are 201611123745.2
The patent application of device and measurement method " is measured using pulse wave sensor all the way in left chest upper left clavicle and second
Close to the pulse wave of the position of arm and the pulse wave of another way left index finger position between rib cage, pass through two-way pulse wave meter
Pulse wave translation time is calculated to estimate blood pressure.Its blood pressure computation model used has biggish difference due to the difference of tester
It is different, and need regularly to adjust model.Entitled " the pulse based on photoelectricity volume that domestic applications number are 201310148670.3
The patent application of the measuring device and method of wave velocity physiological parameter ", it is nameless using photoplethysmographic sensor measurement
Pulse wave velocity is obtained with the pulse wave of little finger, the blood vessel distance of two measurement points of manual measurement is needed in the invention equipment
Difference can generate biggish error due to the more difficult measurement of artery range difference between two different fingers.
Summary of the invention
In view of the above-mentioned deficiencies in the prior art, it is an object of the present invention to propose a kind of pulse wave biography based on two-way pulse wave
Velocity measuring device and method are led, including singly refers to fixed module, first via pulse wave sensor module, the second road pulse wave sensing
Device module and data processing module.First via pulse wave sensor and the second road pulse wave sensor are separately fixed at Dan Zhigu
On the flexible bundling belt of two of cover half block, it is connect by data line with data processing module, easy to use, measuring accuracy is high,
It can be connect with smart machine.
In order to achieve the above objectives, the present invention adopts the following technical solutions:
A kind of pulse wave conduction speed measuring device based on two-way pulse wave, it is characterised in that including singly referring to fixed module,
Pulse wave sensor, the second road pulse wave sensor and data processing module all the way, wherein described singly to refer to that fixed module connects
To fix its position, the data processing module receives first for first via pulse wave sensor and the second road pulse wave sensor
Road pulse wave sensor and the second road pulse wave sensor data, and send it in smart machine.
Described singly refers to that fixed module is made of two groups of flexibility bundling belts and ranging telescopic rod, two groups of flexibility bundling belt difference
It is fixed in the first and second finger joints of the single third finger.According to the difference of tester's finger length, two groups of flexibility bundling belts it
Between distance can be adjusted in the control range of ranging telescopic rod.First flexible bundling belt is fixed on nameless first and refers to
Section, Article 2 flexibility bundling belt are fixed on nameless second knuckle.
The first via pulse wave sensor module and the second road pulse wave sensor module is held using transmission type photoelectric
Product pulse wave sensor.It is made of an infrared emission end and an opto-electronic receiver end per sensor all the way.First via pulse
Wave sensor module and the second road pulse wave sensor are separately fixed on two flexible bundling belts, per transmitting terminal all the way and admittedly
Fixed end is fixed on the inside of flexible bundling belt.
First via pulse wave sensor and the second road pulse wave sensor can be passed through one by the data processing module
The mode of a interface is sent on smart machine, and the interface implemer is USB Type-c structure.Wherein first via arteries and veins
It fights two groups of differential signal interfaces connection of wave sensor Type-c interface, the second road pulse wave sensor and Type-c interface
The connection of VBUS1, VBUS2 interface ensure that equipment is synchronous and send two groups of pulse wave datas, and do not need to distinguish insertion smart machine
When it is positive and negative.
The smart machine is one of smart phone, smartwatch, tablet computer, laptop.
The invention also provides a kind of measurement methods using above-mentioned blood pressure measuring device, comprising the following steps:
Step 1: the flexible bundling belt for singly referring to fixed module being separately fixed at the first knuckle of tester's third finger and second and is referred to
Section.Its position is adjusted, so that the transmitting terminal of pulse wave sensor and receiving terminal is turned to nameless finger belly and refers to the position of back.Step
Rapid 2: the pulse wave at finger is acquired by first via pulse wave sensor module and the second road pulse wave sensor module synchronization
Signal.Constitute the two-way pulse wave signal for having fixed delay on single finger.
Step 3: being sent the collected original pulse wave data of two-way pulse wave sensor to using data transmission blocks
In smart machine, preliminary treatment is carried out to original pulse wave data by the software in smart machine, obtains two-way pulse wave wave
Shape anchor point obtains the pulse wave delay time on finger between two measurement points.
Step 4: using the distance between known two pulse wave sensors and pulse wave delay time PTT, according to public affairs
Formula obtains pulse wave conduction speed:
The present invention compared with prior art, has following obvious prominent substantive distinguishing features and significant technological progress:
(1) measurement that pulse wave velocity is completed on a finger may be implemented in the present invention, and equipment is small and exquisite convenient, avoids other
The pulse wave velocity equipment of type needs the inconvenience in human body different parts measurement pulse wave.
(2) when the delay of the invention using the pulse wave data of different location on single finger to calculate two-way pulse wave
Between, the measurement error between two measurement points is small, and actual blood vessel distance is more accurate.
(3) data transmission blocks of the invention use the interface mode of Type-c, and data transmission bauds faster, reduces two
Delay error between the pulse wave of road, and Type-c structure is more convenient to use, needs not distinguish between interface in use
Both forward and reverse directions, convenient for being connect in actual use with smart machine.
Detailed description of the invention
Accompanying drawing 1 is the structural representation of the present invention.
Attached drawing 2 is the numerical value display schematic diagram of graduated scale.
Attached drawing 3 is process for using figure of the invention.
Specific embodiment
The contents of the present invention are described in further detail below in conjunction with attached drawing and preferred embodiments.
1. embodiment one: a kind of pulse wave conduction speed measuring device based on two-way pulse wave, it is characterised in that including
Singly refer to fixed module 11, first via pulse wave sensor 5, the second road pulse wave sensor 6 and data processing module 8, wherein
It is described singly refer to fixed module connection first via pulse wave sensor 5 and the second road pulse wave sensor 6 its position to be fixed, institute
It states data processing module 8 and receives 6 data of first via pulse wave sensor 5 and the second road pulse wave sensor, and send it to
In smart machine 9.
Embodiment two: the present embodiment is basically the same as the first embodiment, and special feature is as follows:
Described singly refers to that fixed module 11 is made of two groups of flexibility bundling belts 4,7 and ranging telescopic rod 1, two groups of flexibility bundling belts 4,
7 are individually fixed in the both ends of ranging telescopic rod 10.The ranging telescopic rod 10 is socketed an outer bar 2 by interior bar 1 with a scale
Composition.10 minimum scale of ranging telescopic rod is 3 centimetres, and maximum length is 5 centimetres, the reality of two groups of flexibility bundling belts 4,7
Border distance manifests on the graduated scale of ranging telescopic rod 10.The first via pulse wave sensor 5 and the second road pulse wave
Sensor 6 uses identical transmission type photoelectric volume pulsation wave sensor.The first via pulse wave sensor 5 and the second tunnel
Pulse wave sensor 6 is separately fixed on the two groups of flexibility bundling belts 4,7 singly referred on fixed module 11.The data processing mould
The signal that block 8 can input first via pulse wave sensor 5 and the second road pulse wave sensor 6 after treatment, passes through one
Interface is sent on smart machine 9, and the interface implemer is USB Type-c structure.The smart machine 9 is intelligence
It can mobile phone or tablet computer or laptop.The interface implemer utilizes two groups of differential signals in Type-c interface
Port and SUBS1, the port SUBS2 ensure that no matter the synchronous of two groups of pulse wave datas can be achieved in positive anti-plug and send, do not need
Other chips.
Embodiment three: the structure of the pulse wave conduction speed measuring device based on two-way pulse wave is as shown in Figure 1, include interior
Bar 1, outer bar 2, data transmission line 3, flexible bundling belt 4 and 7, pulse wave sensor 5 and 6.The operating procedure used is as follows:
Step 1: when in use, tester first stretches the third finger, and device of the present invention is put on the third finger, adjustment
The length of ranging telescopic rod makes the distance between two groups of flexibility bundling belts be less than tester's third finger first knuckle and second knuckle
Between maximum length, two groups of flexibility bundling belts are bundled in respectively on the first knuckle and second knuckle of tester's third finger,
The tightness of two groups of flexibility bundling belts is adjusted, guarantees that device does not shake on tester's third finger and ranging telescopic rod is with quarter
The one side for spending ruler is parallel with finger back.
Step 2: finger is acquired by first via pulse wave sensor module and the second road pulse wave sensor module synchronization
The pulse wave signal at place.Two-way pulse wave sensor passes through infrared emission end and opto-electronic receiver end and obtains nameless upper first and refer to
The photoplethysmographic of section and second knuckle.Believe to the pulse wave of data transmission blocks transmission of analogue signal form receiving end
Number.
Step 3: data processing module receives what first via pulse wave sensor and the second road pulse wave sensor were sent
Pulse wave signal data are simulated, smart machine is sent to by Type-c interface after being pre-processed.Data processing module mass
Analog-to-digital conversion part, amplifier section, low-pass filtering part.After data processing module receives the data of pulse wave transmission, first
Analog-to-digital conversion is carried out, digital signal is amplified using amplifier section later, finally using low-pass filter part to two-way pulse
Wave signal is filtered, and is connect using Type-c interface with smart machine, is sent pretreated two-way pulse wave signal.
Step 4: utilizing smart machine, calculates by pretreated two-way pulse wave signal, obtains pulse wave
Waveform anchor point compares two-way pulse waveform anchor point and obtains pulse wave translation time.
Step 5: the distance between two sensors are obtained according to the scale on the ranging telescopic rod singly referred on fixed module
The pulse wave delay time PTT obtained using step 4 calculates pulse wave conduction speed using following formula:
(1)
The above are specific embodiments of the present invention, shown in the drawings is one of embodiments of the present invention.If this field
Technical staff under the inspiration of the present invention, on the basis of not departing from present inventive concept and structure, without creative design
Similar structural implementations and embodiment with the present invention out, all belong to the scope of protection of the present invention.
Claims (10)
1. a kind of pulse wave conduction speed measuring device based on two-way pulse wave, it is characterised in that including singly referring to fixed module
(11), first via pulse wave sensor (5), the second road pulse wave sensor (6) and data processing module (8), wherein described
Singly refer to fixed module connection first via pulse wave sensor (5) and the second road pulse wave sensor (6) its position to be fixed, institute
State data processing module (8) and receive first via pulse wave sensor (5) and second road pulse wave sensor (6) data, and by its
It is sent in smart machine (9).
2. as described in claim 1 based on the pulse wave conduction speed measuring device of two-way pulse wave, it is characterised in that: described
Singly refer to that fixed module (11) is made of two groups of flexibility bundling belts (4,7) and ranging telescopic rod (10), two groups of flexibility bundling belts (4,
7) both ends of ranging telescopic rod (10) are individually fixed in.
3. as claimed in claim 2 based on the pulse wave conduction speed measuring device of two-way pulse wave, it is characterised in that: described
Ranging telescopic rod (10) outer bar (2) be socketed by interior bar (1) with a scale form.
4. as claimed in claim 2 based on the pulse wave conduction speed measuring device of two-way pulse wave, it is characterised in that: described
Ranging telescopic rod (10) minimum scale be 3 centimetres, maximum length be 5 centimetres, the actual range of two groups of flexibility bundling belts (4,7)
It is manifested on the graduated scale of ranging telescopic rod (10).
5. as described in claim 1 based on the pulse wave conduction speed measuring device of two-way pulse wave, it is characterised in that: described
First via pulse wave sensor (5) and the second road pulse wave sensor (6) use identical transmission type photoelectric volume pulsation wave
Sensor.
6. as described in claim 1 based on the pulse wave conduction speed measuring device of two-way pulse wave, it is characterised in that: described
First via pulse wave sensor (5) and the second road pulse wave sensor (6) be separately fixed at and singly refer on fixed module (11)
On two groups of flexibility bundling belts (4,7).
7. as described in claim 1 based on the pulse wave conduction speed measuring device of two-way pulse wave, it is characterised in that: described
The signal that first via pulse wave sensor (5) and the second road pulse wave sensor (6) can be inputted of data processing module (8) pass through
It after crossing processing, is sent on smart machine (9) by an interface, the interface implemer is USB Type-c structure.
8. as claimed in claim 7 based on the pulse wave conduction speed measuring device of two-way pulse wave, it is characterised in that: described
Smart machine (9) be smart phone or tablet computer or laptop.
9. as claimed in claim 7 based on the pulse wave conduction speed measuring device of two-way pulse wave, it is characterised in that: described
Interface implemer using the two groups of differential signal ports and the port SUBS1, SUBS2 in Type-c interface, ensure that no matter
Positive anti-plug can be achieved the synchronous of two groups of pulse wave datas and send, and not need other chips.
10. pulse wave conduction speed measurement method as described in claim 1 is based on two-way using according to described in claim 1
The pulse wave conduction speed measuring device of pulse wave is operated, it is characterised in that: including following operating procedure:
Step 1: the two groups of flexibility bundling belts (4,7) for singly referring to fixed module (11) are separately fixed at nameless first of tester
In finger joint and second knuckle;
Step 2: passing through the arteries and veins at first via pulse wave sensor (5) and second road pulse wave sensor (6) synchronous acquisition finger
It fights wave signal;
Step 3: the data that data processing module (8) sends two-way pulse wave sensor (5,6) pre-process, and pass through USB
The transmission pulse waveform data of type-c interface synchronization;
Step 4: the pulse on finger between two measurement points being obtained according to pulse waveform anchor point using smart machine (9)
Wave conduction time PTT;
Step 5: according to the scale on the ranging telescopic rod (10) singly referred on fixed module (11) obtain two sensors (5,6) it
Between distance, the pulse wave delay time PTT obtained using step 4, use following formula calculate pulse wave conduction speed:
(1).
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN201811380281.2A CN109394184A (en) | 2018-11-20 | 2018-11-20 | Pulse wave conduction speed measuring device and method based on two-way pulse wave |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CN201811380281.2A CN109394184A (en) | 2018-11-20 | 2018-11-20 | Pulse wave conduction speed measuring device and method based on two-way pulse wave |
Publications (1)
Publication Number | Publication Date |
---|---|
CN109394184A true CN109394184A (en) | 2019-03-01 |
Family
ID=65474174
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN201811380281.2A Pending CN109394184A (en) | 2018-11-20 | 2018-11-20 | Pulse wave conduction speed measuring device and method based on two-way pulse wave |
Country Status (1)
Country | Link |
---|---|
CN (1) | CN109394184A (en) |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20080039731A1 (en) * | 2005-08-22 | 2008-02-14 | Massachusetts Institute Of Technology | Wearable Pulse Wave Velocity Blood Pressure Sensor and Methods of Calibration Thereof |
CN102688024A (en) * | 2012-04-24 | 2012-09-26 | 北京大学 | Blood pressure noninvasive measuring method |
CN106264504A (en) * | 2016-09-30 | 2017-01-04 | 西安邮电大学 | Noninvasive Blood Pressure Measurement System based on finger arteriogram and method |
CN106560155A (en) * | 2015-10-06 | 2017-04-12 | 三星电子株式会社 | Apparatus And Method For Measuring Bioinformation |
CN108720823A (en) * | 2018-07-06 | 2018-11-02 | 浙江大学山东工业技术研究院 | Wristwatch type blood pressure monitoring device and method based on pulse wave velocity method |
CN108742594A (en) * | 2018-06-23 | 2018-11-06 | 苏强 | A kind of wearable coronary heart disease detection device |
-
2018
- 2018-11-20 CN CN201811380281.2A patent/CN109394184A/en active Pending
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20080039731A1 (en) * | 2005-08-22 | 2008-02-14 | Massachusetts Institute Of Technology | Wearable Pulse Wave Velocity Blood Pressure Sensor and Methods of Calibration Thereof |
CN102688024A (en) * | 2012-04-24 | 2012-09-26 | 北京大学 | Blood pressure noninvasive measuring method |
CN106560155A (en) * | 2015-10-06 | 2017-04-12 | 三星电子株式会社 | Apparatus And Method For Measuring Bioinformation |
CN106264504A (en) * | 2016-09-30 | 2017-01-04 | 西安邮电大学 | Noninvasive Blood Pressure Measurement System based on finger arteriogram and method |
CN108742594A (en) * | 2018-06-23 | 2018-11-06 | 苏强 | A kind of wearable coronary heart disease detection device |
CN108720823A (en) * | 2018-07-06 | 2018-11-02 | 浙江大学山东工业技术研究院 | Wristwatch type blood pressure monitoring device and method based on pulse wave velocity method |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CN101773387B (en) | Body feeling network-based sleeveless driven pulse pressure measurement and automatic calibration device | |
CN103385702B (en) | A kind of non-invasive blood pressure continuous detection apparatus and method | |
CN103637787B (en) | The method of blood pressure real-time measurement apparatus and in real time measurement pulse wave transmission time difference | |
CN109512412B (en) | Central artery blood pressure measuring device | |
CN104873186A (en) | Wearable artery detection device and data processing method thereof | |
CN102008300A (en) | Wearable multiple physiological parameter recording device | |
SG191380A1 (en) | Body-worn system for continous, noninvasive measurement of cardiac output, stroke volume, cardiac power, and blood pressure | |
CN103637788B (en) | Blood pressure real-time measurement apparatus | |
CN204708828U (en) | A kind of wearable noinvasive arterial health checkout gear | |
CN102688024A (en) | Blood pressure noninvasive measuring method | |
CN106618504A (en) | High-accuracy continuous non-invasive blood pressure measuring device with self-adaptation calibration function | |
CN109793507A (en) | It is a kind of based on finger pressure oscillographic method without oversleeve blood pressure measuring device and measurement method | |
CN207627308U (en) | A kind of ambulatory blood pressure measuring device | |
CN107049270A (en) | System and method for measuring pulse wave translation time | |
CN112890790B (en) | Wearable noninvasive dynamic blood pressure tracking and monitoring method | |
CN110881967A (en) | Non-invasive multi-segment peripheral arterial vessel elastic function detection method and instrument thereof | |
CN107174225A (en) | A kind of arm belt blood vessel physiologic parameter monitoring device | |
CN107960998A (en) | Blood pressure measuring method and blood pressure measuring device | |
CN103637789B (en) | Blood pressure real-time measurement apparatus | |
CN110420014A (en) | The wearable cardiovascular function evaluation system and method intelligently decomposed based on pulse wave | |
CN106073735A (en) | A kind of integrated circuit structure for continuous detecting human blood-pressure | |
CN103393415A (en) | Method for measuring continuous changing blood pressure | |
CN109394184A (en) | Pulse wave conduction speed measuring device and method based on two-way pulse wave | |
CN105147293A (en) | System and method for measuring respiratory rate | |
CN210843009U (en) | Pulse wave conduction velocity measuring device based on double-path pulse waves |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
PB01 | Publication | ||
PB01 | Publication | ||
SE01 | Entry into force of request for substantive examination | ||
SE01 | Entry into force of request for substantive examination |