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I
SS
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2252
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8806
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ti
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In
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Me
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O
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r
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[
1
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.
On
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ca
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Me
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2
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r
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9
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8
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0
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p
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elate
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[
2
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.
T
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k
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[
3
]
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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I
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8806
Th
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E
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MR
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r
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Un
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u
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s
[
6
]
.
On
e
ef
f
o
r
t
f
o
r
in
cr
ea
s
i
n
g
s
itu
at
io
n
a
w
ar
e
n
ess
i
s
b
y
u
s
in
g
t
h
e
A
u
d
it
Gu
id
elin
es
th
at
ca
n
b
e
u
s
ed
an
d
i
m
p
le
m
en
ted
b
y
n
u
r
s
e
s
.
T
h
e
Au
d
it
Gu
id
eli
n
es
o
f
co
n
tr
o
l
an
d
p
r
e
v
en
t
io
n
o
f
MRS
A
in
f
ec
tio
n
s
in
h
o
s
p
ital,
w
as
w
r
itte
n
in
th
e
f
o
r
m
o
f
d
ir
ec
tiv
e
d
is
co
u
r
s
e
(
DD)
[
7
]
.
T
h
e
r
esear
ch
o
b
j
ec
tiv
e
w
a
s
t
o
an
al
y
s
t
h
e
e
f
f
ec
ti
v
e
n
es
s
t
h
e
Gu
id
eli
n
e
o
f
Au
d
it
i
n
t
h
e
c
o
n
tr
o
l
an
d
p
r
ev
en
tio
n
o
f
MR
S
A
i
n
f
ec
tio
n
s
w
ith
d
ir
ec
tive
d
is
co
u
r
s
e
i
n
i
m
p
r
o
v
in
g
t
h
e
s
it
u
atio
n
a
w
ar
en
ess
o
f
t
h
e
n
u
r
s
e
s
in
h
o
s
p
itals
.
2.
RE
S
E
ARCH
M
E
T
H
O
D
T
h
e
r
esear
ch
w
as
co
n
d
u
cted
i
n
t
w
o
p
h
a
s
es,
t
h
e
f
ir
s
t
p
h
a
s
e
i
s
to
d
esi
g
n
an
d
d
ev
e
lo
p
A
u
d
it
G
u
id
eli
n
es
f
o
r
th
e
co
n
tr
o
l
an
d
p
r
ev
en
tio
n
o
f
MRS
A
i
n
f
ec
tio
n
s
w
i
th
t
h
e
d
ir
ec
tiv
e
d
is
co
u
r
s
e
(
DD)
m
et
h
o
d
.
P
h
ase
I
I
w
as
a
q
u
a
s
i
-
ex
p
erimen
ta
l
s
tu
d
y
u
s
i
n
g
a
p
r
etest
-
p
o
s
ttes
t c
o
n
tr
o
l g
r
o
u
p
d
esig
n
[
8
]
.
T
h
e
p
o
p
u
latio
n
o
f
t
h
is
r
esear
ch
w
er
e
w
ar
d
n
u
r
s
e
s
in
d
r.
S
o
eto
m
o
h
o
s
p
ital
o
f
S
u
r
ab
a
y
a.
Sa
m
p
les
w
er
e
ta
k
en
f
r
o
m
4
w
ar
d
s
,
2
w
ar
d
s
as
tr
ea
t
m
e
n
t
g
r
o
u
p
an
d
2
w
ar
d
s
as
t
h
e
co
n
tr
o
l
g
r
o
u
p
.
T
h
e
n
u
m
b
er
s
o
f
s
a
m
p
les
2
5
n
u
r
s
es
f
o
r
th
e
tr
ea
t
m
e
n
t
g
r
o
u
p
an
d
2
8
n
u
r
s
e
s
as
a
co
n
tr
o
l
g
r
o
u
p
.
A
ll
n
u
r
s
es
in
th
e
s
e
f
o
u
r
w
ar
d
s
th
a
t
m
ee
t to
th
e
i
n
cl
u
s
io
n
cr
ite
r
ia
,
w
er
e
in
cl
u
d
ed
in
t
h
e
s
t
u
d
y
.
I
n
b
o
th
g
r
o
u
p
s
g
o
t
th
e
tr
ain
i
n
g
o
n
th
e
co
n
tr
o
l
an
d
p
r
ev
en
tio
n
o
f
MRS
A
i
n
f
ec
t
io
n
s
,
th
e
t
r
ain
in
g
o
f
A
u
d
it
Gu
id
elin
e
s
w
ith
d
ir
ec
ti
v
e
d
is
co
u
r
s
e
w
as
ap
p
lied
o
n
l
y
f
o
r
th
e
tr
ea
t
m
en
t
g
r
o
u
p
.
Data
w
as
co
llected
f
r
o
m
Ma
y
2
0
1
3
u
n
til
Au
g
u
s
t
2
0
1
3
.
Qu
esti
o
n
n
air
e
ab
o
u
t
s
itu
a
t
io
n
a
w
ar
e
n
ess
o
f
t
h
e
co
n
tr
o
l
an
d
p
r
ev
en
tio
n
o
f
MRS
A
i
n
f
ec
t
io
n
s
a
n
d
ch
ec
k
l
is
t
o
f
s
it
u
atio
n
a
w
ar
en
e
s
s
w
e
r
e
s
u
b
j
ec
ted
f
o
r
all
n
u
r
s
es
th
at
in
clu
d
ed
in
th
e
s
tu
d
y
.
E
ac
h
q
u
e
s
tio
n
n
air
e
w
as
f
illed
t
w
ice
b
y
i
n
cl
u
d
ed
n
u
r
s
es
,
n
a
m
el
y
f
o
r
p
r
etest
an
d
p
o
s
ttes
t.
T
h
e
d
ata
w
a
s
an
al
y
s
is
b
y
co
m
p
u
ter
w
ith
l
ev
el
o
f
s
ig
n
i
f
ica
n
ce
0
.
0
5
.
T
h
e
v
ar
iab
les
o
f
p
er
ce
p
tio
n
,
co
m
p
r
e
h
en
s
io
n
a
n
d
p
r
o
j
ec
tio
n
w
er
e
an
al
y
z
ed
,
b
etw
ee
n
th
e
tr
ea
t
m
e
n
t a
n
d
t
h
e
co
n
tr
o
l g
r
o
u
p
.
T
h
e
s
tu
d
y
w
a
s
ag
r
ee
d
b
y
E
t
h
i
c
co
m
m
ittee
o
f
d
r
.
So
eto
m
o
Ho
s
p
ital
Su
r
ab
a
y
a.
A
ll
s
u
b
j
ec
ts
in
cl
u
d
ed
in
th
is
s
t
u
d
y
,
s
ig
n
ed
a
in
f
o
r
m
co
n
s
en
t f
o
r
m
b
e
f
o
r
e
th
e
s
tar
ti
n
g
th
e
s
tu
d
y
.
3.
RE
SU
L
T
S
A
ND
AN
AL
Y
SI
S
T
h
e
d
is
tr
ib
u
tio
n
o
f
ag
e
an
d
d
u
r
atio
n
o
f
w
o
r
k
,
a
n
d
ed
u
ca
tio
n
w
er
e
i
n
T
ab
le
1
an
d
T
ab
le
2
.
Of
t
h
e
2
g
r
o
u
p
s
i
n
t
h
e
s
t
u
d
y
s
u
b
j
ec
ts
w
er
e
t
h
en
a
n
al
y
s
ed
t
h
eir
c
h
a
r
ac
ter
is
tics
b
ased
o
n
a
g
e,
d
u
r
atio
n
o
f
w
o
r
k
a
n
d
ed
u
ca
tio
n
.
A
g
e,
av
er
a
g
e
o
f
3
7
.
2
y
ea
r
s
,
s
ta
n
d
ar
d
d
ev
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n
(
SD)
o
f
8
.
5
an
d
a
d
u
r
atio
n
o
f
w
o
r
k
,
av
er
ag
e
o
f
1
2
.
2
y
ea
r
s
,
S
D
9
.
0
.
T
h
e
s
e
d
ata
s
h
o
w
ed
w
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e
h
o
m
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g
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n
u
s
l
y
d
i
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tr
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(
K
o
lmo
g
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f
-
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mir
n
o
v
)
o
n
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s
a
m
p
le
te
s
t,
p
=
0
.
3
8
7
f
o
r
ag
e,
an
d
0
.
2
1
2
f
o
r
le
n
g
t
h
o
f
w
o
r
k
.
T
ab
le
1
.
S
u
b
j
ec
t
C
h
ar
a
cter
is
tics
b
ased
o
n
Ag
e
an
d
D
u
r
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n
o
f
W
o
r
k
in
Dr
.
So
eto
m
o
H
o
s
p
ital
i
n
2014
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t si
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ican
t
(
p
>
0
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0
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T
h
e
d
ata
o
f
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o
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o
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f
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S
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ter
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,
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ig
n
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ica
n
t
(p
<
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0
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),
ra
n
g
e
o
f
v
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lu
e
15
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h
e
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m
p
r
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e
n
s
io
n
m
ea
s
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r
e
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en
t
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l
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n
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S
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n
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t
i
o
n
s
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r
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en
t
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t
h
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en
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g
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u
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d
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n
tr
o
l
g
r
o
u
p
i
n
T
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le
5
.
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h
er
e
w
a
s
n
o
t
s
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g
n
i
f
ican
t
l
y
d
if
f
er
e
n
ce
b
et
w
ee
n
tr
ea
t
m
e
n
t
an
d
co
n
tr
o
l
g
r
o
u
p
(
Ma
n
n
-
W
h
itn
ey
test
,
p
=
0
.
0
6
)
T
ab
le
4
.
Dif
f
er
en
ce
s
o
f
C
o
m
p
r
eh
en
s
io
n
i
n
C
o
n
tr
o
l G
r
o
u
p
an
d
T
r
ea
tm
e
n
t G
r
o
u
p
b
ef
o
r
e
an
d
af
ter
T
r
ea
tm
e
n
t
V
a
r
i
a
b
l
e
C
o
n
t
r
o
l
G
r
o
u
p
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r
e
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t
me
n
t
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r
o
u
p
p
n
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e
a
n
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M
e
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n
SD
P
e
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p
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test
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m
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in
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s
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73
T
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Dif
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Sit
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3
.
1
.
Dis
cu
s
s
io
n
Statis
t
ical
an
al
y
s
i
s
s
h
o
w
ed
t
h
at
d
if
f
er
en
ce
s
in
p
er
ce
p
tio
n
,
co
m
p
r
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e
n
s
io
n
,
an
d
p
r
o
j
ec
tio
n
af
ter
tr
ea
t
m
e
n
t
w
er
e
n
o
t
s
i
g
n
i
f
ica
n
t
.
T
h
is
i
n
d
icate
s
th
at
tr
ea
t
m
en
t
d
o
es
n
o
t
c
h
an
g
e
p
er
ce
p
tio
n
,
c
o
m
p
r
e
h
en
s
io
n
,
a
n
d
p
r
o
j
ec
tio
n
o
f
s
itu
atio
n
a
w
ar
en
ess
r
esear
ch
s
u
b
j
ec
ts
.
T
h
er
e
ar
e
s
ev
er
al
p
o
s
s
ib
le
ca
u
s
e
s
,
a
m
o
n
g
o
t
h
er
s
:
f
ir
s
t,
th
e
co
m
p
le
x
it
y
o
f
t
h
e
Au
d
it
Gu
i
d
elin
es
o
f
co
n
tr
o
l
an
d
p
r
ev
e
n
tio
n
o
f
MR
S
A
in
f
ec
tio
n
s
a
n
d
th
e
in
s
tr
u
m
e
n
t
o
f
in
ter
v
e
n
tio
n
in
t
h
e
f
o
r
m
o
f
q
u
esti
o
n
n
air
es
s
itu
a
tio
n
a
w
ar
en
es
s
[
9
]
.
T
h
is
is
in
ac
co
r
d
a
n
ce
w
ith
t
h
e
A
u
d
it
Gu
id
eli
n
es
f
o
r
ass
es
s
m
en
t
b
y
a
n
u
r
s
e
f
o
r
th
e
lo
w
e
s
t
v
alu
e
w
it
h
lo
w
a
v
er
ag
e
co
m
p
le
x
it
y
co
m
p
ar
ed
to
o
th
er
ass
es
s
m
en
t
r
es
u
lt
s
,
ev
e
n
th
o
u
g
h
t
h
e
o
v
er
all
a
v
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e
is
g
o
o
d
.
C
o
m
p
lain
ts
f
o
r
co
m
p
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x
it
y
a
ls
o
ar
is
e
w
h
e
n
th
e
y
r
ea
d
th
e
q
u
est
io
n
n
air
e
o
f
a
w
ar
e
n
ess
o
f
s
it
u
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n
;
th
e
co
m
p
le
x
it
y
w
a
s
t
h
en
u
lt
i
m
a
tel
y
a
f
f
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ti
n
g
t
h
e
u
n
d
er
s
ta
n
d
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g
o
f
t
h
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t
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f
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h
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m
s
a
n
d
a
f
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t
s
to
p
o
s
ttes
t
r
es
u
lt
s
,
w
h
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was
les
s
s
at
is
f
ac
to
r
y
.
Seco
n
d
,
it is
alr
ea
d
y
g
o
o
d
co
n
s
id
er
in
g
t
h
e
u
n
d
er
s
ta
n
d
in
g
ab
o
u
t th
e
co
n
tr
o
l a
n
d
p
r
ev
en
tio
n
o
f
in
f
ec
tio
n
.
Fro
m
t
h
e
r
es
u
lts
o
f
s
tatis
tical
an
al
y
s
is
s
h
o
w
ed
th
at
d
i
f
f
er
e
n
c
es
in
s
it
u
atio
n
a
w
ar
en
e
s
s
ac
t
i
o
n
ag
ai
n
s
t
MRS
A
i
n
f
ec
tio
n
s
af
ter
tr
ea
t
m
en
t
in
t
h
e
co
n
tr
o
l
g
r
o
u
p
an
d
th
e
tr
ea
t
m
e
n
t
g
r
o
u
p
o
b
tain
ed
s
ig
n
i
f
ica
n
t
r
esu
l
ts
.
Fro
m
th
ese
r
es
u
lt
s
it
ca
n
b
e
co
n
clu
d
ed
th
at
th
e
tr
ea
t
m
en
t
is
ef
f
ec
ti
v
e
in
c
h
an
g
i
n
g
t
h
e
s
itu
atio
n
a
w
ar
e
n
es
s
ac
tio
n
s
.
C
h
an
g
es
to
th
e
s
it
u
at
io
n
a
w
ar
e
n
ess
ac
tio
n
w
er
e
ca
u
s
ed
b
y
tr
ain
i
n
g
o
f
au
d
it
g
u
id
elin
es,
th
e
tr
ai
n
in
g
b
ec
o
m
e
s
p
o
s
itiv
e
r
ein
f
o
r
ce
m
e
n
t
an
d
it
b
ec
o
m
e
s
a
s
ti
m
u
l
u
s
t
o
th
e
i
m
p
r
o
v
e
m
e
n
t
o
f
s
it
u
atio
n
a
w
ar
e
n
es
s
ac
tio
n
s
[
1
0
]
.
C
h
an
g
e
s
i
n
th
is
s
itu
a
t
io
n
a
w
ar
en
e
s
s
ac
tio
n
ar
e
n
o
t
ac
co
m
p
a
n
ied
b
y
ch
a
n
g
es
in
t
h
e
p
er
ce
p
tio
n
,
co
m
p
r
e
h
en
s
io
n
a
n
d
p
r
o
j
ec
tio
n
o
f
s
it
u
atio
n
a
w
ar
e
n
ess
,
t
h
at
t
h
is
ch
a
n
g
e
i
s
p
r
ed
icted
n
o
t to
last
lo
n
g
[
1
1
]
.
4.
CO
NCLU
SI
O
N
Fro
m
th
e
ab
o
v
e
d
is
cu
s
s
io
n
i
t
ca
n
b
e
co
n
cl
u
d
ed
th
at
t
h
e
Au
d
it
G
u
id
eli
n
es
o
f
MR
S
A
in
f
ec
tio
n
p
r
ev
en
tio
n
w
i
th
d
ir
ec
ti
v
e
d
is
co
u
r
s
e
h
as
n
o
t
b
ee
n
clea
r
l
y
d
e
m
o
n
s
tr
atin
g
it
s
ef
f
ec
ti
v
en
e
s
s
f
o
r
i
m
p
r
o
v
in
g
th
e
p
er
ce
p
tio
n
,
co
m
p
r
eh
e
n
s
io
n
an
d
p
r
o
j
ec
tio
n
o
f
s
itu
atio
n
a
w
ar
en
es
s
,
b
u
t
h
a
s
s
h
o
w
n
to
b
e
ef
f
ec
tiv
e
i
n
i
m
p
r
o
v
i
n
g
s
itu
a
tio
n
a
w
ar
en
e
s
s
ac
tio
n
RE
F
E
R
E
NC
E
S
[1
]
Na
id
u
,
K.,
Na
b
o
se
,
I
.
,
Ra
m
,
S
.
,
V
i
n
e
y
,
K
.
,
G
ra
h
a
m
,
SM
.,
Biss
e
ll
,
K
A
.,
“
De
s
c
rip
ti
v
e
S
tu
d
y
o
f
No
so
c
o
m
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re
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o
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ro
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.
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]
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,
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M
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rsa
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ste
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tm
l.
[3
]
M
in
istry
o
f
He
a
lt
h
,
“
P
e
d
o
m
a
n
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p
k
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p
p
.
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-
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,
2
0
0
8
.
[4
]
S
a
’d
iy
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h
,
N
.
,
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e
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d
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ri,
EB
.,
K
u
su
m
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n
in
g
ru
m
,
D.
,
“
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RS
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rri
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s
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li
a
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ika
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d
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l
.
48
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p
.
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.
[5
]
Ku
n
tam
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n
,
Ha
d
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U
.
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e
ti
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n
,
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.
,
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o
ri
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.
,
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u
sli,
M
.
,
S
a
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to
sa
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sih
,
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.
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rin
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.,
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e
rb
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g
h
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H
A.
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re
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.
[6
]
En
d
sle
y
,
M
R
.
,
“
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h
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rlan
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.
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]
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rse
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li
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.
[8
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o
li
t
,
DF
.
,
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n
g
ler
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P
.
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“
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sin
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se
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.
[9
]
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g
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rs,
EM
.
,
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1
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u
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.
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h
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.,
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n
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ra
h
a
Ilm
u
,
f
irst
e
d
i
ti
o
n
,
pp
.
2
8
–
34
,
2
0
0
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.
Evaluation Warning : The document was created with Spire.PDF for Python.
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.
Evaluation Warning : The document was created with Spire.PDF for Python.