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Sex
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ac
r
o
s
s
th
e
life
co
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r
s
e
[
1
]
.
R
ec
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t
g
lo
b
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s
y
n
th
eses
d
r
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tially
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g
io
n
an
d
co
u
n
tr
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in
c
o
m
e
lev
el
[
1
]
,
[
2
]
.
I
m
p
o
r
tan
tly
,
s
u
r
v
eillan
ce
an
d
n
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s
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in
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in
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r
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8
8
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6
E
ffective
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f n
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s
in
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micro
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w
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men
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(
R
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707
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[
3
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,
[
4
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Yet
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v
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[
4
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,
[
5
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.
T
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atter
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tr
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h
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I
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I
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R
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ex
p
er
i
en
ce
ad
d
itio
n
al
b
ar
r
ier
s
r
elate
d
to
lim
ited
s
ex
u
ality
ed
u
ca
tio
n
,
r
estricte
d
ac
ce
s
s
to
ad
o
lescen
t
-
f
r
ien
d
l
y
h
ea
lth
s
er
v
ices,
an
d
s
o
cio
cu
ltu
r
al
n
o
r
m
s
th
at
d
is
co
u
r
a
g
e
o
p
en
d
i
s
cu
s
s
io
n
o
f
s
ex
u
al
v
io
len
ce
an
d
h
elp
-
s
ee
k
in
g
b
eh
av
io
r
s
[
7
]
,
[
8
]
.
T
h
ese
co
n
t
ex
tu
al
ch
allen
g
es
h
ig
h
lig
h
t
t
h
e
u
r
g
e
n
t
n
ee
d
f
o
r
ac
ce
s
s
ib
le,
d
ev
elo
p
m
en
tally
ap
p
r
o
p
r
iate,
an
d
s
u
s
tain
ab
le
p
r
ev
en
tio
n
ed
u
ca
tio
n
s
tr
ateg
ies
tailo
r
ed
f
o
r
r
u
r
al
I
n
d
o
n
esian
ad
o
lescen
ts
.
R
u
r
al
co
n
tex
ts
m
ay
f
u
r
th
er
in
ten
s
if
y
v
u
ln
er
a
b
ilit
y
th
r
o
u
g
h
s
tr
u
ctu
r
al
an
d
s
o
cio
c
u
ltu
r
al
b
ar
r
ier
s
th
at
lim
it
ad
o
lescen
ts
’
ac
ce
s
s
to
ac
cu
r
ate
in
f
o
r
m
atio
n
,
co
n
f
i
d
en
tial
s
u
p
p
o
r
t,
an
d
y
o
u
th
-
f
r
ien
d
ly
s
er
v
ices.
A
s
y
s
tem
atic
r
ev
iew
o
f
r
u
r
al
ad
o
lescen
ts
’
r
ep
r
o
d
u
ctiv
e
h
ea
lt
h
awa
r
en
ess
(
2
0
1
9
–
2
0
2
4
)
h
ig
h
lig
h
ted
m
u
ltil
ev
el
o
b
s
tacle
s
,
m
y
th
s
an
d
m
is
c
o
n
ce
p
tio
n
s
,
s
h
am
e
a
n
d
f
ea
r
,
r
estrictiv
e
n
o
r
m
s
,
lim
ited
p
ar
en
t
–
a
d
o
lescen
t
co
m
m
u
n
icatio
n
,
s
er
v
ice
s
ca
r
city
,
an
d
n
eg
ativ
e
s
er
v
ice
ex
p
er
ien
ce
s
th
at
co
llectiv
ely
r
ed
u
ce
awa
r
en
ess
an
d
d
elay
tim
ely
h
elp
-
s
ee
k
in
g
[
7
]
.
W
h
ile
th
is
ev
id
en
ce
is
n
o
t
s
p
ec
if
ic
to
s
ex
u
al
v
io
len
ce
alo
n
e,
th
e
im
p
licatio
n
s
tr
an
s
late
d
ir
ec
tly
:
p
r
ev
en
tio
n
ed
u
ca
tio
n
d
ep
e
n
d
s
o
n
th
e
s
am
e
en
ab
lin
g
co
n
d
itio
n
s
cr
ed
ib
le
in
f
o
r
m
atio
n
,
p
s
y
ch
o
lo
g
ically
s
af
e
lear
n
in
g
s
p
ac
es,
an
d
cl
ea
r
p
ath
way
s
to
co
n
f
id
en
tial su
p
p
o
r
t th
at
ar
e
o
f
ten
wea
k
er
in
r
u
r
al
s
ettin
g
s
[
7
]
,
[
8
]
.
I
n
ad
d
itio
n
,
b
r
o
ad
e
r
ev
id
en
ce
o
n
ch
ild
r
e
n
’
s
an
d
ad
o
lescen
ts
’
f
o
r
m
al
h
el
p
-
s
ee
k
in
g
s
u
g
g
ests
th
at
ev
en
wh
en
y
o
u
n
g
p
eo
p
le
r
ec
o
g
n
ize
h
ar
m
,
u
n
ce
r
tain
ty
a
b
o
u
t
wh
er
e
t
o
g
o
,
f
ea
r
o
f
n
o
t
b
ein
g
b
eliev
e
d
,
an
d
co
n
ce
r
n
s
ab
o
u
t
co
n
f
id
en
tialit
y
ca
n
s
u
p
p
r
ess
d
is
clo
s
u
r
e
b
ar
r
ier
s
th
at
m
ay
b
e
am
p
lifie
d
wh
er
e
s
er
v
ices
ar
e
d
is
tan
t
o
r
s
o
cially
v
is
ib
le
[
8
]
,
[
9
]
.
As
a
r
esu
lt,
p
r
o
g
r
a
m
s
d
esig
n
ed
f
o
r
u
r
b
an
o
r
r
eso
u
r
ce
-
r
ich
s
ch
o
o
l
en
v
ir
o
n
m
en
ts
m
ay
n
o
t
tr
an
s
f
er
ef
f
ec
tiv
el
y
to
r
u
r
al
ad
o
l
escen
ts
with
o
u
t
ad
ap
tin
g
d
el
iv
er
y
m
et
h
o
d
s
f
o
r
f
ea
s
ib
ilit
y
,
p
r
iv
ac
y
,
s
tig
m
a,
an
d
r
ein
f
o
r
ce
m
en
t
n
ee
d
s
[
7
]
,
[
9
]
.
Sch
o
o
l
-
an
d
co
m
m
u
n
ity
-
b
a
s
ed
p
r
ev
en
tio
n
p
r
o
g
r
am
s
h
av
e
b
ee
n
wid
ely
im
p
lem
en
ted
to
s
tr
en
g
th
en
k
n
o
wled
g
e,
attitu
d
es,
an
d
p
r
o
tectiv
e
b
eh
av
i
o
r
s
r
elate
d
to
ch
ild
s
ex
u
al
ab
u
s
e
an
d
s
ex
u
al
v
io
le
n
ce
.
R
ec
en
t
s
y
n
th
eses
g
en
er
ally
r
ep
o
r
t
b
en
e
f
icial
ef
f
ec
ts
,
b
u
t
th
e
y
also
em
p
h
asize
s
u
b
s
tan
tial
h
eter
o
g
en
eity
ac
r
o
s
s
p
r
o
g
r
a
m
s
co
n
ten
t,
in
s
tr
u
ctio
n
al
s
ty
le,
an
d
d
o
s
e
s
u
g
g
esti
n
g
th
at
o
u
tco
m
es
ar
e
h
ig
h
ly
s
en
s
itiv
e
to
h
o
w
ed
u
ca
tio
n
is
d
esig
n
e
d
an
d
d
eliv
er
e
d
[
1
0
]
,
[
1
1
]
.
I
n
lo
w
-
an
d
m
id
d
le
-
in
co
m
e
s
ettin
g
s
,
d
ig
ital
an
d
m
o
b
ile
ap
p
r
o
ac
h
es a
r
e
in
cr
ea
s
in
g
ly
ex
p
lo
r
ed
to
ex
p
a
n
d
r
ea
c
h
an
d
s
tan
d
ar
d
ize
co
n
te
n
t.
Fo
r
ex
am
p
le,
a
clu
s
ter
-
r
an
d
o
m
ize
d
co
n
tr
o
lled
tr
ial
in
I
n
d
o
n
esia
f
o
u
n
d
th
at
a
m
o
b
ile
ap
p
licatio
n
–
b
ased
ch
ild
s
ex
u
al
ab
u
s
e
p
r
ev
en
tio
n
p
r
o
g
r
am
s
d
eliv
er
ed
o
v
e
r
s
ev
er
al
wee
k
s
(
with
p
ar
en
t
an
d
teac
h
er
in
v
o
lv
e
m
en
t)
was
f
ea
s
ib
le
an
d
im
p
r
o
v
ed
p
r
ev
e
n
tio
n
-
r
elate
d
o
u
tc
o
m
es
[
1
2
]
.
E
v
e
n
s
o
,
m
a
n
y
i
n
ter
v
en
tio
n
s
s
till
r
ely
o
n
r
elativ
el
y
“m
ass
ed
”
lear
n
in
g
(
s
in
g
le
-
s
ess
io
n
o
r
s
h
o
r
t
-
c
o
u
r
s
e
d
eliv
er
y
)
,
wh
ich
ca
n
lead
to
r
ap
id
k
n
o
wled
g
e
d
ec
ay
,
p
ar
ticu
lar
ly
wh
en
ad
o
lescen
ts
f
ac
e
co
m
p
etin
g
s
ch
o
o
l
d
em
an
d
s
a
n
d
lim
ited
o
p
p
o
r
tu
n
ities
f
o
r
r
ein
f
o
r
ce
m
e
n
t [
1
0
]
,
[
1
1
]
.
L
ea
r
n
in
g
s
cien
ce
o
f
f
er
s
a
m
ec
h
an
is
m
-
d
r
iv
e
n
s
tr
ateg
y
t
o
ad
d
r
ess
r
eten
tio
n
an
d
e
n
g
ag
em
en
t:
m
icr
o
lear
n
in
g
co
m
b
in
ed
with
s
p
ac
ed
r
ein
f
o
r
ce
m
en
t.
Mic
r
o
lear
n
in
g
d
eliv
er
s
s
h
o
r
t,
f
o
c
u
s
ed
u
n
its
th
at
ar
e
ea
s
ier
to
co
m
p
lete,
r
ep
ea
t,
an
d
in
teg
r
ate
i
n
to
s
ch
o
o
l
r
o
u
tin
es.
E
v
id
en
ce
f
r
o
m
h
ea
lth
p
r
o
f
ess
io
n
s
ed
u
ca
tio
n
s
h
o
ws
m
icr
o
lear
n
in
g
ca
n
im
p
r
o
v
e
k
n
o
wled
g
e
an
d
c
o
n
f
id
e
n
c
e,
wh
ile
also
n
o
tin
g
p
r
ac
tical
co
n
ce
r
n
s
,
in
clu
d
in
g
tech
n
o
lo
g
y
in
eq
u
ities
an
d
p
r
iv
ac
y
th
at
b
ec
o
m
e
esp
ec
ially
im
p
o
r
tan
t
in
r
eso
u
r
ce
-
lim
ited
co
n
tex
ts
[
1
3
]
.
Sp
ac
ed
d
ig
ital
ed
u
ca
tio
n
,
wh
e
r
e
k
e
y
c
o
n
ce
p
ts
ar
e
r
ev
is
ited
o
v
er
tim
e,
h
as
s
h
o
wn
ad
v
a
n
tag
es
f
o
r
k
n
o
wled
g
e
o
u
tco
m
es
in
s
y
s
tem
atic
r
ev
iew
ev
id
e
n
ce
[
1
4
]
,
a
n
d
c
o
n
tr
o
lled
s
tu
d
ies
o
f
m
o
b
ile
s
p
ac
ed
-
r
ep
etitio
n
ap
p
r
o
ac
h
es
d
em
o
n
s
tr
ate
im
p
r
o
v
e
d
k
n
o
wled
g
e
r
eten
tio
n
co
m
p
ar
ed
with
co
n
v
en
tio
n
al
lear
n
in
g
p
atter
n
s
[
1
5
]
.
Pre
v
io
u
s
f
in
d
in
g
s
s
u
p
p
o
r
t
a
p
lau
s
ib
le
p
r
ev
en
tio
n
p
ath
way
:
r
ep
ea
ted
,
lo
w
-
b
u
r
d
e
n
e
x
p
o
s
u
r
e
to
ess
en
tial
co
n
ce
p
ts
m
ay
b
u
ild
m
o
r
e
d
u
r
ab
le
awa
r
en
es
s
,
wh
ich
m
atte
r
s
f
o
r
r
ec
o
g
n
i
zin
g
b
o
u
n
d
ar
y
v
io
latio
n
s
,
in
t
er
p
r
etin
g
co
e
r
civ
e
s
itu
atio
n
s
,
an
d
in
itiatin
g
tim
el
y
h
elp
-
s
ee
k
in
g
[
8
]
,
[
9
]
,
[
1
4
]
.
I
n
ad
o
lescen
t
s
ex
u
al
an
d
r
ep
r
o
d
u
ctiv
e
h
ea
lth
ed
u
c
atio
n
,
au
d
io
v
is
u
al
an
d
leaf
let
-
b
ased
a
p
p
r
o
ac
h
es
r
em
ain
p
o
p
u
lar
b
ec
au
s
e
th
e
y
ar
e
s
c
alab
le
an
d
g
e
n
er
ally
a
cc
ep
tab
le
in
s
ch
o
o
l
s
ettin
g
s
.
R
ec
en
t
in
ter
v
en
tio
n
ev
id
en
ce
in
d
icate
s
th
at
v
id
eo
-
b
ased
ed
u
ca
tio
n
an
d
e
-
leaf
let
s
ca
n
im
p
r
o
v
e
k
n
o
wled
g
e
a
n
d
r
elate
d
o
u
tco
m
es,
alth
o
u
g
h
ef
f
ec
ts
ca
n
v
ar
y
b
y
m
o
d
ality
an
d
im
p
lem
e
n
tatio
n
co
n
tex
t
[
1
6
]
.
Ho
wev
er
,
th
ese
m
o
d
alities
ar
e
o
f
ten
d
eliv
er
ed
as
s
in
g
le
e
x
p
o
s
u
r
es
o
r
s
h
o
r
t
p
r
o
g
r
am
s
,
lea
v
in
g
a
p
r
ac
tical
q
u
esti
o
n
u
n
a
n
s
wer
ed
:
d
o
a
d
o
lescen
ts
r
etain
an
d
ap
p
ly
k
n
o
wled
g
e
wee
k
s
later
,
esp
ec
ially
in
r
u
r
al
s
ettin
g
s
wh
er
e
s
tig
m
a
an
d
lim
ited
co
n
f
id
en
tial
s
u
p
p
o
r
t
m
a
y
s
til
l
s
u
p
p
r
ess
d
is
clo
s
u
r
e
ev
en
wh
en
awa
r
en
ess
im
p
r
o
v
es
[
7
]
,
[
9
]
,
[
1
6
]
.
T
h
e
r
esear
ch
g
ap
is
n
o
t
wh
eth
er
e
d
u
ca
tio
n
ca
n
im
p
r
o
v
e
awa
r
e
n
ess
in
p
r
in
cip
le,
b
u
t
wh
eth
e
r
a
n
e
d
u
ca
tio
n
d
esig
n
g
r
o
u
n
d
ed
in
r
eten
tio
n
s
cien
ce
,
b
u
t
also
m
icr
o
lear
n
in
g
co
m
b
in
ed
with
s
p
ac
ed
r
ei
n
f
o
r
ce
m
en
t
ca
n
p
r
o
d
u
ce
m
o
r
e
d
u
r
ab
le
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
7
0
6
-
716
708
im
p
r
o
v
em
e
n
ts
in
ad
o
lescen
ts
’
s
ex
u
al
v
io
le
n
ce
awa
r
en
ess
in
r
u
r
al
co
n
te
x
ts
[
7
]
,
[
10
]
,
[
1
4
]
.
Pre
v
en
ti
o
n
p
r
o
g
r
a
m
s
s
y
n
th
eses
h
ig
h
lig
h
t
d
eliv
er
y
h
ete
r
o
g
e
n
eity
an
d
d
o
n
o
t y
et
estab
lis
h
o
p
tim
al
r
ein
f
o
r
ce
m
en
t sch
ed
u
les
f
o
r
s
u
s
tain
ed
awa
r
en
ess
o
u
tc
o
m
es
[
1
0
]
,
[
1
1
]
.
Mo
r
e
o
v
er
,
d
esp
ite
g
r
o
wth
in
d
ig
ital
p
r
ev
en
tio
n
p
r
o
g
r
am
s
(
in
clu
d
in
g
L
MI
C
-
b
ased
tr
ials
)
[
1
2
]
,
r
i
g
o
r
o
u
s
ex
p
er
im
e
n
tal
ev
alu
atio
n
s
th
at
ex
p
licitly
o
p
er
atio
n
alize
m
icr
o
lear
n
in
g
with
s
p
ac
ed
r
ei
n
f
o
r
ce
m
e
n
t
f
o
r
s
ex
u
al
v
io
le
n
c
e
awa
r
e
n
ess
test
ed
am
o
n
g
r
u
r
al
ad
o
lescen
ts
an
d
ass
es
s
ed
with
r
ep
ea
ted
m
ea
s
u
r
em
en
ts
to
ex
am
i
n
e
p
er
s
is
ten
ce
r
em
ain
lim
ited
in
r
ec
en
t
liter
atu
r
e
[
7
]
,
[
14
]
,
[
1
6
]
.
Ad
d
r
ess
in
g
th
is
g
ap
is
i
m
p
o
r
tan
t
b
ec
a
u
s
e
ed
u
ca
tio
n
al
ef
f
ec
ts
th
at
f
ad
e
q
u
ick
ly
m
ay
h
av
e
lim
ited
r
ea
l
-
wo
r
ld
p
r
e
v
en
tiv
e
v
alu
e.
Desp
ite
g
r
o
win
g
ev
id
en
ce
s
u
p
p
o
r
tin
g
d
i
g
ital
an
d
s
ch
o
o
l
-
b
ased
s
ex
u
al
v
io
len
ce
p
r
e
v
en
tio
n
p
r
o
g
r
a
m
s
,
f
ew
s
tu
d
ies
h
av
e
s
p
ec
if
ical
ly
ev
alu
ated
th
e
ef
f
ec
tiv
en
ess
o
f
m
icr
o
lear
n
i
n
g
c
o
m
b
in
ed
with
s
p
ac
ed
r
ein
f
o
r
ce
m
e
n
t
f
o
r
im
p
r
o
v
in
g
s
u
s
tain
ed
s
ex
u
al
v
io
len
ce
awa
r
en
ess
am
o
n
g
r
u
r
al
ad
o
lescen
ts
in
I
n
d
o
n
esia
[
1
0
]
,
[
1
2
]
,
[
1
4
]
.
I
n
ad
d
itio
n
,
p
r
ev
io
u
s
in
ter
v
en
tio
n
s
h
a
v
e
p
r
ed
o
m
in
an
tly
f
o
c
u
s
ed
o
n
im
m
ed
iate
p
o
s
t
-
in
ter
v
en
tio
n
o
u
tco
m
es
with
o
u
t
ex
am
in
in
g
wh
eth
er
awa
r
en
ess
im
p
r
o
v
em
en
ts
ar
e
r
etain
ed
o
v
er
tim
e.
T
h
er
ef
o
r
e
,
ev
id
e
n
ce
r
eg
ar
d
in
g
th
e
lo
n
g
-
ter
m
ed
u
ca
tio
n
al
v
alu
e
o
f
r
ete
n
tio
n
-
b
ased
lear
n
in
g
s
tr
ateg
ies
in
ad
o
lescen
t
s
ex
u
al
v
io
len
ce
p
r
ev
en
tio
n
r
e
m
ain
s
lim
ited
.
T
h
er
ef
o
r
e,
th
is
s
tu
d
y
aim
e
d
to
ev
alu
ate
th
e
ef
f
ec
tiv
e
n
ess
o
f
a
n
u
r
s
in
g
-
led
ed
u
ca
tio
n
al
in
ter
v
en
tio
n
u
s
in
g
m
icr
o
lear
n
in
g
with
s
p
ac
e
d
r
ein
f
o
r
ce
m
e
n
t
to
im
p
r
o
v
e
ad
o
lescen
ts
’
awa
r
en
ess
o
f
s
ex
u
al
v
io
len
ce
in
r
u
r
al
ar
e
as,
u
s
in
g
an
e
x
p
er
im
e
n
tal
d
esig
n
with
r
e
p
ea
ted
o
u
tco
m
e
m
e
asu
r
em
en
t
to
ass
ess
b
o
th
im
m
e
d
iate
g
ain
s
an
d
s
h
o
r
t
-
ter
m
r
eten
tio
n
.
2.
M
E
T
H
O
D
2
.
1
.
Study
des
ig
n a
nd
s
et
t
ing
T
h
is
s
tu
d
y
u
s
ed
a
n
ex
p
er
im
en
tal,
r
ep
ea
ted
-
m
ea
s
u
r
es,
two
-
a
r
m
d
esig
n
co
n
d
u
cted
in
r
u
r
al
j
u
n
io
r
h
ig
h
s
ch
o
o
ls
.
Ou
tco
m
es we
r
e
as
s
es
s
ed
at
b
aselin
e
(
T
0
)
,
im
m
ed
iately
af
ter
th
e
co
r
e
lear
n
in
g
p
h
a
s
e
(
T
1
)
,
an
d
at
f
o
u
r
wee
k
s
af
ter
c
o
m
p
letio
n
(
T
2
)
to
e
v
alu
ate
b
o
th
im
m
ed
iate
lear
n
in
g
g
ain
s
an
d
s
h
o
r
t
-
ter
m
r
eten
tio
n
u
n
d
er
a
s
p
ac
ed
r
ein
f
o
r
ce
m
en
t
ap
p
r
o
ac
h
.
T
h
e
s
tu
d
y
was
im
p
lem
en
te
d
in
r
u
r
al
s
ch
o
o
l
ca
tch
m
en
t
ar
ea
s
ch
ar
ac
ter
ized
b
y
lim
ited
ac
ce
s
s
to
y
o
u
th
-
f
r
ien
d
ly
in
f
o
r
m
atio
n
an
d
s
er
v
ices,
wh
er
e
s
ch
o
o
l
-
b
ased
h
ea
lt
h
ed
u
ca
tio
n
r
em
ai
n
s
a
p
r
im
ar
y
c
h
an
n
el
f
o
r
p
r
ev
e
n
tio
n
m
ess
ag
in
g
.
2
.
2
.
P
a
rt
icipa
nts a
nd
s
a
m
pli
ng
T
h
e
tar
g
et
p
o
p
u
latio
n
was
ad
o
lescen
ts
en
r
o
lled
in
g
r
ad
es
8
–
9
(
ap
p
r
o
x
im
ately
1
3
–
1
6
y
ea
r
s
)
.
E
lig
ib
ilit
y
cr
iter
ia
wer
e:
en
r
o
l
led
as
an
ac
tiv
e
s
tu
d
en
t
at
th
e
p
ar
ticip
atin
g
s
ch
o
o
l;
ab
le
to
r
ea
d
an
d
u
n
d
er
s
tan
d
B
a
h
a
s
a
I
n
d
o
n
esia
;
h
ad
ac
ce
s
s
to
a
p
h
o
n
e
(
p
er
s
o
n
al
o
r
s
h
ar
ed
with
in
th
e
h
o
u
s
eh
o
ld
)
s
u
f
f
icie
n
t
to
r
ec
eiv
e
s
h
o
r
t
lear
n
in
g
c
o
n
ten
t;
a
n
d
p
r
o
v
id
e
d
wr
itten
ass
en
t
with
wr
itten
p
ar
en
tal/g
u
ar
d
ia
n
co
n
s
en
t.
St
u
d
en
ts
wer
e
ex
clu
d
e
d
if
th
ey
r
ep
o
r
ted
c
u
r
r
en
t
s
ev
er
e
p
s
y
ch
o
l
o
g
ical
d
is
tr
ess
r
eq
u
ir
i
n
g
im
m
e
d
iate
r
ef
e
r
r
al
at
s
cr
ee
n
in
g
b
y
t
h
e
s
ch
o
o
l
co
u
n
s
elo
r
/teac
h
er
(
p
er
s
af
e
g
u
ar
d
in
g
p
r
o
to
c
o
l)
,
h
a
d
p
a
r
ticip
ated
in
a
s
tr
u
ctu
r
e
d
s
ex
u
al
v
io
len
ce
p
r
ev
e
n
tio
n
p
r
o
g
r
a
m
with
in
th
e
p
ast s
ix
m
o
n
th
s
,
o
r
we
r
e
ab
s
en
t d
u
r
in
g
b
aselin
e
ass
es
s
m
en
t.
A
m
u
lti
-
s
tag
e
clu
s
ter
s
am
p
lin
g
tech
n
iq
u
e
was
ap
p
lied
.
Fo
u
r
r
u
r
al
ju
n
i
o
r
h
ig
h
s
ch
o
o
ls
wer
e
s
elec
ted
f
r
o
m
two
r
u
r
al
s
u
b
d
is
tr
icts
b
ased
o
n
ac
ce
s
s
ib
ilit
y
,
willi
n
g
n
ess
to
p
ar
ticip
ate,
an
d
s
im
ilar
ity
o
f
s
ch
o
o
l
ch
ar
ac
ter
is
tics
.
Sch
o
o
ls
wer
e
allo
ca
ted
in
to
in
ter
v
e
n
tio
n
an
d
c
o
m
p
a
r
is
o
n
co
n
d
itio
n
s
to
m
in
im
ize
co
n
tam
in
atio
n
b
etwe
en
p
ar
ticip
an
ts
with
in
th
e
s
am
e
ed
u
ca
tio
n
al
en
v
ir
o
n
m
en
t.
T
wo
s
ch
o
o
ls
wer
e
as
s
ig
n
ed
to
th
e
m
icr
o
lea
r
n
in
g
in
ter
v
en
tio
n
g
r
o
u
p
a
n
d
two
s
ch
o
o
ls
to
t
h
e
leaf
let
c
o
m
p
a
r
is
o
n
g
r
o
u
p
.
Ap
p
r
o
x
im
ately
3
0
elig
ib
le
s
tu
d
en
ts
wer
e
r
ec
r
u
ited
f
r
o
m
ea
ch
s
ch
o
o
l c
lu
s
ter
,
r
esu
ltin
g
in
a
to
tal
s
am
p
le
o
f
1
2
0
p
ar
ticip
an
ts
.
R
u
r
al
s
ch
o
o
ls
m
ee
tin
g
in
clu
s
io
n
cr
iter
ia
wer
e
f
ir
s
t
i
d
en
tifie
d
in
co
llab
o
r
atio
n
with
lo
ca
l
ed
u
ca
tio
n
a
u
th
o
r
ities
;
s
ch
o
o
ls
wer
e
th
en
s
elec
ted
p
u
r
p
o
s
iv
ely
to
r
ef
lect
r
u
r
al
ac
ce
s
s
co
n
s
tr
ain
ts
an
d
f
ea
s
ib
ilit
y
f
o
r
f
o
llo
w
-
u
p
.
W
ith
in
ea
ch
s
elec
ted
s
ch
o
o
l,
elig
ib
le
s
tu
d
en
ts
wer
e
in
v
ited
co
n
s
ec
u
tiv
ely
u
n
til
t
h
e
tar
g
et
s
am
p
le
s
ize
was
ac
h
iev
ed
.
B
ec
au
s
e
p
ar
ticip
an
ts
wer
e
e
m
b
ed
d
e
d
with
in
s
ch
o
o
l
clu
s
ter
s
an
d
r
ep
ea
te
d
ly
m
ea
s
u
r
ed
,
th
e
an
aly
s
is
p
la
n
ex
p
licitly
ac
co
u
n
te
d
f
o
r
with
in
-
s
tu
d
en
t a
n
d
with
in
-
s
ch
o
o
l c
o
r
r
elatio
n
.
A
p
r
io
r
i
s
am
p
le
s
ize
esti
m
a
tio
n
was
co
n
d
u
cted
u
s
in
g
G
Po
wer
(
v
er
s
io
n
3
.
1
)
to
d
ete
r
m
in
e
th
e
m
in
im
u
m
n
u
m
b
e
r
o
f
p
ar
tici
p
an
ts
r
eq
u
ir
e
d
to
d
etec
t
a
g
r
o
u
p
-
by
-
tim
e
in
ter
ac
tio
n
f
o
r
r
ep
ea
ted
-
m
ea
s
u
r
es
o
u
tco
m
es
with
ad
e
q
u
ate
s
tatis
tical
p
o
wer
.
C
o
n
s
is
ten
t
with
g
u
id
an
ce
o
n
u
s
in
g
GPo
wer
f
o
r
h
ea
lth
r
esear
ch
p
lan
n
in
g
,
ass
u
m
p
tio
n
s
wer
e
s
p
ec
if
ied
f
o
r
a
m
ix
ed
r
ep
ea
te
d
-
m
ea
s
u
r
es
ef
f
ec
t
(
two
g
r
o
u
p
s
,
th
r
ee
m
ea
s
u
r
em
en
t
o
cc
asio
n
s
)
,
two
-
s
id
ed
α
=
0
.
0
5
,
p
o
wer
(
1
−β)
=
0
.
8
0
,
an
d
a
m
o
d
er
ate
s
tan
d
ar
d
ized
ef
f
ec
t
s
ize
(
f
=
0
.
2
5
)
[
1
7
]
.
T
h
e
with
in
-
s
u
b
ject
c
o
r
r
elatio
n
was
co
n
s
er
v
ativ
el
y
s
et
at
0
.
5
0
with
n
o
s
p
h
er
icity
c
o
r
r
ec
tio
n
ε
=
1
.
0
0
.
T
h
e
m
in
im
u
m
r
eq
u
ir
ed
s
am
p
le
was in
f
lated
to
ac
co
m
m
o
d
ate
an
t
icip
ated
attr
itio
n
at
f
o
llo
w
-
u
p
in
r
u
r
al
s
ettin
g
s
an
d
p
o
ten
tial
clu
s
ter
in
g
e
f
f
ec
ts
;
th
er
ef
o
r
e
,
th
e
f
in
al
r
ec
r
u
itm
e
n
t
tar
g
et
was
in
cr
ea
s
ed
b
y
a
p
p
r
o
x
im
ately
1
5
%,
y
ield
in
g
a
p
lan
n
ed
to
tal
s
am
p
l
e
o
f
1
2
0
ad
o
lescen
ts
(
6
0
p
er
ar
m
)
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
ffective
n
ess
o
f n
u
r
s
in
g
-
led
micro
lea
r
n
in
g
w
ith
s
p
a
ce
d
r
ein
fo
r
ce
men
t o
n
s
ex
u
a
l v
io
le
n
ce
…
(
R
is
n
a
h
)
709
2
.
3
.
I
nte
rv
ent
io
n a
nd
co
m
pa
riso
n c
o
nd
it
io
n
T
h
e
in
ter
v
en
tio
n
was
a
n
u
r
s
in
g
-
led
m
icr
o
lear
n
in
g
p
r
o
g
r
am
with
s
p
ac
ed
r
ein
f
o
r
ce
m
e
n
t
d
esig
n
ed
to
en
h
an
ce
ad
o
lescen
ts
’
awa
r
e
n
ess
o
f
s
ex
u
al
v
io
len
ce
in
a
f
ea
s
ib
le,
lo
w
-
b
u
r
d
en
f
o
r
m
at
a
p
p
r
o
p
r
iate
f
o
r
r
u
r
al
s
ettin
g
s
.
Mic
r
o
lear
n
in
g
was
o
p
er
atio
n
alize
d
as
b
r
ief
,
f
o
cu
s
ed
lear
n
in
g
u
n
its
d
eliv
er
ed
i
n
s
h
o
r
t
s
ess
io
n
s
to
s
u
p
p
o
r
t
en
g
a
g
em
en
t
an
d
r
ed
u
ce
co
g
n
itiv
e
o
v
er
lo
ad
,
c
o
n
s
is
ten
t
with
e
v
id
en
ce
th
at
m
ic
r
o
le
ar
n
in
g
ca
n
im
p
r
o
v
e
k
n
o
wled
g
e
o
u
tco
m
es
w
h
ile
m
ain
tain
in
g
f
ea
s
ib
ilit
y
in
h
ea
lth
ed
u
ca
tio
n
co
n
te
x
ts
[
1
3
]
,
[
1
8
]
.
T
h
e
co
r
e
co
n
ten
t
co
n
s
is
ted
o
f
s
ix
m
icr
o
lear
n
in
g
m
o
d
u
les
(
3
–
5
m
in
u
tes
ea
c
h
)
d
eliv
er
e
d
o
v
er
two
wee
k
s
v
i
a
a
m
o
b
ile
-
f
r
ien
d
ly
f
o
r
m
at.
Mo
d
u
les
ad
d
r
ess
ed
:
r
ec
o
g
n
izin
g
s
ex
u
al
v
io
len
ce
a
n
d
c
o
er
c
io
n
;
co
n
s
en
t
an
d
b
o
u
n
d
ar
ies;
o
n
li
n
e
a
n
d
p
ee
r
-
r
elate
d
r
is
k
s
;
m
y
th
s
an
d
n
o
r
m
aliza
tio
n
;
s
af
e
r
esp
o
n
s
es
an
d
r
ef
u
s
al
s
k
ills
;
an
d
h
elp
-
s
ee
k
in
g
p
ath
way
s
an
d
tr
u
s
ted
ad
u
lts
.
Sp
ac
ed
r
ein
f
o
r
ce
m
en
t
was
i
m
p
lem
en
ted
th
r
o
u
g
h
s
ch
ed
u
led
b
o
o
s
ter
p
r
o
m
p
ts
an
d
r
etr
iev
al
-
s
ty
le
ch
ec
k
s
at
in
cr
ea
s
in
g
in
ter
v
al
s
(
e.
g
.
,
d
ay
3
,
d
ay
7
,
an
d
d
ay
1
4
f
o
llo
win
g
k
ey
m
o
d
u
le
s
)
.
R
ein
f
o
r
ce
m
en
t
in
clu
d
ed
s
h
o
r
t
r
ec
a
p
ca
r
d
s
an
d
two
to
t
h
r
ee
a
p
p
licatio
n
q
u
esti
o
n
s
with
im
m
ed
iate
co
r
r
ec
tiv
e
f
ee
d
b
ac
k
.
T
h
is
ap
p
r
o
ac
h
was
alig
n
ed
with
e
v
id
en
ce
th
at
s
p
ac
ed
lea
r
n
in
g
m
o
d
els
ca
n
im
p
r
o
v
e
r
ete
n
tio
n
an
d
p
er
f
o
r
m
an
ce
co
m
p
ar
ed
with
m
ass
ed
d
eliv
er
y
[
19
]
,
a
n
d
with
b
r
o
a
d
er
f
i
n
d
i
n
g
s
th
at
p
r
e
v
en
tio
n
p
r
o
g
r
am
e
f
f
ec
tiv
en
ess
ca
n
b
e
in
f
lu
en
ce
d
b
y
in
s
tr
u
ctio
n
al
d
o
s
e
an
d
d
eliv
er
y
s
tr
u
ctu
r
e
[
2
0
].
T
h
e
co
m
p
ar
is
o
n
g
r
o
u
p
r
ec
eiv
ed
s
ta
n
d
ar
d
s
ch
o
o
l
h
ea
lth
ed
u
ca
tio
n
m
ater
ials
in
p
r
in
t
f
o
r
m
(
leaf
let)
co
v
er
in
g
t
h
e
s
am
e
co
r
e
to
p
ic
s
.
T
h
e
m
ater
ials
wer
e
d
eliv
er
ed
o
n
ce
in
a
s
in
g
le
s
ess
io
n
with
o
u
t
s
ch
ed
u
led
r
ein
f
o
r
ce
m
e
n
t.
B
o
th
ar
m
s
h
a
d
ac
ce
s
s
to
t
h
e
s
am
e
s
af
e
g
u
ar
d
in
g
in
f
o
r
m
atio
n
(
e.
g
.
,
c
o
n
tacts
f
o
r
th
e
s
ch
o
o
l
co
u
n
s
elo
r
a
n
d
lo
ca
l r
e
f
er
r
al
s
e
r
v
ices)
to
en
s
u
r
e
et
h
ical
p
ar
ity
f
o
r
s
af
ety
.
2
.
4
.
I
ns
t
rum
ent
s
T
h
e
p
r
im
ar
y
o
u
tco
m
e
was
ad
o
lescen
ts
’
awa
r
en
ess
o
f
s
ex
u
al
v
io
len
ce
.
Awa
r
en
ess
was
m
ea
s
u
r
ed
u
s
in
g
th
e
s
ex
u
al
v
i
o
len
ce
awa
r
en
ess
q
u
esti
o
n
n
air
e
–
a
d
o
lescen
ts
(
SVAQ
-
A)
,
d
ev
elo
p
ed
f
o
r
th
is
s
tu
d
y
b
ased
o
n
co
n
tem
p
o
r
ar
y
p
r
e
v
en
tio
n
f
r
a
m
ewo
r
k
s
an
d
r
u
r
al
f
ea
s
ib
ilit
y
co
n
s
id
er
atio
n
s
.
I
tem
d
ev
el
o
p
m
en
t
f
o
llo
wed
an
ev
id
en
ce
-
in
f
o
r
m
e
d
co
n
ten
t
s
p
ec
if
icatio
n
an
d
ex
p
er
t
r
ev
ie
w
co
n
s
is
ten
t
with
C
OS
MI
N
-
o
r
ien
ted
p
r
in
ci
p
les
em
p
h
asizin
g
r
elev
an
ce
,
co
m
p
r
eh
en
s
iv
e
n
ess
,
an
d
co
m
p
r
eh
en
s
ib
ilit
y
f
o
r
th
e
tar
g
et
p
o
p
u
latio
n
[
2
1
].
T
h
e
p
r
e
l
i
m
i
n
a
r
y
i
t
e
m
p
o
o
l
was
r
e
v
i
ew
e
d
b
y
a
p
a
n
e
l
o
f
e
x
p
er
t
s
(
c
o
m
m
u
n
i
t
y
/
p
u
b
l
i
c
h
ea
l
t
h
n
u
r
s
i
n
g
,
a
d
o
l
es
c
e
n
t
h
e
a
l
t
h
,
s
c
h
o
o
l
c
o
u
n
s
el
i
n
g
,
a
n
d
c
h
i
l
d
p
r
o
t
e
c
t
i
o
n
)
.
A
f
t
e
r
r
ev
i
s
i
o
n
s
,
t
h
e
f
i
n
a
l
SV
AQ
-
A
c
o
n
t
a
i
n
e
d
2
4
i
t
e
m
s
a
c
r
o
s
s
f
o
u
r
d
o
m
a
i
n
s
:
r
e
c
o
g
n
it
io
n
o
f
s
e
x
u
a
l
v
i
o
l
e
n
c
e
a
n
d
c
o
e
r
c
i
o
n
,
c
o
n
s
e
n
t
a
n
d
b
o
u
n
d
a
r
i
es
,
m
y
t
h
r
e
j
e
ct
i
o
n
a
n
d
n
o
r
m
a
l
i
z
a
t
i
o
n
,
a
n
d
h
el
p
-
s
e
ek
i
n
g
r
e
a
d
i
n
e
s
s
.
C
o
n
t
e
n
t
v
al
i
d
i
t
y
w
a
s
q
u
a
n
t
i
t
at
i
v
e
l
y
a
s
s
e
s
s
e
d
u
s
i
n
g
t
h
e
c
o
n
t
e
n
t
v
a
li
d
i
t
y
i
n
d
e
x
(
C
V
I
)
.
E
x
p
e
r
t
r
a
t
i
n
g
s
d
e
m
o
n
s
t
r
a
t
e
d
a
cc
e
p
t
a
b
l
e
i
t
e
m
-
le
v
e
l
c
o
n
t
e
n
t
v
ali
d
i
t
y
(
I
-
C
V
I
≥
0
.
7
8
)
a
n
d
s
a
t
is
f
a
ct
o
r
y
s
c
al
e
-
l
e
v
e
l
v
a
l
i
d
i
t
y
.
C
o
n
s
t
r
u
c
t
v
a
li
d
i
t
y
was
e
v
a
l
u
at
e
d
d
u
r
i
n
g
p
i
l
o
t
t
e
s
t
in
g
u
s
i
n
g
i
t
e
m
-
t
o
t
a
l
c
o
r
r
e
l
a
t
i
o
n
a
n
al
y
s
is
,
w
i
t
h
al
l
r
e
ta
i
n
e
d
i
t
e
m
s
m
e
et
i
n
g
th
e
m
i
n
i
m
u
m
a
cc
e
p
t
a
b
l
e
c
o
r
r
e
l
a
t
i
o
n
t
h
r
e
s
h
o
l
d
(
r
>
0
.
3
0
)
.
I
n
t
e
r
n
a
l
c
o
n
s
i
s
t
en
c
y
r
e
l
i
a
b
i
li
t
y
te
s
t
i
n
g
d
e
m
o
n
s
t
r
a
t
e
d
g
o
o
d
r
e
l
i
a
b
il
i
t
y
f
o
r
th
e
f
i
n
a
l
i
n
s
t
r
u
m
e
n
t
(
C
r
o
n
b
a
c
h
’
s
α
=
0
.
8
6
)
.
I
tem
s
wer
e
s
co
r
ed
o
n
a
4
-
p
o
in
t
L
ik
er
t
s
ca
le
(
0
=
s
tr
o
n
g
ly
d
is
ag
r
ee
to
3
=
s
tr
o
n
g
ly
ag
r
e
e)
.
Neg
ativ
ely
k
ey
ed
item
s
wer
e
r
ev
er
s
e
-
s
co
r
ed
.
T
o
tal
s
co
r
es
r
an
g
e
d
f
r
o
m
0
to
7
2
,
with
h
ig
h
er
s
co
r
e
s
in
d
icatin
g
g
r
ea
ter
awa
r
en
ess
an
d
p
r
ep
a
r
ed
n
ess
to
r
ec
o
g
n
ize
s
ex
u
al
v
io
len
ce
an
d
id
en
tif
y
ap
p
r
o
p
r
iate
h
el
p
-
s
ee
k
in
g
ac
tio
n
s
.
Sco
r
es
wer
e
in
ter
p
r
eted
u
s
in
g
d
is
tr
ib
u
tio
n
-
b
ased
cu
t
p
o
in
ts
(
ter
tiles
)
to
cla
s
s
if
y
lo
w,
m
o
d
er
ate,
an
d
h
ig
h
awa
r
en
ess
f
o
r
d
escr
ip
tiv
e
r
ep
o
r
tin
g
.
B
ec
au
s
e
th
e
q
u
esti
o
n
n
air
e
was
ad
m
in
is
ter
ed
in
B
ah
asa
I
n
d
o
n
esia
an
d
was
in
ten
d
e
d
f
o
r
r
u
r
al
ad
o
lescen
ts
,
lan
g
u
ag
e
clar
ity
was
p
r
io
r
itized
.
I
f
an
y
item
s
wer
e
ad
ap
ted
f
r
o
m
E
n
g
lis
h
s
o
u
r
ce
s
,
tr
an
s
latio
n
an
d
cu
ltu
r
al
ad
ap
tatio
n
p
r
o
ce
d
u
r
e
s
f
o
llo
wed
r
ec
en
t
m
eth
o
d
o
lo
g
ical
r
ec
o
m
m
en
d
atio
n
s
f
o
r
tr
an
s
latio
n
,
cu
ltu
r
al
ad
ap
tatio
n
,
an
d
v
alid
atio
n
o
f
h
ea
lth
-
r
elate
d
in
s
tr
u
m
en
ts
,
in
clu
d
in
g
iter
ativ
e
r
ev
iew
with
tar
g
et
u
s
er
s
an
d
r
ec
o
n
ciliatio
n
o
f
s
em
an
tic
an
d
cu
ltu
r
al
e
q
u
iv
alen
ce
[
2
2
]
.
A
p
ilo
t
test
was
c
o
n
d
u
cted
with
a
s
m
all
g
r
o
u
p
o
f
s
tu
d
en
ts
f
r
o
m
a
n
o
n
-
p
ar
ticip
a
tin
g
s
ch
o
o
l
to
ass
ess
co
m
p
r
e
h
en
s
ib
ilit
y
an
d
co
m
p
letio
n
ti
m
e.
R
eliab
ilit
y
was
ev
alu
ated
as
in
ter
n
al
co
n
s
is
ten
cy
.
I
n
p
ilo
t
test
in
g
,
SVAQ
-
A
d
em
o
n
s
tr
ated
ac
ce
p
tab
le
i
n
ter
n
al
co
n
s
is
ten
cy
(
C
r
o
n
b
ac
h
’
s
α
≥
0
.
7
0
)
,
an
d
r
eliab
ilit
y
was
r
e
-
esti
m
ated
u
s
in
g
b
aselin
e
d
ata
in
th
e
f
u
ll
s
tu
d
y
s
am
p
le.
I
n
ad
d
itio
n
,
a
b
r
ief
ac
ce
p
tab
ilit
y
an
d
u
s
ab
ilit
y
f
o
r
m
(
5
item
s
;
4
-
p
o
in
t
r
esp
o
n
s
e
o
p
tio
n
s
)
ca
p
tu
r
ed
p
er
ce
iv
e
d
clar
ity
,
co
m
f
o
r
t,
u
s
ef
u
l
n
ess
,
an
d
willin
g
n
ess
to
r
ec
o
m
m
en
d
th
e
lear
n
in
g
a
p
p
r
o
ac
h
to
p
ee
r
s
.
2
.
5
.
P
r
o
ce
du
re
s
R
ec
r
u
itm
en
t
was
co
n
d
u
cted
th
r
o
u
g
h
co
o
r
d
in
ate
d
s
ch
o
o
l
an
n
o
u
n
ce
m
en
ts
an
d
p
ar
e
n
t
in
f
o
r
m
atio
n
letter
s
.
Data
co
llectio
n
o
cc
u
r
r
ed
in
s
u
p
er
v
is
ed
class
r
o
o
m
s
ettin
g
s
to
en
s
u
r
e
p
r
iv
ac
y
an
d
m
in
im
ize
p
ee
r
in
f
lu
en
ce
.
T
r
ain
e
d
r
esear
ch
a
s
s
is
tan
ts
wer
e
av
ailab
le
to
cl
ar
if
y
item
m
ea
n
in
g
s
with
o
u
t
lead
in
g
p
ar
ticip
an
ts
'
r
esp
o
n
s
es.
At
T
0
,
p
ar
ticip
an
ts
co
m
p
leted
th
e
b
aselin
e
q
u
esti
o
n
n
air
e.
T
h
e
in
ter
v
en
tio
n
ar
m
th
e
n
r
ec
eiv
ed
m
icr
o
lear
n
in
g
m
o
d
u
les
o
v
e
r
two
wee
k
s
,
f
o
llo
wed
b
y
s
ch
ed
u
led
s
p
ac
ed
r
ein
f
o
r
ce
m
en
t
b
o
o
s
ter
s
.
T
h
e
co
m
p
ar
is
o
n
a
r
m
r
ec
ei
v
ed
th
e
leaf
let
s
ess
io
n
at
b
aselin
e
with
o
u
t
f
o
llo
w
-
u
p
b
o
o
s
ter
s
.
I
m
m
ed
iate
p
o
s
t
-
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
7
0
6
-
716
710
in
ter
v
en
tio
n
ass
ess
m
en
t
(
T
1
)
was
co
n
d
u
cte
d
with
in
o
n
e
wee
k
af
ter
co
m
p
letin
g
t
h
e
c
o
r
e
lear
n
i
n
g
p
h
ase.
Fo
llo
w
-
u
p
a
s
s
ess
m
en
t
(
T
2
)
w
as
co
n
d
u
cte
d
f
o
u
r
wee
k
s
af
te
r
co
m
p
letio
n
to
ev
alu
ate
r
eten
t
io
n
.
T
o
in
c
o
r
p
o
r
ate
p
ar
ticip
an
t
f
ee
d
b
ac
k
,
a
s
h
o
r
t
d
eb
r
ief
was
co
n
d
u
cted
af
ter
T
1
in
b
o
th
g
r
o
u
p
s
,
f
o
c
u
s
in
g
o
n
clar
ity
o
f
co
n
ten
t,
p
er
ce
iv
ed
r
elev
an
ce
,
an
d
s
u
g
g
esti
o
n
s
f
o
r
im
p
r
o
v
in
g
d
el
iv
er
y
in
r
u
r
al
s
ch
o
o
l
c
o
n
te
x
ts
.
Feed
b
ac
k
was
s
u
m
m
ar
ized
f
o
r
iter
ativ
e
r
e
f
in
em
en
t o
f
th
e
ed
u
ca
tio
n
al
p
ac
k
ag
e.
2
.
6
.
Da
t
a
a
na
ly
s
is
Data
wer
e
an
aly
ze
d
u
s
in
g
a
p
r
e
-
s
p
ec
if
ied
p
lan
s
u
itab
le
f
o
r
co
r
r
elate
d
r
ep
ea
ted
m
ea
s
u
r
es
an
d
clu
s
ter
in
g
b
y
s
ch
o
o
l.
Descr
ip
t
iv
e
s
tatis
t
ics
s
u
m
m
ar
ized
p
ar
ticip
an
t
ch
ar
ac
ter
is
tics
an
d
b
aselin
e
s
co
r
es.
Gr
o
u
p
eq
u
iv
alen
ce
at
b
aselin
e
was
ass
es
s
ed
u
s
in
g
ap
p
r
o
p
r
iate
te
s
ts
(
t
-
test
o
r
Ma
n
n
–
W
h
itn
ey
U
f
o
r
co
n
tin
u
o
u
s
v
ar
iab
les;
χ²
f
o
r
ca
teg
o
r
ical
v
ar
iab
les),
with
em
p
h
asis
o
n
s
tan
d
ar
d
ized
d
if
f
er
en
ce
s
.
Pri
m
ar
y
ef
f
ec
tiv
e
n
ess
an
aly
s
is
u
s
ed
lin
ea
r
m
ix
ed
-
ef
f
ec
ts
m
o
d
elin
g
to
esti
m
ate
th
e
i
n
ter
v
en
tio
n
ef
f
ec
t o
v
er
tim
e
w
h
ile
ac
co
u
n
tin
g
f
o
r
with
in
-
s
tu
d
en
t
co
r
r
elatio
n
(
r
ep
ea
ted
m
ea
s
u
r
es)
an
d
p
o
te
n
tial
clu
s
ter
in
g
with
in
s
ch
o
o
ls
.
M
o
d
els
in
clu
d
ed
f
ix
ed
ef
f
ec
ts
f
o
r
g
r
o
u
p
(
m
icr
o
lear
n
i
n
g
v
s
leaf
let)
,
tim
e
(
T
0
,
T
1
,
T
2
)
,
a
n
d
th
e
g
r
o
u
p
-
by
-
tim
e
i
n
ter
ac
tio
n
(
p
r
im
ar
y
p
ar
am
eter
o
f
in
ter
est).
R
an
d
o
m
in
ter
ce
p
ts
wer
e
s
p
ec
if
ied
f
o
r
p
ar
ticip
an
ts
,
an
d
a
s
ch
o
o
l
-
l
ev
el
r
an
d
o
m
ef
f
ec
t
was
ad
d
ed
wh
en
s
u
p
p
o
r
te
d
b
y
th
e
d
ata
s
tr
u
ct
u
r
e.
Mix
ed
m
o
d
els
wer
e
s
elec
ted
b
ec
au
s
e
th
e
y
ca
n
p
r
o
v
id
e
v
alid
in
f
er
en
ce
u
n
d
er
m
is
s
in
g
-
at
-
r
a
n
d
o
m
ass
u
m
p
tio
n
s
u
s
in
g
m
ax
im
u
m
lik
elih
o
o
d
esti
m
atio
n
a
n
d
ar
e
ap
p
r
o
p
r
iate
f
o
r
u
n
b
alan
ce
d
r
ep
ea
te
d
-
m
ea
s
u
r
es
d
esig
n
s
co
m
m
o
n
in
f
i
eld
-
b
ased
in
ter
v
e
n
tio
n
s
tu
d
ie
s
[
2
3
]
.
S
en
s
itiv
ity
an
aly
s
es
wer
e
co
n
d
u
cted
u
s
in
g
g
en
er
alize
d
esti
m
atin
g
e
q
u
a
tio
n
s
(
GE
E
)
with
r
o
b
u
s
t
s
tan
d
ar
d
er
r
o
r
s
to
ass
ess
wh
eth
er
c
o
n
clu
s
io
n
s
wer
e
co
n
s
is
ten
t
u
n
d
er
a
p
o
p
u
latio
n
-
a
v
er
ag
ed
ap
p
r
o
ac
h
f
o
r
co
r
r
ela
ted
o
u
tc
o
m
es
[
2
4
]
.
C
o
v
ar
iates
co
n
s
id
er
ed
a
p
r
io
r
i
in
cl
u
d
ed
ag
e,
s
ex
,
g
r
ad
e
le
v
el,
an
d
p
r
i
o
r
ex
p
o
s
u
r
e
to
g
e
n
er
al
r
ep
r
o
d
u
ctiv
e
h
ea
lth
ed
u
ca
tio
n
.
E
f
f
ec
t
s
izes
wer
e
r
ep
o
r
ted
as
esti
m
ated
m
ar
g
in
al
m
ea
n
d
i
f
f
er
en
ce
s
an
d
s
tan
d
ar
d
ized
m
ea
n
d
if
f
er
en
ce
s
with
9
5
% c
o
n
f
i
d
e
n
ce
in
ter
v
als.
Statis
tical
s
ig
n
if
ican
ce
was set a
t
p
<
0
.
0
5
.
3.
RE
SU
L
T
S
T
h
e
p
a
r
ticip
an
t
r
ec
r
u
itm
en
t
,
allo
ca
tio
n
,
f
o
llo
w
-
u
p
,
an
d
an
aly
s
is
p
r
o
ce
d
u
r
es
ar
e
s
u
m
m
ar
ized
in
Fig
u
r
e
1
.
B
aselin
e
d
em
o
g
r
ap
h
ic
ch
ar
ac
ter
is
tics
o
f
p
ar
ticip
an
ts
ar
e
p
r
esen
ted
i
n
T
ab
le
1
.
T
h
e
m
ea
n
ag
e
o
f
p
ar
ticip
an
ts
was
1
4
.
6
y
ea
r
s
(
SD
=
1
.
1
)
,
an
d
5
4
.
2
%
wer
e
f
e
m
ale.
No
s
tatis
t
ically
s
ig
n
if
ic
an
t
d
if
f
er
en
ce
s
wer
e
o
b
s
er
v
ed
b
etwe
en
t
h
e
in
ter
v
e
n
tio
n
a
n
d
c
o
n
tr
o
l
g
r
o
u
p
s
i
n
te
r
m
s
o
f
ag
e,
s
ex
d
is
tr
ib
u
tio
n
,
g
r
ad
e
lev
el,
o
r
p
r
i
o
r
ex
p
o
s
u
r
e
to
g
en
e
r
al
r
ep
r
o
d
u
cti
v
e
h
ea
lth
ed
u
ca
tio
n
(
p
>
0
.
0
5
)
,
in
d
icatin
g
b
aselin
e
c
o
m
p
ar
a
b
ilit
y
.
Me
an
s
ex
u
al
v
i
o
len
ce
awa
r
e
n
ess
s
co
r
es
at
b
aselin
e
(
T
0
)
,
im
m
ed
iate
p
o
s
t
-
in
ter
v
en
tio
n
(
T
1
)
,
an
d
f
o
u
r
-
wee
k
f
o
llo
w
-
u
p
(
T
2
)
ar
e
s
u
m
m
ar
ized
in
T
ab
le
2
.
At
b
aselin
e,
m
ea
n
awa
r
en
ess
s
co
r
es
d
id
n
o
t
d
i
f
f
er
s
ig
n
if
ican
tly
b
etwe
en
g
r
o
u
p
s
(
p
=
0
.
6
2
1
)
.
Fo
llo
win
g
th
e
in
t
er
v
en
tio
n
,
th
e
m
icr
o
lear
n
i
n
g
g
r
o
u
p
d
em
o
n
s
tr
ated
a
m
ar
k
ed
in
cr
ea
s
e
in
awa
r
en
ess
s
co
r
es a
t
T
1
,
wh
ich
was
s
u
s
t
ain
ed
at
T
2
.
I
n
co
n
tr
ast,
th
e
leaf
let
g
r
o
u
p
s
h
o
wed
a
m
o
d
est in
cr
ea
s
e
at
T
1
with
p
ar
tial d
ec
lin
e
at
T
2
(
T
a
b
le
2
)
.
T
h
e
p
r
im
ar
y
ef
f
ec
tiv
en
ess
an
aly
s
is
was
co
n
d
u
cted
u
s
in
g
li
n
ea
r
m
ix
ed
-
ef
f
ec
ts
m
o
d
elin
g
with
f
ix
ed
ef
f
ec
ts
f
o
r
g
r
o
u
p
,
tim
e,
an
d
g
r
o
u
p
-
by
-
tim
e
in
ter
ac
tio
n
,
an
d
r
an
d
o
m
in
ter
ce
p
ts
f
o
r
p
ar
ticip
a
n
ts
.
T
h
e
r
esu
lts
ar
e
p
r
esen
ted
in
T
ab
le
3
.
A
s
tatis
tically
s
ig
n
if
ican
t
g
r
o
u
p
-
by
-
tim
e
in
ter
ac
tio
n
was
o
b
s
er
v
ed
(
p
<
0
.
0
0
1
)
,
in
d
icatin
g
th
at
ch
a
n
g
es
in
a
war
en
ess
s
co
r
es
o
v
er
tim
e
d
if
f
er
ed
s
ig
n
if
ican
tly
b
etwe
e
n
th
e
two
g
r
o
u
p
s
.
C
o
m
p
ar
ed
with
th
e
leaf
let
g
r
o
u
p
,
p
ar
ticip
a
n
ts
in
th
e
m
icr
o
lear
n
in
g
g
r
o
u
p
d
e
m
o
n
s
tr
ated
s
ig
n
if
ican
tly
g
r
ea
ter
in
cr
ea
s
es
in
awa
r
en
ess
s
co
r
es
at
T
1
(
β
=
9
.
1
,
9
5
%
C
I
:
7
.
2
–
1
1
.
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I
:
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ex
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e.
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.
Dem
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T
ab
le
2
.
Sex
u
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v
io
len
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awa
r
en
ess
s
co
r
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v
er
tim
e
b
y
s
tu
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u
p
Ti
me
p
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M
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g
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a
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l
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e
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8
4
0
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7
±
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.
1
P
o
st
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i
n
t
e
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(
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1
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6
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2
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8
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p
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T2
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4
.
8
±
6
.
5
4
4
.
9
±
7
.
3
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
ffective
n
ess
o
f n
u
r
s
in
g
-
led
micro
lea
r
n
in
g
w
ith
s
p
a
ce
d
r
ein
fo
r
ce
men
t o
n
s
ex
u
a
l v
io
le
n
ce
…
(
R
is
n
a
h
)
711
I
n
p
r
ac
tical
ter
m
s
,
th
e
o
b
s
er
v
ed
in
cr
ea
s
e
in
awa
r
en
ess
s
co
r
es
s
u
g
g
ests
th
at
ad
o
lescen
ts
r
ec
eiv
in
g
th
e
m
icr
o
lear
n
in
g
in
ter
v
e
n
tio
n
d
em
o
n
s
tr
ated
im
p
r
o
v
ed
ab
ilit
y
to
r
ec
o
g
n
ize
in
ap
p
r
o
p
r
iate
b
e
h
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io
r
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id
en
tify
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ci
v
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s
itu
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s
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d
u
n
d
er
s
tan
d
ap
p
r
o
p
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iate
h
el
p
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s
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k
in
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p
at
h
way
s
.
T
h
e
s
u
s
tain
ed
im
p
r
o
v
em
en
t
o
b
s
er
v
ed
at
th
e
f
o
u
r
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p
f
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r
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er
i
n
d
icate
s
t
h
at
th
e
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ter
v
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o
n
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ay
s
u
p
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o
r
t
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tio
n
o
f
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r
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tectiv
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k
n
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h
is
s
u
g
g
ests
th
at
th
e
b
en
ef
its
o
f
th
e
in
ter
v
en
tio
n
ex
ten
d
b
ey
o
n
d
im
m
e
d
iate
ex
p
o
s
u
r
e.
T
h
e
GE
E
an
aly
s
is
s
h
o
wed
r
es
u
lts
co
n
s
is
ten
t
with
th
e
p
r
im
a
r
y
m
i
x
ed
-
ef
f
ec
ts
m
o
d
els.
T
h
e
r
e
was
n
o
s
ig
n
if
ican
t
b
aselin
e
d
if
f
er
en
ce
b
etwe
en
g
r
o
u
p
s
(
β
=
0
.
5
,
p
=
0
.
5
3
6
)
.
Awa
r
en
ess
s
co
r
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cr
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s
ed
s
ig
n
if
ican
tly
o
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at
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th
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o
s
t
-
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ter
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n
(
T
1
:
β
=
6
.
5
,
p
<
0
.
0
0
1
)
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d
f
o
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r
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k
f
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llo
w
-
u
p
(
T
2
: β
=
4
.
6
,
p
<
0
.
0
0
1
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.
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n
if
ican
t
g
r
o
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p
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s
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icate
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h
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r
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ater
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p
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th
an
th
e
lea
f
let
g
r
o
u
p
at
T
1
(
β
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8
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9
,
p
<
0
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0
0
1
)
an
d
m
ain
tain
ed
h
ig
h
er
s
co
r
es
at
T
2
(
β
=
8
.
2
,
p
<
0
.
0
0
1
)
(
T
ab
le
4
)
.
Fig
u
r
e
1
.
Stu
d
y
f
lo
w
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h
ar
t
T
ab
le
3
.
L
in
ea
r
m
ix
e
d
-
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f
ec
ts
m
o
d
el
f
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r
s
ex
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al
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o
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s
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r
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c
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r
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SE
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t
)
0
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6
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9
−
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2
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o
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4
0
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5
1
4
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me
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v
s
T
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6
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8
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5
.
4
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o
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2
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me
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v
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T
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4
.
9
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3
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o
6
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5
<
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0
1
G
r
o
u
p
×
Ti
me
(
T
1
)
9
.
1
1
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0
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2
t
o
1
1
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0
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0
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1
G
r
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p
×
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me
(
T
2
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8
.
6
1
.
1
6
.
5
t
o
1
0
.
7
<
0
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0
0
1
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
7
0
6
-
716
712
T
ab
le
4
.
Sen
s
itiv
ity
an
aly
s
is
o
f
s
ex
u
al
v
io
len
ce
awa
r
en
ess
s
co
r
es u
s
in
g
g
e
n
er
alize
d
esti
m
atin
g
eq
u
atio
n
s
(
GE
E
)
P
r
e
d
i
c
t
o
r
β (est
i
ma
t
e
)
SE
9
5
%
C
I
p
-
v
a
l
u
e
G
r
o
u
p
(
mi
c
r
o
l
e
a
r
n
i
n
g
v
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l
e
a
f
l
e
t
)
0
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5
0
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8
−
1
.
1
t
o
2
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1
0
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5
3
6
Ti
me
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T
0
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6
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5
0
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6
5
.
3
t
o
7
.
7
<
0
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0
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1
Ti
me
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v
s
T
0
)
4
.
6
0
.
7
3
.
2
t
o
6
.
0
<
0
.
0
0
1
G
r
o
u
p
×
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me
(
T
1
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8
.
9
0
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9
7
.
1
t
o
1
0
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7
<
0
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1
G
r
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u
p
×
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me
(
T
2
)
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2
1
.
0
6
.
2
t
o
1
0
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2
<
0
.
0
0
1
4.
DIS
CU
SS
I
O
N
T
h
is
ex
p
er
im
en
tal
s
tu
d
y
d
em
o
n
s
tr
ated
th
at
a
n
u
r
s
in
g
-
led
m
icr
o
lear
n
in
g
in
ter
v
en
tio
n
with
s
p
ac
ed
r
ein
f
o
r
ce
m
e
n
t
p
r
o
d
u
ce
d
s
i
g
n
if
ican
tly
g
r
ea
ter
a
n
d
m
o
r
e
s
u
s
tain
ed
im
p
r
o
v
em
e
n
t
s
in
ad
o
lescen
ts
’
awa
r
en
ess
o
f
s
ex
u
al
v
io
len
ce
in
r
u
r
al
ar
ea
s
co
m
p
ar
e
d
with
co
n
v
e
n
tio
n
al
leaf
let
-
b
ased
ed
u
ca
tio
n
.
B
aselin
e
eq
u
iv
alen
ce
b
etwe
en
g
r
o
u
p
s
in
d
em
o
g
r
a
p
h
ic
ch
ar
ac
ter
i
s
tics
an
d
p
r
io
r
r
ep
r
o
d
u
ctiv
e
h
ea
lth
ed
u
ca
tio
n
s
tr
en
g
th
en
s
in
ter
n
al
v
alid
ity
a
n
d
s
u
p
p
o
r
ts
th
e
attr
ib
u
tio
n
o
f
o
b
s
er
v
ed
ef
f
ec
ts
to
th
e
in
ter
v
en
tio
n
r
ath
e
r
th
an
p
r
e
-
ex
is
t
in
g
d
if
f
er
e
n
ce
s
.
T
h
e
co
n
s
is
ten
t
f
in
d
in
g
s
ac
r
o
s
s
lin
ea
r
m
i
x
ed
-
ef
f
ec
ts
m
o
d
el
s
an
d
g
e
n
er
alize
d
esti
m
atin
g
eq
u
atio
n
s
f
u
r
th
er
co
n
f
ir
m
th
e
r
o
b
u
s
tn
ess
o
f
th
e
in
ter
v
e
n
tio
n
ef
f
ec
t
at
b
o
th
in
d
iv
id
u
al
a
n
d
p
o
p
u
latio
n
lev
els.
T
h
e
m
ar
k
e
d
in
cr
ea
s
e
in
awa
r
en
ess
s
co
r
es
o
b
s
er
v
ed
im
m
ed
iately
af
ter
th
e
in
ter
v
e
n
tio
n
(
T
1
)
an
d
th
e
s
u
s
tain
ed
ad
v
an
tag
e
at
f
o
u
r
-
w
ee
k
f
o
llo
w
-
u
p
(
T
2
)
in
th
e
m
ic
r
o
lear
n
in
g
g
r
o
u
p
in
d
icate
th
at
ed
u
ca
tio
n
al
f
o
r
m
at
an
d
d
eliv
er
y
s
tr
u
ctu
r
e
p
lay
a
cr
itical
r
o
le
in
d
eter
m
i
n
in
g
n
o
t
o
n
ly
im
m
ed
iate
lear
n
in
g
g
ain
s
b
u
t
also
s
h
o
r
t
-
ter
m
r
eten
tio
n
.
W
h
ile
b
o
th
g
r
o
u
p
s
s
h
o
wed
s
o
m
e
im
p
r
o
v
e
m
en
t
o
v
er
tim
e
,
r
ef
lectin
g
th
e
g
en
er
al
b
e
n
ef
it
o
f
ex
p
o
s
u
r
e
t
o
s
ex
u
al
v
i
o
len
ce
ed
u
ca
tio
n
,
t
h
e
m
ag
n
itu
d
e
a
n
d
p
er
s
is
ten
ce
o
f
g
ain
s
wer
e
s
u
b
s
tan
tially
g
r
ea
ter
am
o
n
g
a
d
o
lescen
ts
r
ec
eiv
in
g
m
icr
o
l
ea
r
n
in
g
with
s
p
ac
ed
r
ein
f
o
r
ce
m
en
t.
T
h
e
s
ig
n
if
ic
an
t
g
r
o
u
p
-
by
-
tim
e
in
ter
ac
tio
n
s
o
b
s
er
v
ed
in
b
o
th
a
n
aly
tic
ap
p
r
o
ac
h
es u
n
d
er
s
co
r
e
th
at
th
e
in
ter
v
en
tio
n
ef
f
ec
t w
a
s
n
o
t tr
an
s
ien
t a
n
d
was
r
esil
ien
t
to
al
ter
n
ativ
e
m
o
d
elin
g
ass
u
m
p
tio
n
s
.
Fro
m
a
lear
n
in
g
s
cien
ce
p
er
s
p
ec
tiv
e,
t
h
ese
f
in
d
in
g
s
alig
n
with
ev
id
en
ce
th
at
s
p
ac
ed
e
d
u
ca
tio
n
al
ex
p
o
s
u
r
e
c
o
u
n
ter
ac
t
s
r
ap
id
f
o
r
g
ettin
g
an
d
s
u
p
p
o
r
ts
co
n
s
o
lid
atio
n
o
f
k
n
o
wled
g
e
in
t
o
lo
n
g
e
r
-
ter
m
m
em
o
r
y
[
2
5
]
,
[
2
6
]
.
T
h
ese
f
in
d
in
g
s
ar
e
also
co
n
s
is
ten
t
with
co
g
n
itiv
e
lear
n
in
g
th
eo
r
ies
s
u
g
g
es
tin
g
th
at
r
ep
ea
ted
r
etr
iev
al
p
r
ac
tice
an
d
d
is
tr
ib
u
ted
lear
n
in
g
ex
p
o
s
u
r
e
im
p
r
o
v
e
m
em
o
r
y
co
n
s
o
lid
atio
n
a
n
d
lo
n
g
-
ter
m
r
eten
tio
n
c
o
m
p
a
r
ed
with
s
in
g
le
-
s
ess
io
n
ed
u
ca
tio
n
al
d
eliv
er
y
[
2
7
],
[2
8
]
.
Mic
r
o
lear
n
in
g
f
o
r
m
ats,
ch
a
r
ac
ter
ized
b
y
s
h
o
r
t,
f
o
cu
s
ed
c
o
n
t
en
t
u
n
its
,
m
ay
also
r
ed
u
ce
co
g
n
itiv
e
o
v
er
lo
a
d
an
d
im
p
r
o
v
e
en
g
ag
em
e
n
t,
p
ar
ticu
lar
ly
am
o
n
g
a
d
o
lescen
ts
b
alan
cin
g
ac
ad
em
ic
d
em
a
n
d
s
an
d
lim
ited
lear
n
in
g
r
eso
u
r
ce
s
in
r
u
r
al
s
ettin
g
s
[
2
7
]
.
T
o
g
eth
e
r
,
th
ese
m
ec
h
a
n
is
m
s
p
lau
s
ib
ly
ex
p
lain
th
e
s
u
p
er
i
o
r
r
eten
tio
n
o
b
s
er
v
ed
in
th
e
in
ter
v
e
n
tio
n
g
r
o
u
p
co
m
p
ar
ed
with
s
in
g
le
-
e
x
p
o
s
u
r
e
leaf
let
ed
u
ca
tio
n
.
T
h
e
p
r
esen
t
f
in
d
in
g
s
ex
te
n
d
p
r
io
r
r
esear
ch
o
n
s
ch
o
o
l
-
an
d
co
m
m
u
n
ity
-
b
ased
s
ex
u
a
l
v
io
len
ce
p
r
ev
en
tio
n
p
r
o
g
r
am
s
.
Similar
f
in
d
in
g
s
h
a
v
e
also
b
ee
n
r
ep
o
r
ted
in
ad
o
lescen
t
d
i
g
ital
h
ea
lth
ed
u
ca
tio
n
s
tu
d
ies
d
em
o
n
s
tr
atin
g
t
h
at
r
ep
ea
ted
a
n
d
in
ter
ac
tiv
e
e
d
u
ca
tio
n
al
e
x
p
o
s
u
r
e
ca
n
im
p
r
o
v
e
en
g
ag
em
en
t
an
d
k
n
o
wled
g
e
s
u
s
tain
ab
ilit
y
am
o
n
g
ad
o
lescen
ts
[
29
].
Me
ta
-
a
n
aly
tic
ev
id
en
ce
in
d
icate
s
th
at
s
u
ch
p
r
o
g
r
am
s
ca
n
im
p
r
o
v
e
k
n
o
wled
g
e
an
d
p
r
o
tectiv
e
o
u
t
co
m
es
b
u
t
h
ig
h
lig
h
ts
s
u
b
s
tan
tial
h
eter
o
g
en
eity
r
elate
d
to
p
r
o
g
r
am
m
er
i
n
ten
s
ity
,
in
s
tr
u
ctio
n
al
m
eth
o
d
s
,
an
d
r
ei
n
f
o
r
ce
m
e
n
t stra
teg
ies [
2
8
]
.
M
an
y
in
ter
v
e
n
tio
n
s
r
ely
o
n
o
n
e
-
o
f
f
o
r
s
h
o
r
t
-
d
u
r
atio
n
s
ess
io
n
s
,
wh
ich
m
ay
ex
p
lain
th
e
atten
u
atio
n
o
f
ef
f
ec
ts
o
v
er
tim
e
r
ep
o
r
ted
in
s
ev
er
al
s
tu
d
ies.
Ou
r
r
esu
lts
co
n
tr
ib
u
te
to
th
is
liter
atu
r
e
b
y
d
em
o
n
s
tr
atin
g
th
at
em
b
e
d
d
in
g
r
ein
f
o
r
ce
m
en
t
in
to
th
e
ed
u
c
atio
n
al
d
esig
n
ca
n
m
ea
n
in
g
f
u
lly
en
h
a
n
ce
o
u
tco
m
e
d
u
r
ab
ilit
y
.
R
ec
en
t
d
ig
ital
an
d
m
o
b
ile
-
b
a
s
ed
p
r
ev
e
n
tio
n
i
n
ter
v
en
tio
n
s
h
av
e
s
h
o
wn
p
r
o
m
is
in
g
e
f
f
ec
t
s
o
n
s
ex
u
al
ab
u
s
e
an
d
v
io
len
ce
awa
r
en
es
s
am
o
n
g
ch
ild
r
e
n
an
d
ad
o
lescen
ts
,
in
clu
d
in
g
s
tu
d
ies
co
n
d
u
cted
in
lo
w
-
a
n
d
m
id
d
le
-
in
co
m
e
co
u
n
tr
ies
[
29
]
,
[
3
0
]
.
Ho
wev
er
,
m
o
s
t
ev
al
u
atio
n
s
f
o
cu
s
o
n
f
ea
s
ib
ilit
y
o
r
im
m
ed
iate
p
o
s
t
-
in
ter
v
en
tio
n
o
u
tco
m
es,
with
l
im
ited
atten
tio
n
to
r
eten
tio
n
b
ey
o
n
d
th
e
in
itial
ex
p
o
s
u
r
e.
B
y
in
co
r
p
o
r
atin
g
r
ep
ea
ted
m
ea
s
u
r
em
en
ts
an
d
s
p
ac
ed
r
ein
f
o
r
ce
m
en
t,
th
e
p
r
esen
t
s
tu
d
y
p
r
o
v
id
es
em
p
ir
ical
s
u
p
p
o
r
t
f
o
r
a
th
eo
r
etica
lly
g
r
o
u
n
d
ed
ap
p
r
o
ac
h
to
im
p
r
o
v
in
g
d
u
r
ab
ilit
y
o
f
lear
n
in
g
ef
f
ec
ts
in
ad
o
lescen
t
s
ex
u
al
v
io
len
ce
ed
u
ca
tio
n
.
Mo
r
eo
v
er
,
th
e
r
u
r
al
f
o
c
u
s
o
f
th
is
s
tu
d
y
ad
d
r
ess
es
an
im
p
o
r
tan
t
co
n
te
x
tu
al
g
a
p
.
R
u
r
al
a
d
o
lescen
ts
o
f
ten
f
ac
e
co
m
p
o
u
n
d
ed
b
ar
r
ie
r
s
to
in
f
o
r
m
atio
n
,
co
n
f
id
en
tial
ity
,
an
d
s
u
p
p
o
r
tiv
e
s
er
v
ices,
w
h
ich
ca
n
lim
it
b
o
th
awa
r
en
ess
an
d
h
elp
-
s
ee
k
in
g
b
eh
av
io
r
s
[
3
1
]
.
E
d
u
ca
tio
n
al
i
n
ter
v
en
tio
n
s
d
esig
n
e
d
f
o
r
u
r
b
an
o
r
r
eso
u
r
ce
-
r
ich
co
n
tex
ts
m
ay
n
o
t
tr
an
s
late
e
f
f
ec
tiv
ely
with
o
u
t
ad
a
p
tatio
n
.
T
h
e
o
b
s
er
v
e
d
ef
f
ec
tiv
en
ess
o
f
a
lo
w
-
b
u
r
d
en
m
icr
o
lear
n
in
g
ap
p
r
o
ac
h
s
u
g
g
e
s
ts
th
at
s
u
ch
s
tr
ateg
ies
m
ay
b
e
p
a
r
ticu
lar
ly
well
s
u
ited
f
o
r
r
u
r
al
s
ettin
g
s
wh
er
e
s
u
s
tain
ed
,
r
eso
u
r
ce
-
in
ten
s
iv
e
p
r
o
g
r
a
m
m
in
g
is
d
if
f
icu
lt
to
im
p
lem
en
t.
T
h
is
f
in
d
in
g
s
u
p
p
o
r
t
s
p
r
ev
io
u
s
ev
id
e
n
ce
s
u
g
g
esti
n
g
th
at
f
le
x
ib
le
d
ig
i
tal
lear
n
in
g
a
p
p
r
o
ac
h
es
m
ay
b
e
p
a
r
ticu
lar
ly
b
en
ef
icial
f
o
r
ad
o
lescen
ts
in
u
n
d
er
s
er
v
e
d
an
d
g
eo
g
r
ap
h
ically
is
o
lated
co
m
m
u
n
ities
[
3
0
].
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
E
ffective
n
ess
o
f n
u
r
s
in
g
-
led
micro
lea
r
n
in
g
w
ith
s
p
a
ce
d
r
ein
fo
r
ce
men
t o
n
s
ex
u
a
l v
io
le
n
ce
…
(
R
is
n
a
h
)
713
Nev
er
th
eless
,
in
cr
ea
s
ed
awa
r
en
ess
s
h
o
u
ld
n
o
t
au
to
m
atica
lly
b
e
in
ter
p
r
eted
as
d
ir
ec
t
b
eh
av
io
r
al
ch
an
g
e.
Alth
o
u
g
h
im
p
r
o
v
ed
r
ec
o
g
n
itio
n
o
f
s
ex
u
al
v
i
o
len
ce
an
d
h
el
p
-
s
ee
k
in
g
r
ea
d
i
n
ess
ar
e
im
p
o
r
tan
t
p
r
ev
en
tiv
e
o
u
tc
o
m
es,
ad
o
lescen
ts
m
ay
s
till
f
ac
e
s
u
b
s
tan
tial
b
ar
r
ier
s
t
o
d
is
clo
s
u
r
e
an
d
s
er
v
ice
u
tili
za
tio
n
,
p
ar
ticu
lar
ly
in
r
u
r
al
s
ettin
g
s
ch
ar
ac
ter
ized
b
y
s
tig
m
a,
f
ea
r
o
f
s
o
cial
co
n
s
eq
u
en
ce
s
,
an
d
lim
ited
co
n
f
id
en
tial
s
u
p
p
o
r
t
s
y
s
tem
s
[
8
]
,
[
9
]
.
T
h
er
ef
o
r
e,
ed
u
ca
tio
n
al
in
ter
v
e
n
t
io
n
s
alo
n
e
m
a
y
b
e
in
s
u
f
f
icie
n
t
with
o
u
t
b
r
o
ad
e
r
s
tr
u
ctu
r
al
an
d
p
s
y
ch
o
s
o
cial
s
u
p
p
o
r
t
m
ec
h
a
n
is
m
s
.
Fu
tu
r
e
i
n
ter
v
en
tio
n
s
s
h
o
u
ld
c
o
n
s
id
er
in
teg
r
atin
g
p
ar
en
tal
en
g
ag
em
e
n
t,
s
ch
o
o
l
s
af
eg
u
ar
d
in
g
s
y
s
tem
s
,
an
d
ad
o
lescen
t
-
f
r
ien
d
ly
r
ef
e
r
r
al
p
ath
wa
y
s
t
o
s
tr
en
g
th
en
tr
a
n
s
latio
n
o
f
awa
r
en
ess
in
to
p
r
o
tectiv
e
b
eh
av
io
r
s
an
d
ac
tu
al
h
elp
-
s
ee
k
in
g
p
r
ac
tices.
4
.
1
.
Clini
ca
l a
nd
pu
bli
c
hea
l
t
h im
pli
ca
t
io
ns
T
h
e
f
in
d
in
g
s
h
a
v
e
s
ev
er
al
im
p
licatio
n
s
f
o
r
n
u
r
s
in
g
p
r
ac
tice
an
d
p
u
b
lic
h
ea
lth
p
r
o
g
r
a
m
m
in
g
.
First,
n
u
r
s
es
s
er
v
in
g
as
s
ch
o
o
l
a
n
d
co
m
m
u
n
ity
h
ea
lth
ed
u
ca
to
r
s
a
r
e
well
p
o
s
itio
n
ed
to
d
eliv
er
m
icr
o
lear
n
in
g
-
b
ased
in
ter
v
en
tio
n
s
,
in
te
g
r
atin
g
b
r
ie
f
ed
u
ca
tio
n
al
m
o
d
u
les
in
to
ex
is
tin
g
s
ch
o
o
l
h
ea
lth
ac
tiv
ities
with
o
u
t
s
u
b
s
tan
tial
d
is
r
u
p
tio
n
.
Seco
n
d
,
th
e
u
s
e
o
f
s
p
ac
ed
r
ein
f
o
r
ce
m
en
t
o
f
f
er
s
a
p
r
ac
tical
m
ea
n
s
t
o
en
h
an
c
e
r
eten
tio
n
with
o
u
t
r
eq
u
ir
in
g
p
r
o
lo
n
g
e
d
co
n
tact
tim
e,
wh
ich
is
esp
ec
ially
v
alu
a
b
le
in
r
u
r
al
a
n
d
r
eso
u
r
ce
-
lim
it
ed
co
n
tex
ts
.
At
th
e
s
y
s
tem
s
lev
el,
th
e
in
ter
v
e
n
tio
n
m
o
d
el
s
u
p
p
o
r
ts
a
s
h
if
t
f
r
o
m
s
in
g
le
-
s
ess
io
n
aw
ar
en
ess
ca
m
p
aig
n
s
t
o
war
d
ev
id
en
ce
-
in
f
o
r
m
e
d
ed
u
ca
tio
n
al
d
esig
n
s
th
at
p
r
io
r
itize
r
eten
tio
n
an
d
r
ein
f
o
r
ce
m
en
t.
I
n
co
r
p
o
r
atin
g
m
icr
o
lear
n
in
g
an
d
s
p
ac
ed
r
ei
n
f
o
r
ce
m
e
n
t
in
to
ad
o
lescen
t
h
ea
lth
p
r
o
m
o
tio
n
s
tr
ateg
ies
m
ay
s
tr
en
g
th
en
ea
r
ly
r
ec
o
g
n
itio
n
o
f
s
ex
u
al
v
io
len
ce
,
im
p
r
o
v
e
r
ea
d
in
ess
to
s
ee
k
h
elp
,
an
d
u
ltima
tely
co
n
t
r
ib
u
te
to
u
p
s
tr
ea
m
p
r
ev
en
tio
n
.
T
h
ese
ap
p
r
o
ac
h
es
ar
e
also
co
m
p
atib
le
with
d
ig
it
al
h
ea
lth
a
n
d
s
ch
o
o
l
-
b
ased
p
la
tf
o
r
m
s
in
cr
ea
s
in
g
l
y
em
p
h
asized
in
p
u
b
lic
h
ea
lth
s
tr
ateg
ies tar
g
etin
g
ad
o
lescen
ts
[
3
2
].
4
.
2
.
St
ud
y
lim
it
a
t
io
ns
Sev
er
al
lim
itatio
n
s
s
h
o
u
ld
b
e
co
n
s
id
er
ed
wh
en
i
n
ter
p
r
eti
n
g
th
ese
f
in
d
in
g
s
.
First,
alt
h
o
u
g
h
th
e
ex
p
er
im
en
tal
d
esig
n
an
d
r
ep
e
ated
m
ea
s
u
r
es
s
tr
en
g
th
en
ca
u
s
al
in
f
er
en
ce
,
t
h
e
s
tu
d
y
was
co
n
d
u
cted
i
n
s
elec
ted
r
u
r
al
s
ch
o
o
ls
,
wh
ich
m
a
y
li
m
it
g
en
er
al
izab
ilit
y
to
u
r
b
an
s
ettin
g
s
o
r
o
u
t
-
of
-
s
ch
o
o
l
a
d
o
lescen
ts
.
Seco
n
d
,
awa
r
en
ess
was
m
ea
s
u
r
ed
u
s
i
n
g
a
s
elf
-
r
ep
o
r
t
in
s
tr
u
m
en
t,
wh
ich
m
ay
b
e
s
u
b
ject
to
s
o
c
ial
d
esira
b
ilit
y
b
ias
d
esp
ite
ass
u
r
an
ce
s
o
f
co
n
f
id
e
n
tiality
.
T
h
ir
d
,
th
e
f
o
llo
w
-
u
p
p
er
io
d
was
lim
ited
to
f
o
u
r
we
ek
s
,
wh
ich
r
estricts
co
n
clu
s
io
n
s
r
e
g
ar
d
in
g
lo
n
g
-
ter
m
s
u
s
tain
ab
ilit
y
o
f
lear
n
in
g
r
e
ten
tio
n
an
d
b
eh
av
io
r
al
im
p
ac
t.
I
t
r
e
m
ain
s
u
n
clea
r
wh
eth
er
awa
r
en
ess
g
ain
s
wo
u
ld
p
er
s
is
t
o
v
er
s
ev
er
al
m
o
n
t
h
s
o
r
tr
an
s
late
in
to
ac
tu
al
p
r
ev
en
tiv
e
b
eh
a
v
io
r
s
,
d
is
clo
s
u
r
e
p
r
ac
t
ices,
o
r
in
cr
ea
s
ed
u
tili
za
tio
n
o
f
s
u
p
p
o
r
t
s
er
v
ices.
Fin
ally
,
wh
ile
s
en
s
itiv
ity
an
aly
s
es
s
u
p
p
o
r
ted
th
e
r
o
b
u
s
tn
ess
o
f
th
e
f
in
d
in
g
s
,
th
e
s
tu
d
y
was
n
o
t
p
o
wer
ed
t
o
ex
p
l
o
r
e
s
u
b
g
r
o
u
p
ef
f
ec
ts
(
e.
g
.
,
b
y
s
ex
o
r
p
r
io
r
ex
p
o
s
u
r
e
t
o
v
io
len
ce
)
,
wh
ich
s
h
o
u
ld
b
e
e
x
am
in
e
d
i
n
f
u
tu
r
e
r
esear
ch
.
Pre
v
io
u
s
s
tu
d
ies
h
av
e
s
h
o
wn
th
at
s
h
o
r
t
-
ter
m
ed
u
ca
tio
n
al
g
ai
n
s
d
o
n
o
t
alwa
y
s
t
r
an
s
late
in
to
s
u
s
tain
ed
b
eh
a
v
io
r
al
ch
an
g
e
with
o
u
t
o
n
g
o
in
g
r
ein
f
o
r
ce
m
e
n
t a
n
d
s
u
p
p
o
r
tiv
e
en
v
ir
o
n
m
en
tal
f
ac
to
r
s
[
3
1
].
5.
CO
NCLU
SI
O
N
I
n
co
n
clu
s
io
n
,
th
is
s
tu
d
y
p
r
o
v
id
es
ev
i
d
en
ce
t
h
at
a
n
u
r
s
in
g
-
led
m
icr
o
lear
n
in
g
in
ter
v
e
n
tio
n
with
s
p
ac
ed
r
ein
f
o
r
ce
m
e
n
t is m
o
r
e
ef
f
ec
tiv
e
th
an
co
n
v
e
n
tio
n
al
le
af
let
-
b
ased
ed
u
ca
tio
n
in
im
p
r
o
v
in
g
an
d
s
u
s
tain
in
g
ad
o
lescen
ts
’
awa
r
en
ess
o
f
s
ex
u
al
v
io
len
ce
i
n
r
u
r
al
ar
ea
s
.
B
y
in
teg
r
atin
g
p
r
in
cip
les
f
r
o
m
le
ar
n
in
g
s
cien
ce
i
n
to
p
u
b
lic
h
ea
lth
ed
u
ca
tio
n
,
th
i
s
ap
p
r
o
ac
h
o
f
f
er
s
a
f
ea
s
ib
l
e,
s
ca
lab
le,
an
d
c
o
n
tex
t
-
s
en
s
itiv
e
s
tr
ateg
y
f
o
r
s
tr
en
g
th
en
in
g
a
d
o
lescen
t
s
ex
u
al
v
io
len
ce
p
r
ev
en
tio
n
ef
f
o
r
ts
.
Fu
tu
r
e
s
tu
d
ies
s
h
o
u
ld
ex
am
in
e
lo
n
g
e
r
-
ter
m
o
u
tco
m
es
an
d
ex
p
l
o
r
e
in
teg
r
at
io
n
with
b
r
o
ad
er
s
af
eg
u
a
r
d
in
g
an
d
h
elp
-
s
ee
k
in
g
p
ath
wa
y
s
to
m
ax
im
ize
p
u
b
lic
h
ea
lth
im
p
ac
t.
ACK
NO
WL
E
DG
E
M
E
NT
S
T
h
e
au
th
o
r
s
wo
u
ld
lik
e
to
t
h
an
k
th
e
p
ar
ticip
atin
g
s
ch
o
o
l
s
,
s
tu
d
en
ts
,
p
ar
e
n
ts
,
an
d
s
ch
o
o
l
h
ea
lth
teac
h
er
s
f
o
r
th
eir
c
o
o
p
er
atio
n
an
d
s
u
p
p
o
r
t.
Ap
p
r
ec
iatio
n
is
also
ex
ten
d
e
d
to
lo
ca
l
ed
u
ca
tio
n
au
th
o
r
ities
f
o
r
f
ac
ilit
atin
g
th
e
s
tu
d
y
im
p
lem
e
n
tatio
n
.
F
UNDING
I
NF
O
R
M
A
T
I
O
N
T
h
is
s
tu
d
y
r
ec
eiv
ed
n
o
e
x
ter
n
a
l
f
u
n
d
in
g
.
AUTHO
R
CO
NT
RI
B
UT
I
O
NS ST
A
T
E
M
E
N
T
T
h
is
jo
u
r
n
al
u
s
es
th
e
C
o
n
t
r
ib
u
to
r
R
o
les
T
a
x
o
n
o
m
y
(
C
R
ed
iT)
to
r
ec
o
g
n
ize
in
d
iv
i
d
u
al
au
th
o
r
co
n
tr
ib
u
tio
n
s
,
r
ed
u
ce
au
th
o
r
s
h
ip
d
is
p
u
tes,
an
d
f
ac
ilit
ate
co
llab
o
r
atio
n
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
7
0
6
-
716
714
Na
m
e
o
f
Aut
ho
r
C
M
So
Va
Fo
I
R
D
O
E
Vi
Su
P
Fu
R
is
n
ah
✓
✓
✓
✓
✓
✓
Mu
th
ah
h
ar
a
h
✓
✓
✓
✓
✓
✓
E
k
a
Had
r
ay
a
n
i
✓
✓
✓
Ais
y
ah
B
ah
ar
✓
✓
✓
Har
m
awa
ti
✓
✓
✓
Mu
h
am
m
ad
I
r
wan
✓
✓
✓
Su
d
ar
m
an
✓
✓
✓
C
:
C
o
n
c
e
p
t
u
a
l
i
z
a
t
i
o
n
M
:
M
e
t
h
o
d
o
l
o
g
y
So
:
So
f
t
w
a
r
e
Va
:
Va
l
i
d
a
t
i
o
n
Fo
:
Fo
r
mal
a
n
a
l
y
s
i
s
I
:
I
n
v
e
s
t
i
g
a
t
i
o
n
R
:
R
e
so
u
r
c
e
s
D
:
D
a
t
a
C
u
r
a
t
i
o
n
O
:
W
r
i
t
i
n
g
-
O
r
i
g
i
n
a
l
D
r
a
f
t
E
:
W
r
i
t
i
n
g
-
R
e
v
i
e
w
&
E
d
i
t
i
n
g
Vi
:
Vi
su
a
l
i
z
a
t
i
o
n
Su
:
Su
p
e
r
v
i
s
i
o
n
P
:
P
r
o
j
e
c
t
a
d
mi
n
i
st
r
a
t
i
o
n
Fu
:
Fu
n
d
i
n
g
a
c
q
u
i
si
t
i
o
n
CO
NF
L
I
C
T
O
F
I
N
T
E
R
E
S
T
ST
A
T
E
M
E
NT
T
h
e
au
th
o
r
s
d
ec
lar
e
n
o
co
n
f
lict o
f
in
ter
est
.
E
T
H
I
CAL AP
P
RO
V
AL
E
th
ical
ap
p
r
o
v
al
was
o
b
tain
ed
f
r
o
m
th
e
in
s
titu
tio
n
al
r
ev
iew
b
o
ar
d
(
I
R
B
)
o
f
th
e
in
v
esti
g
ato
r
s
’
in
s
titu
tio
n
p
r
io
r
to
d
ata
co
lle
ctio
n
(
No
.
C
.
144
/KE
PK/F
KI
K/I
X/2
0
2
5
)
.
Per
m
is
s
io
n
s
wer
e
s
ec
u
r
ed
f
r
o
m
th
e
d
is
tr
ict
ed
u
ca
tio
n
o
f
f
ice
an
d
s
ch
o
o
l
p
r
in
cip
als.
A
s
af
eg
u
ar
d
i
n
g
p
r
o
to
c
o
l
was
estab
lis
h
ed
in
co
llab
o
r
atio
n
with
s
ch
o
o
l
co
u
n
s
elo
r
s
,
in
cl
u
d
in
g
r
ef
er
r
al
p
ath
wa
y
s
an
d
co
n
f
id
en
tial
r
ep
o
r
tin
g
p
r
o
ce
d
u
r
es
f
o
r
p
ar
ticip
an
ts
wh
o
d
is
clo
s
ed
d
is
tr
ess
o
r
ex
p
er
ie
n
ce
s
r
eq
u
ir
in
g
s
u
p
p
o
r
t.
W
r
itten
p
ar
en
tal/g
u
ar
d
ian
c
o
n
s
en
t
an
d
s
tu
d
en
t
ass
en
t
wer
e
o
b
tain
ed
b
ef
o
r
e
b
aselin
e
ass
e
s
s
m
en
t.
Af
ter
T
2
,
s
tu
d
en
ts
in
th
e
co
m
p
ar
is
o
n
ar
m
wer
e
o
f
f
er
ed
ac
ce
s
s
to
th
e
m
icr
o
lear
n
i
n
g
m
ater
ia
ls
as a
n
eth
ical
b
en
e
f
it.
DATA AV
AI
L
AB
I
L
I
T
Y
T
h
e
d
atasets
g
en
er
ated
an
d
/o
r
an
aly
ze
d
d
u
r
in
g
t
h
e
cu
r
r
en
t
s
tu
d
y
ar
e
a
v
ailab
le
f
r
o
m
th
e
co
r
r
esp
o
n
d
in
g
a
u
th
o
r
u
p
o
n
r
ea
s
o
n
ab
le
r
eq
u
est.
RE
F
E
R
E
NC
E
S
[
1
]
A
.
P
i
o
l
a
n
t
i
,
I
.
E.
S
c
h
m
i
d
,
F
.
J
.
F
i
d
e
r
e
r
,
C
.
L
.
W
a
r
d
,
H
.
S
t
ö
c
k
l
,
a
n
d
H
.
M
.
F
o
r
a
n
,
“
G
l
o
b
a
l
p
r
e
v
a
l
e
n
c
e
o
f
se
x
u
a
l
v
i
o
l
e
n
c
e
a
g
a
i
n
s
t
c
h
i
l
d
r
e
n
:
a
s
y
st
e
ma
t
i
c
r
e
v
i
e
w
a
n
d
m
e
t
a
-
a
n
a
l
y
si
s
,
”
J
A
MA
Pe
d
i
a
t
r
i
c
s
,
v
o
l
.
1
7
9
,
n
o
.
3
,
p
p
.
2
6
4
–
2
7
2
,
2
0
2
5
,
d
o
i
:
1
0
.
1
0
0
1
/
j
a
ma
p
e
d
i
a
t
r
i
c
s.
2
0
2
4
.
5
3
2
6
.
[
2
]
J.
C
a
g
n
e
y
e
t
a
l
.
,
“
P
r
e
v
a
l
e
n
c
e
o
f
se
x
u
a
l
v
i
o
l
e
n
c
e
a
g
a
i
n
s
t
c
h
i
l
d
r
e
n
a
n
d
a
g
e
a
t
f
i
r
s
t
e
x
p
o
s
u
r
e
:
a
g
l
o
b
a
l
a
n
a
l
y
si
s
b
y
l
o
c
a
t
i
o
n
,
a
g
e
,
a
n
d
sex
(
1
9
9
0
–
2
0
2
3
)
,
”
T
h
e
L
a
n
c
e
t
,
v
o
l
.
4
0
5
,
n
o
.
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[
18
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[
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[
20
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[
21
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[
25
]
J.
D
.
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.
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.
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[
26
]
N
.
J.
C
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,
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.
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,
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T.
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R
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.
[
27
]
J.
D
u
n
l
o
sk
y
,
K
.
A
.
R
a
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,
E
.
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M
.
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.
T.
W
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.
[
28
]
H
.
L
.
R
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.
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.
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.
[
29
]
S
.
M
.
B
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d
L.
M
.
K
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MIR
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[
30
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[
31
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[
32
]
W
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