CN222676190U - A simulated weight-bearing device for assisting magnetic resonance imaging of lower limb joints - Google Patents

Abstract

The utility model relates to a simulated weight-bearing device for assisting magnetic resonance imaging of lower limb joints, which includes a head-shoulder fixation module, a foot-ankle fixation module and a sole force-applying module installed on a magnetic resonance examination bed; the head-shoulder fixation module includes a fixed base plate, a head-neck fixation component connected to the fixed base plate and a shoulder fixation component symmetrically installed on the fixed base plate; the foot-ankle fixation module includes a vertically arranged force transmission plate, and a side of the force transmission plate close to the head-shoulder fixation module is symmetrically installed with the foot-ankle fixation component; the sole force-applying module includes a mounting seat and a force-applying component on the mounting seat for driving the force transmission plate to move horizontally. Compared with the prior art, the simulated weight-bearing device of the utility model can directly simulate weight-bearing on the lower limb joints and maintain the stability of the upper limbs during magnetic resonance imaging of the lower limb joints, and also has the advantages of high flexibility, high comfort, and precise force application.

Description

Simulation load device for assisting lower limb joint magnetic resonance imaging

Technical Field

The utility model relates to the technical field of medical auxiliary instruments, in particular to a load simulating device for assisting lower limb joint magnetic resonance imaging.

Background

Radiological examinations have been widely used in clinic, especially with outstanding auxiliary diagnostic efficacy in lower limb joints, including digital radiography (Digital Radiography, DR), computed tomography (Computer Tomography, CT), magnetic resonance imaging (Magnetic Resonance Imaging, MRI), the soft tissue contrast of MRI being significantly better than DR and CT, especially for the observation of joint space, ligaments, cartilage, muscle and bone lesions.

Symptoms and signs of the lower limb joint non-tumor related diseases are aggravated when the lower limb joint is in a loading state, and the lying position is relieved. Clinically, there are varus and valgus of knee joint, flatfoot and arthritis, which cause abrasion of joint cartilage due to various reasons, and damage of balance structure of soft tissue and bone joint, thereby causing deformity and abnormal force lines of lower limb joint, causing serious pain, limited movement, fracture and other risks. Therefore, it is a key point to ensure the subsequent formulation of the treatment scheme to determine the degree of cartilage wear under the load state and the biological force line of the joint.

It has been reported that there are currently most advanced open MRI in the industry abroad that can image the spine and lower limb joints under weight bearing conditions of the human body. But is limited to the construction technology and cost of MRI equipment and various factors such as clinical practical application scene, at present, the traditional magnetic resonance imaging equipment, that is, the mode of combining an image acquisition system and an examining table is adopted in China for examining the patient in the supine position, and the disadvantage of the system is that the anatomical structure and functional state of bones, muscles and joints of lower limbs of the patient in the loading state can not be truly reflected. If the MRI photography can be carried out on the patient in the loading state or the simulated loading state, the method can be greatly helpful for the accurate diagnosis and treatment of the diseases related to the non-tumorous lower limb joints.

CN109171798a discloses a lower limb simulated load traction apparatus, the apparatus comprises a waistband, a shoulder strap, a weight scale, a steel cable winch, a plantar pressure plate and other devices, the apparatus can fix a human body through the waistband and the shoulder strap and apply traction force to the human body, the length of the traction steel cable is adjusted to apply load to the human body, and after the load reading of the plantar pressure plate is matched with the numerical value of a patient standing on the weight scale with the same specification, CT scanning is started. CN116725568a discloses a CT system with a load simulator, which comprises a CT inspection device, an inspection bed, various wrapping belts for body, a pressure sensor, a traction device, a control unit and other devices, and can automatically control and adjust the load applied to the patient and the position thereof according to the weight and posture of the patient, so that the patient can simulate the physiological load state of the joint when standing in a comfortable lying posture, thereby obtaining more accurate CT image data. CN219397311U discloses a horizontal low limbs heavy burden analogue means and CT system of taking photograph, and the device contains devices such as pedestal, pressurization platform, electronic scale, and it can bind the patient through safety belt and traction area, and the operation adds the pressurization of platform to patient's low limbs to can look over the simulation pressure directly perceivedly through the electronic scale numerical value, in order to satisfy specific heavy burden requirement. The three existing methods only refer to CT imaging, CT can scan the joints of lower limbs or the whole length of the lower limbs under the condition of simulating load, and related data is obtained through processing and analyzing images in the later period, but due to the influences of a plurality of factors such as poor soft tissue contrast, large radiation dose, convenience in operation, force application size, force application position accuracy and the like, the current clinic is still to carry out load position imaging and MRI on the joints of lower limbs or the whole length of the lower limbs for multi-purpose DR to observe anatomical structures.

CN216417165U discloses an MRI simulation load device, which simulates the pressurization of the shoulder and the subsequent adjustment of the shoulder pressurization force in the MRI scanning process by arranging a vertical plate, a limiting wheel, a sleeve, a supporting rod, a clamping plate, a moving plate, a screw rod and other devices. However, in the method, although the MRI imaging principle and the specificity thereof are considered, the device adopts MRI compatible materials, so that the influence of the device on the uniformity of the magnetic field is reduced, and the MRI lower limb joint photographing under the loading state is possible, but in the process of applying pressure to the shoulder, the force is lost in the transmission process, the force applied to the lower limb joint is not accurate enough, the upper limb and the head shoulder are not fixed, and the limb stability of a patient in the examination process is poor.

Therefore, a load simulator for directly applying force to the joints of the lower limbs has yet to be developed for assisting the magnetic resonance imaging of the joints of the lower limbs.

Disclosure of utility model

The utility model aims to provide a load simulator for assisting lower limb joint magnetic resonance imaging, which is used for directly simulating load on lower limb joints in magnetic resonance imaging and maintaining upper limb stability.

The aim of the utility model can be achieved by the following technical scheme:

The simulated load device for assisting the magnetic resonance imaging of the joints of the lower limbs comprises a head and shoulder fixing module, an ankle fixing module and a sole force application module which are arranged on a magnetic resonance examination bed;

the head and shoulder fixing module comprises a fixing bottom plate, a head and neck fixing assembly connected with the fixing bottom plate and shoulder fixing assemblies symmetrically arranged on the fixing bottom plate;

The ankle fixing module comprises a vertically arranged force transfer plate, and ankle fixing assemblies are symmetrically arranged on one surface of the force transfer plate, which is close to the head and shoulder fixing module;

the plantar force application module comprises a mounting seat and a force application assembly used for driving the force transmission plate to horizontally move on the mounting seat.

Further, the clamping groove is formed in the fixed bottom plate, and the shoulder fixing assemblies are all provided with buckles capable of sliding along the clamping groove.

Further, the inner side surfaces of the head and neck fixing assembly and the shoulder fixing assembly are cambered surfaces which adapt to the contours of the head and the shoulder respectively.

Further, the inner side surfaces of the head and neck fixing assembly and the shoulder fixing assembly are respectively provided with a sponge cushion so as to improve the comfort level during inspection.

Further, ankle fixing subassembly includes the footboard and the design sponge that stand in the footboard both sides of being connected with the biography power board and with the direct contact of sole, is connected with the bandage that is used for fixed ankle between the design sponge. The shaping sponge is high-density shaping sponge.

Further, the high-density shaping sponge is a polyurethane soft foam sponge with a density of 35-50 d. Wherein d represents the weight of the sponge per cubic meter, and 35d represents the weight of the sponge per cubic meter up to 35kg. The heavier the sponge weight per cubic meter, the greater the density of the sponge, and the better the support.

Further, the force transfer plate comprises a fixed vertical plate and movable vertical plates arranged at two ends of the fixed vertical plate in a sliding mode.

Further, the ankle fixing components are all arranged on the movable vertical plate, the back surfaces of the ankle fixing components are fixedly connected with rotating shafts penetrating through the movable vertical plate, and the parts, extending out of the movable vertical plate, of the rotating shafts are connected with locking components.

Further, the locking component comprises a ratchet gear fixedly sleeved on the rotating shaft and a locking claw arranged on the back of the movable vertical plate. When the rotating shaft rotates to a proper angle, the locking claw is meshed with a tooth groove of the ratchet gear to carry out locking fixation.

Further, the movable vertical plate is provided with angle scale marks corresponding to the rotation of the rotating shaft.

Further, the force application component is a nylon air cylinder and comprises a fixing part arranged on the mounting seat and a telescopic part connected with one surface of the force transmission plate, which is away from the head shoulder fixing module.

Further, the force application components are arranged at equal intervals, and the force application components are connected with the pressurizing components through the guide pipes.

Furthermore, the pressurizing component is an all-copper double-cylinder air compressor and is arranged in the equipment room.

Further, the pressurizing assemblies are all connected with the pressure control assembly.

Still further, the pressure control assembly includes a PLC controller, and a solenoid valve of the pressurizing assembly is controlled by the PLC controller to control a pressurizing process of the pressurizing assembly.

Compared with the prior art, the utility model has the following beneficial effects:

(1) The load simulating device can directly simulate the load of the joints of the lower limbs in the magnetic resonance imaging through the arrangement of the ankle fixing module and the plantar force applying module, and can stabilize the upper limbs of a patient through the arrangement of the head-shoulder fixing module so as to maintain the stability of the upper limbs of the patient during examination.

(2) The simulated load device can reflect the anatomical structure and the functional state of bones, muscles and joints of a patient in a load state as truly as possible when the patient adopts a supine position to perform magnetic resonance imaging examination, reduces the force loss in the pressure applying process, and can effectively improve the accuracy of lower limb joint magnetic resonance imaging.

(3) The shoulder fixing component and the ankle fixing component can be adjusted according to the body types of patients, so that the examination requirements of patients with different body types are met.

(4) The ankle securing assembly of the present utility model can adjust the pronation or valgus angle of the foot to meet patient comfort and related clinical needs.

(5) The inner side surfaces of the head and neck fixing assembly and the shoulder fixing assembly are cambered surfaces which are adaptive to the contours of the head and the shoulder respectively, and are provided with sponge cushions so as to improve the comfort level of patients during examination.

(6) The gas pressurizing assembly can enable the uniformity of the magnetic field to be more stable, and meanwhile, the applied pressure is more accurate by being matched with the pressure control assembly.

(7) The load simulator provided by the utility model takes the imaging principle and the specificity of MRI into consideration, and adopts MRI compatible materials, so that the influence of the device on the uniformity of a magnetic field is reduced.

Drawings

FIG. 1 is a schematic view of the overall structure of an MRI examination using the simulated weight bearing device of the present utility model.

Fig. 2 is a schematic structural view of the head-shoulder fixing module of the present utility model.

Fig. 3 is a schematic view showing the structure of an ankle fixing module according to embodiment 2 of the present utility model.

Fig. 4 is a schematic connection diagram of the ankle fixing module and the plantar force applying module according to embodiment 2 of the present utility model.

Fig. 5 is a schematic view showing the structure of an ankle fixing module according to embodiment 3 of the present utility model.

Fig. 6 is a schematic rear view of an ankle securing module according to embodiment 3 of the present utility model.

Fig. 7 is a schematic distribution diagram of force application components in embodiment 3 of the present utility model.

The figure indicates:

1-a magnetic resonance examination bed;

2-head and shoulder fixing modules, 21-fixing bottom plates, 211-clamping grooves, 22-head and neck fixing components and 23-shoulder fixing components;

The ankle fixing device comprises a 3-ankle fixing module, a 31-force transmission plate, a 311-fixing vertical plate, a 312-moving vertical plate, 313-angle scale marks, a 32-ankle fixing component, a 321-pedal, a 322-shaping sponge, 323-binding belts, 324-rotating shafts and 325-locking components;

4-plantar force application module, 41-mounting seat, 42-force application component, 421-fixed part, 422-telescopic part, 43-pressurizing component and 44-pressure control component.

Detailed Description

The utility model will now be described in detail with reference to the drawings and specific examples. The present embodiment is implemented on the premise of the technical scheme of the present utility model, and a detailed implementation manner and a specific operation process are given, but the protection scope of the present utility model is not limited to the following examples.

In the present utility model, it should be noted that the terms "center," "upper," "lower," "left," "right," "vertical," "horizontal," "inner," "outer," and the like refer to an orientation or a positional relationship based on that shown in the drawings, merely for convenience of description and to simplify the description, and do not indicate or imply that the apparatus or elements referred to must have a specific orientation, be configured and operated in a specific orientation, and thus should not be construed as limiting the utility model, the terms "first," "second," "third," are used for descriptive purposes only and should not be construed as indicating or implying relative importance, and furthermore, unless explicitly stated or defined otherwise, the terms "mounted," "connected," or "connected" should be construed broadly, for example, as being either fixedly connected, as being detachably connected, as being integrally connected, as being mechanically connected, as being electrically connected, as being directly connected, as being indirectly connected through intermediate media, as being in communication between two elements. The specific meaning of the above terms in the present utility model can be understood by those of ordinary skill in the art according to the specific circumstances.

It should be noted that like reference numerals and letters refer to like items in the following figures, and thus once an item is defined in one figure, no further definition or explanation thereof is necessary in the following figures.

Example 1:

A simulated weight bearing device for assisting lower limb joint magnetic resonance imaging, as shown in fig. 1, comprises a head and shoulder fixing module 2, an ankle fixing module 3 and a sole force application module 4 which are arranged on a magnetic resonance examination bed 1.

The head and shoulder fixation module 2 includes a fixation base plate 21, a head and neck fixation assembly 22, and a shoulder fixation assembly 23. The head and neck fixing assembly 22 is connected with the long side of the fixing base plate 21, and the shoulder fixing assemblies 23 are symmetrically arranged on the fixing base plate 21.

The ankle fixing module 3 comprises a vertically arranged force transmission plate 31, and ankle fixing assemblies 32 are symmetrically arranged on one surface of the force transmission plate 31, which is close to the head and shoulder fixing module 2, and are used for fixing the ankles of patients.

The plantar force application module 4 comprises a mounting seat 41 which is mounted on the magnetic resonance examination bed 1, and a force application assembly 42 for driving the force transmission plate 31 to horizontally move is mounted on the mounting seat 41.

When a patient performs magnetic resonance imaging of the lower limb joints, the patient needs to lie on the magnetic resonance examination table 1. The feet are placed in the ankle securing assembly 32, respectively, and the head and shoulder securing module 2 is adjusted so that the head and shoulders are in the head and neck securing assembly 22 and the shoulder securing assembly 23, respectively. The force application assembly 42 is activated to apply the desired simulated weight bearing pressure to the force transfer plate 31 based on the patient's weight such that horizontal movement of the force transfer plate 31 squeezes the ankle securing assembly 32 to simulate a standing weight bearing condition.

Example 2:

The utility model provides an auxiliary lower limb joint magnetic resonance imaging's simulation loading device, it includes head shoulder fixed module 2, ankle fixed module 3 and plantar force application module 4 that install on magnetic resonance examination bed 1.

As shown in fig. 2, the head and shoulder fixing module 2 includes a fixing base plate 21, a head and neck fixing assembly 22, and a shoulder fixing assembly 23. The head and neck fixing assembly 22 is connected with the long side of the fixing base plate 21, and the shoulder fixing assemblies 23 are symmetrically arranged on the fixing base plate 21. The clamping groove 211 is formed in the fixing bottom plate 21, and the shoulder fixing assemblies 23 are provided with buckles capable of sliding along the clamping groove 211, so that adjustment is performed according to different sizes of patients, and the stability of the upper limbs is improved better. The inner side surfaces of the head and neck fixing assembly 22 and the shoulder fixing assembly 23 are cambered surfaces which adapt to the contours of the head and the shoulder respectively, and the inner side surfaces of the head and neck fixing assembly 22 and the shoulder fixing assembly 23 are provided with sponge cushions so as to improve the comfort level of patients during examination. The head and shoulder fixing module 2 can be connected with the magnetic resonance examination bed 1 through fixing slots at the bottoms of the head and neck fixing assembly 22 and the shoulder fixing assembly 23 so as to improve the stability during magnetic resonance examination.

As shown in fig. 3, the ankle fixing module 3 includes a vertically arranged force transfer plate 31, and two ankle fixing assemblies 32 for fixing the foot of the patient under examination are symmetrically installed on one side of the force transfer plate 31 close to the head and shoulder fixing module 2. The ankle fixing unit 32 includes a pedal 321 in direct contact with the sole of the foot and a set sponge 322 standing on both sides of the pedal 321, and a strap 323 for fixing the ankle is connected between the set sponges 322. The shaping sponge selected in the embodiment is a high-density polyurethane soft foam sponge, in particular a 40d high-density polyurethane soft foam sponge, which has better comfort and supporting performance.

As shown in fig. 4, the plantar force application module 4 includes a mounting seat 41 fixedly mounted on the magnetic resonance examination table 1, and a force application assembly 42 for driving the force transmission plate 31 to move horizontally is mounted on the mounting seat 41. The force application component 42 of this embodiment is a nylon cylinder, a fixing portion 421 of the nylon cylinder is mounted on the mounting seat 41, and a telescopic portion 422 of the nylon cylinder is connected with one side of the force transmission plate 31, which is away from the head shoulder fixing module 2. The nylon air cylinders of the embodiment are arranged at equal intervals, and each nylon air cylinder is connected with a pressurizing assembly 43 in the equipment room through a guide pipe and used for driving the nylon air cylinder to apply force to the force transmission plate 31. The pressurizing assembly 43 of the present embodiment is an all-copper double-cylinder air compressor.

Example 3:

The present embodiment provides a simulated load device for assisting in magnetic resonance imaging of lower limb joints, which can adjust the distance between the ankle fixing components 32 according to the body shape of a patient, and can rotate the ankle fixing components 32 to adjust the internal rotation or the external rotation of the ankle of the patient so as to meet the related requirements of comfort and clinic of the patient.

As shown in fig. 5 to 7, the force transmitting plate 31 of the present embodiment is different from that of embodiment 2 in that it includes a fixed standing plate 311 and moving standing plates 312 slidably provided at both ends of the fixed standing plate 311. The ankle fixing components 32 are all disposed on the movable riser 312, the back surfaces of the ankle fixing components 32 are all fixedly connected with a rotating shaft 324 penetrating through the movable riser 312, and the part of the rotating shaft 324 extending out of the movable riser 312 is connected with a locking component 325. The locking assembly 325 includes a ratchet gear 3251 fixedly sleeved on the rotation shaft 324 and a locking claw 3252 provided on the rear surface of the moving riser 312. When the rotation shaft 324 is rotated to a proper angle, the locking claw 3252 is engaged with the tooth groove of the ratchet gear 3251 to perform locking fixation. The movable vertical plate 312 is provided with angle graduation marks 313 corresponding to the rotation of the rotating shaft 324, and the top of the pedal 321 of the ankle fixing assembly 32 is also connected with a conical indication arrow, so that the actual angle of the internal rotation or the external turning of the foot can be conveniently and quantitatively observed. The fixed vertical plate 311, the movable vertical plate 312, the rotating shaft 324 and the locking component 325 of this embodiment are all made of metal-free high-strength nylon plastic.

Example 4:

The embodiment provides a simulated load device for assisting lower limb joint magnetic resonance imaging and a specific application method thereof. The load simulator of the present embodiment includes a head-shoulder fixation module 2, an ankle fixation module 3, and a sole bias module 4 mounted on the magnetic resonance examination table 1, wherein the specific arrangement of the head-shoulder fixation module 2 is referred to in example 2, and the specific arrangement of the ankle fixation module 3 is referred to in example 3.

The plantar force application module 4 comprises a mounting seat 41 fixedly mounted on the magnetic resonance examination bed 1, a nylon air cylinder (force application component 42) for driving the force transmission plate 31 to horizontally move is mounted on the mounting seat 41, a fixing part 421 of the nylon air cylinder is mounted on the mounting seat 41, and a telescopic part 422 of the nylon air cylinder is connected with the force transmission plate 31.

In this embodiment, 6 nylon cylinders are provided, and two movable vertical plates 312 and two fixed vertical plates 311 are provided with one nylon cylinder up and down, so that the nylon cylinders are uniformly distributed, and meanwhile, the transmission of force is ensured to be uniform, and the thrust of the nylon cylinders is directly transmitted to the force transmission plate 31. Each nylon cylinder is connected with an all-copper double-cylinder air compressor (a pressurizing assembly 43) in the equipment room through a rubber conduit. The air compressor is connected to a pressure control assembly 44 with a PLC controller. The pressure control component 44 can control the electromagnetic valve of the air compressor, regulate and control the air inlet time and air inlet frequency of the compressed air of the air compressor, and convert the working pressure of the air cylinder into the thrust of the air cylinder according to the piston area and the working pressure of the air cylinder, thereby indirectly controlling the pressure and time applied by the force transmission plate 31 to the foot of the patient.

When the patient needs to perform lower limb joint magnetic resonance imaging, the specific examination steps are as follows:

1. The body weight was weighed and the amount of applied pressure was determined.

2. Lying on the magnetic resonance examination bed 1, placing feet in the ankle fixing components 32 respectively, binding the binding belts, adjusting the head and shoulder fixing modules 2 to enable the head and the shoulders to be respectively positioned in the head and neck fixing components 22 and the shoulder fixing components 23, and connecting the head and shoulder fixing modules 2 and the magnetic resonance examination bed 1 to the fixing slots to ensure the stability of the upper limbs.

3. The distance between the ankle securing members 32 is adjusted according to the patient's body size, and the ankle securing members 32 can be rotated to adjust pronation or eversion of the patient's foot to meet different examination needs.

4. The nylon cylinders are uniformly dispersed by adjusting the positions of the nylon cylinders, the air compressors in the equipment rooms are turned on, the air inlet time and the air inlet frequency of the compressed air are regulated and controlled through the pressure control assembly 44, the pressure applied by the nylon cylinders to the ankle fixing assembly 32 is controlled to be equivalent to the weight of the ankle fixing assembly, so that the real load condition under the standing condition is simulated, and then the magnetic resonance examination is carried out.

The previous description of the embodiments is provided to facilitate a person of ordinary skill in the art in order to make and use the present utility model. It will be apparent to those skilled in the art that various modifications can be readily made to these embodiments and the generic principles described herein may be applied to other embodiments without the use of the inventive faculty. Therefore, the present utility model is not limited to the above-described embodiments, and those skilled in the art, based on the present disclosure, should make improvements and modifications without departing from the scope of the present utility model.

Claims (7)

1. The simulated load device for assisting the magnetic resonance imaging of the joints of the lower limbs is characterized by comprising a head and shoulder fixing module (2), an ankle fixing module (3) and a sole force application module (4) which are arranged on a magnetic resonance examination bed (1);

the head and shoulder fixing module (2) comprises a fixing bottom plate (21), a head and neck fixing assembly (22) connected with the fixing bottom plate (21) and shoulder fixing assemblies (23) symmetrically arranged on the fixing bottom plate (21);

the ankle fixing module (3) comprises a vertically arranged force transmission plate (31), and ankle fixing assemblies (32) are symmetrically arranged on one surface of the force transmission plate (31) close to the head and shoulder fixing module (2);

The sole force application module (4) comprises a mounting seat (41) and a force application assembly (42) used for driving the force transmission plate (31) to horizontally move on the mounting seat (41).

2. The simulated weight bearing device for assisting in magnetic resonance imaging of joints of lower limbs according to claim 1, wherein the fixed bottom plate (21) is provided with a clamping groove (211), and the shoulder fixing assemblies (23) are provided with buckles capable of sliding along the clamping groove (211).

3. The simulated weight bearing device for assisting in magnetic resonance imaging of a lower limb joint according to claim 1, wherein the inner side surfaces of the head and neck fixing assembly (22) and the shoulder fixing assembly (23) are cambered surfaces which adapt to the contours of the head and the shoulder respectively;

The inner side surfaces of the head and neck fixing assembly (22) and the shoulder fixing assembly (23) are respectively provided with a sponge cushion.

4. The load simulator for assisting magnetic resonance imaging of lower limb joints according to claim 1, wherein the ankle fixing assembly (32) comprises a pedal (321) connected with the force transmission plate (31) and in direct contact with the sole of the foot, and shaping sponges (322) standing on two sides of the pedal (321), and binding bands (323) for fixing the ankle are connected between the shaping sponges (322).

5. The simulated weight bearing device for assisting in magnetic resonance imaging of a lower limb joint according to claim 1, wherein the force application assembly (42) is a nylon cylinder and comprises a fixing part (421) arranged on the mounting seat (41) and a telescopic part (422) connected with one surface of the force transmission plate (31) away from the head-shoulder fixing module (2).

6. The simulated weight device for assisting magnetic resonance imaging of a lower limb joint according to claim 5, wherein the force application components (42) are arranged at equal intervals, and the force application components (42) are connected with a pressurizing component (43) through a conduit.

7. A simulated weight device for assisting magnetic resonance imaging of a lower extremity joint in accordance with claim 6, wherein said pressurizing assemblies (43) are each connected to a pressure control assembly (44).