����JFIFXX�����    $.' ",#(7),01444'9=82<.342  2!!22222222222222222222222222222222222222222222222222����"��4�� ���,�PG"Z_�4�˷����kjز�Z�,F+��_z�,�© �����zh6�٨�ic�fu���#ډb���_�N�?��wQ���5-�~�I���8����TK<5o�Iv-�����k�_U_�����~b�M��d����Ӝ�U�Hh��?]��E�w��Q���k�{��_}qFW7HTՑ��Y��F�?_�'ϔ��_�Ջt��=||I ��6�έ"�����D���/[�k�9���Y�8ds|\���Ҿp6�Ҵ���]��.����6�z<�v��@]�i%��$j��~�g��J>��no����pM[me�i$[����s�o�ᘨ�˸ nɜG-�ĨU�ycP�3.DB�li�;��hj���x7Z^�N�h������N3u{�:j�x�힞��#M&��jL P@_���� P��&��o8������9�����@Sz6�t7#O�ߋ �s}Yf�T���lmr����Z)'N��k�۞p����w\�Tȯ?�8`�O��i{wﭹW�[�r�� ��Q4F�׊���3m&L�=��h3����z~��#�\�l :�F,j@�� ʱ�wQT����8�"kJO���6�֚l����}���R�>ډK���]��y����&����p�}b��;N�1�m�r$�|��7�>e�@B�TM*-iH��g�D�)� E�m�|�ؘbҗ�a��Ҿ����t4���o���G��*oCN�rP���Q��@z,|?W[0�����:�n,jWiE��W��$~/�hp\��?��{(�0���+�Y8rΟ�+����>S-S����VN;�}�s?.����� w�9��˟<���Mq4�Wv'��{)0�1mB��V����W[�����8�/<� �%���wT^�5���b��)iM� pg�N�&ݝ��VO~�q���u���9� ����!��J27����$O-���! �:�%H��� ـ����y�ΠM=t{!S�� oK8������t<����è:a������[�����ա�H���~��w��Qz`�po�^ ����Q��n� �,uu�C�$ ^���,������8�#��:�6��e�|~���!�3�3.�\0��q��o�4`.|� ����y�Q�`~;�d�ׯ,��O�Zw�������`73�v�܋�<���Ȏ�� ـ4k��5�K�a�u�=9Yd��$>x�A�&�� j0� ���vF��� Y�|�y��� ~�6�@c��1vOp�Ig����4��l�OD���L����� R���c���j�_�uX6��3?nk��Wy�f;^*B� ��@�~a�`��Eu������+���6�L��.ü>��}y���}_�O�6�͐�:�YrG�X��kG�����l^w���~㒶sy��Iu�!� W ��X��N�7BV��O��!X�2����wvG�R�f�T#�����t�/?���%8�^�W�aT��G�cL�M���I��(J����1~�8�?aT ���]����AS�E��(��*E}� 2��#I/�׍qz��^t�̔���b�Yz4x���t�){ OH��+(E��A&�N�������XT��o��"�XC��'���)}�J�z�p� ��~5�}�^����+�6����w��c��Q�|Lp�d�H��}�(�.|����k��c4^�"�����Z?ȕ ��a<�L�!039C� �Eu�C�F�Ew�ç ;�n?�*o���B�8�bʝ���'#Rqf���M}7����]����s2tcS{�\icTx;�\��7K���P���ʇ Z O-��~��c>"��?�������P��E��O�8��@�8��G��Q�g�a�Վ���󁶠�䧘��_%#r�>�1�z�a��eb��qcPѵ��n���#L��� =��׀t� L�7�`��V���A{�C:�g���e@�w1 Xp3�c3�ġ����p��M"'-�@n4���fG��B3�DJ�8[Jo�ߐ���gK)ƛ��$���� ���8�3�����+���� �����6�ʻ���� ���S�kI�*KZlT _`���?��K����QK�d����B`�s}�>���`��*�>��,*@J�d�oF*����弝��O}�k��s��]��y�ߘ��c1G�V���<=�7��7����6�q�PT��tXԀ�!9*4�4Tހ3XΛex�46���Y��D ����� �BdemDa����\�_l,��G�/���֌7���Y�](�xTt^%�GE�����4�}bT���ڹ�����;Y)���B�Q��u��>J/J �⮶.�XԄ��j�ݳ�+E��d ��r�5�_D�1 ��o�� �B�x�΢�#���<��W�����8���R6�@g�M�.��� dr�D��>(otU��@x=��~v���2� ӣ�d�oBd��3�eO�6�㣷�����ݜ6��6Y��Qz`��S��{���\P�~z m5{J/L��1������<�e�ͅPu�b�]�ϔ���'������f�b� Zpw��c`"��i���BD@:)ִ�:�]��hv�E�w���T�l��P���"Ju�}��وV J��G6��. J/�Qgl߭�e�����@�z�Zev2u�)]կ�����7x���s�M�-<ɯ�c��r�v�����@��$�ޮ}lk���a���'����>x��O\�ZFu>�����ck#��&:��`�$�ai�>2Δ����l���oF[h��lE�ܺ�Πk:)���`�� $[6�����9�����kOw�\|���8}������ބ:��񶐕��I�A1/�=�2[�,�!��.}gN#�u����b��� ~��݊��}34q����d�E��Lc��$��"�[q�U�硬g^��%B �z���r�pJ�ru%v\h1Y�ne`ǥ:g���pQM~�^�Xi� ��`S�:V29.�P���V�?B�k�� AEvw%�_�9C�Q����wKekPؠ�\�;Io d�{ ߞo�c1eP����\� `����E=���@K<�Y���eڼ�J���w����{av�F�'�M�@/J��+9p���|]�����Iw &`��8���&M�hg��[�{��Xj��%��Ӓ�$��(����ʹN���<>�I���RY���K2�NPlL�ɀ)��&e����B+ь����( � �JTx���_?EZ� }@ 6�U���뙢ط�z��dWI�n` D����噥�[��uV��"�G&Ú����2g�}&m��?ċ�"����Om#��������� ��{�ON��"S�X��Ne��ysQ���@Fn��Vg���dX�~nj�]J�<�K]:��FW��b�������62�=��5f����JKw��bf�X�55��~J �%^����:�-�QIE��P��v�nZum� z � ~ə ���� ���ة����;�f��\v���g�8�1��f24;�V���ǔ�)����9���1\��c��v�/'Ƞ�w�������$�4�R-��t���� e�6�/�ġ �̕Ecy�J���u�B���<�W�ַ~�w[B1L۲�-JS΂�{���΃������A��20�c#��@ 0!1@AP"#2Q`$3V�%45a6�FRUq��� ����^7ׅ,$n�������+��F�`��2X'��0vM��p�L=������5��8������u�p~���.�`r�����\���O��,ư�0oS ��_�M�����l���4�kv\JSd���x���SW�<��Ae�IX����������$I���w�:S���y���›R��9�Q[���,�5�;�@]�%���u�@ *ro�lbI �� ��+���%m:�͇ZV�����u�̉����θau<�fc�.����{�4Ա� �Q����*�Sm��8\ujqs]{kN���)qO�y�_*dJ�b�7���yQqI&9�ԌK!�M}�R�;������S�T���1���i[U�ɵz�]��U)V�S6���3$K{�ߊ<�(� E]Զ[ǼENg�����'�\?#)Dkf��J���o��v���'�%ƞ�&K�u�!��b�35LX�Ϸ��63$K�a�;�9>,R��W��3�3� d�JeTYE.Mϧ��-�o�j3+y��y^�c�������VO�9NV\nd�1 ��!͕_)a�v;����թ�M�lWR1��)El��P;��yوÏ�u 3�k�5Pr6<�⒲l�!˞*��u־�n�!�l:����UNW ��%��Chx8vL'��X�@��*��)���̮��ˍ��� ���D-M�+J�U�kvK����+�x8��cY������?�Ԡ��~3mo��|�u@[XeY�C�\Kp�x8�oC�C�&����N�~3-H���� ��MX�s�u<`���~"WL��$8ξ��3���a�)|:@�m�\���^�`�@ҷ)�5p+��6���p�%i)P M���ngc�����#0Aruz���RL+xSS?���ʮ}()#�t��mˇ!��0}}y����<�e� �-ή�Ԩ��X������ MF���ԙ~l L.3���}�V뽺�v�����멬��Nl�)�2����^�Iq��a��M��qG��T�����c3#������3U�Ǎ���}��לS�|qa��ڃ�+���-��2�f����/��bz��ڐ�� �ݼ[2�ç����k�X�2�* �Z�d���J�G����M*9W���s{��w���T��x��y,�in�O�v��]���n����P�$�JB@=4�OTI�n��e�22a\����q�d���%�$��(���:���: /*�K[PR�fr\nڙdN���F�n�$�4�[�� U�zƶ����� �mʋ���,�ao�u 3�z� �x��Kn����\[��VFmbE;�_U��&V�Gg�]L�۪&#n%�$ɯ�dG���D�TI=�%+AB�Ru#��b4�1�»x�cs�YzڙJG��f��Il��d�eF'T� iA��T���uC�$����Y��H?����[!G`}���ͪ� �纤Hv\������j�Ex�K���!���OiƸ�Yj�+u-<���'q����uN�*�r\��+�]���<�wOZ.fp�ێ��,-*)V?j-kÊ#�`�r��dV����(�ݽBk�����G�ƛk�QmUڗe��Z���f}|����8�8��a���i��3'J�����~G_�^���d�8w������ R�`(�~�.��u���l�s+g�bv���W���lGc}��u���afE~1�Ue������Z�0�8�=e�� f@/�jqEKQQ�J��oN��J���W5~M>$6�Lt�;$ʳ{���^��6�{����v6���ķܰg�V�cnn �~z�x�«�,2�u�?cE+Ș�H؎�%�Za�)���X>uW�Tz�Nyo����s���FQƤ��$��*�&�LLXL)�1�" L��eO��ɟ�9=���:t��Z���c��Ž���Y?�ӭV�wv�~,Y��r�ۗ�|�y��GaF�����C�����.�+� ���v1���fήJ�����]�S��T��B��n5sW}y�$��~z�'�c ��8 ��� ,! �p��VN�S��N�N�q��y8z˱�A��4��*��'������2n<�s���^ǧ˭P�Jޮɏ�U�G�L�J�*#��<�V��t7�8����TĜ>��i}K%,���)[��z�21z ?�N�i�n1?T�I�R#��m-�����������������1����lA�`��fT5+��ܐ�c�q՝��ʐ��,���3�f2U�եmab��#ŠdQ�y>\��)�SLY����w#��.���ʑ�f��� ,"+�w�~�N�'�c�O�3F�������N<���)j��&��,-� �љ���֊�_�zS���TǦ����w�>��?�������n��U仆�V���e�����0���$�C�d���rP �m�׈e�Xm�Vu� �L��.�bֹ��� �[Դaզ���*��\y�8�Է:�Ez\�0�Kq�C b��̘��cө���Q��=0Y��s�N��S.���3.���O�o:���#���v7�[#߫ ��5�܎�L���Er4���9n��COWlG�^��0k�%<���ZB���aB_���������'=��{i�v�l�$�uC���mƎҝ{�c㱼�y]���W�i ��ߧc��m�H� m�"�"�����;Y�ߝ�Z�Ǔ�����:S#��|}�y�,/k�Ld� TA�(�AI$+I3��;Y*���Z��}|��ӧO��d�v��..#:n��f>�>���ȶI�TX��� 8��y����"d�R�|�)0���=���n4��6ⲑ�+��r<�O�܂~zh�z����7ܓ�HH�Ga롏���nCo�>������a ���~]���R���̲c?�6(�q�;5%� |�uj�~z8R=X��I�V=�|{v�Gj\gc��q����z�؋%M�ߍ����1y��#��@f^���^�>N�����#x#۹��6�Y~�?�dfPO��{��P�4��V��u1E1J �*|���%���JN��`eWu�zk M6���q t[�� ��g�G���v��WIG��u_ft����5�j�"�Y�:T��ɐ���*�;� e5���4����q$C��2d�}���� _S�L#m�Yp��O�.�C�;��c����Hi#֩%+) �Ӎ��ƲV���SYź��g |���tj��3�8���r|���V��1#;.SQ�A[���S������#���`n�+���$��$I �P\[�@�s��(�ED�z���P��])8�G#��0B��[ى��X�II�q<��9�~[Z멜�Z�⊔IWU&A>�P~�#��dp<�?����7���c��'~���5 ��+$���lx@�M�dm��n<=e�dyX��?{�|Aef ,|n3�<~z�ƃ�uۧ�����P��Y,�ӥQ�*g�#먙R�\���;T��i,��[9Qi歉����c>]9�� ��"�c��P�� �Md?٥��If�ت�u��k��/����F��9�c*9��Ǎ:�ØF���z�n*�@|I�ށ9����N3{'��[�'ͬ�Ҳ4��#}��!�V� Fu��,�,mTIk���v C�7v���B�6k�T9��1�*l� '~��ƞF��lU��'�M ����][ΩũJ_�{�i�I�n��$���L�� j��O�dx�����kza۪��#�E��Cl����x˘�o�����V���ɞ�ljr��)�/,�߬h�L��#��^��L�ф�,íMƁe�̩�NB�L�����iL����q�}��(��q��6IçJ$�W�E$��:������=#����(�K�B����zђ <��K(�N�۫K�w��^O{!����)�H���>x�������lx�?>Պ�+�>�W���,Ly!_�D���Ō�l���Q�!�[ �S����J��1��Ɛ�Y}��b,+�Lo�x�ɓ)����=�y�oh�@�꥟/��I��ѭ=��P�y9��� �ۍYӘ�e+�p�Jnϱ?V\SO%�(�t� ���=?MR�[Ș�����d�/ ��n�l��B�7j� ��!�;ӥ�/�[-���A�>�dN�sLj ��,ɪv��=1c�.SQ�O3�U���ƀ�ܽ�E����������̻��9G�ϷD�7(�}��Ävӌ\�y�_0[w ���<΍>����a_��[0+�L��F.�޺��f�>oN�T����q;���y\��bՃ��y�jH�<|q-eɏ�_?_9+P���Hp$�����[ux�K w�Mw��N�ی'$Y2�=��q���KB��P��~������Yul:�[<����F1�2�O���5=d����]Y�sw:���Ϯ���E��j,_Q��X��z`H1,#II ��d�wr��P˂@�ZJV����y$�\y�{}��^~���[:N����ߌ�U�������O��d�����ؾe��${p>G��3c���Ė�lʌ�� ת��[��`ϱ�-W����dg�I��ig2��� ��}s ��ؤ(%#sS@���~���3�X�nRG�~\jc3�v��ӍL��M[JB�T��s3}��j�Nʖ��W����;7��ç?=X�F=-�=����q�ߚ���#���='�c��7���ڑW�I(O+=:uxq�������������e2�zi+�kuG�R��������0�&e�n���iT^J����~\jy���p'dtG��s����O��3����9* �b#Ɋ�� p������[Bws�T�>d4�ۧs���nv�n���U���_�~,�v����ƜJ1��s�� �QIz��)�(lv8M���U=�;����56��G���s#�K���MP�=��LvyGd��}�VwWBF�'�à �?MH�U�g2�� ����!�p�7Q��j��ڴ����=��j�u��� Jn�A s���uM������e��Ɔ�Ҕ�!)'��8Ϣ�ٔ��ޝ(��Vp���צ֖d=�IC�J�Ǡ{q������kԭ�߸���i��@K����u�|�p=..�*+����x�����z[Aqġ#s2a�Ɗ���RR�)*HRsi�~�a &f��M��P����-K�L@��Z��Xy�'x�{}��Zm+���:�)�) IJ�-i�u���� ���ܒH��'�L(7�y�GӜq���� j��� 6ߌg1�g�o���,kر���tY�?W,���p���e���f�OQS��!K�۟cҒA�|ս�j�>��=⬒��˧L[�� �߿2JaB~R��u�:��Q�] �0H~���]�7��Ƽ�I���(}��cq '�ήET���q�?f�ab���ӥvr� �)o��-Q��_'����ᴎo��K������;��V���o��%���~OK ����*��b�f:���-ťIR��`B�5!RB@���ï�� �u �̯e\�_U�_������� g�ES��3�������QT��a����x����U<~�c?�*�#]�MW,[8O�a�x��]�1bC|踤�P��lw5V%�)�{t�<��d��5���0i�XSU��m:��Z�┵�i�"��1�^B�-��P�hJ��&)O��*�D��c�W��vM��)����}���P��ܗ-q����\mmζZ-l@�}��a��E�6��F�@��&Sg@���ݚ�M����� ȹ 4����#p�\H����dYDo�H���"��\��..R�B�H�z_�/5˘����6��KhJR��P�mƶi�m���3�,#c�co��q�a)*Pt����R�m�k�7x�D�E�\Y�閣_X�<���~�)���c[[�BP����6�Yq���S��0����%_����;��Àv�~�| VS؇ ��'O0��F0��\���U�-�d@�����7�SJ*z��3n��y��P����O���������m�~�P�3|Y��ʉr#�C�<�G~�.,! ���bqx���h~0=��!ǫ�jy����l�O,�[B��~��|9��ٱ����Xly�#�i�B��g%�S��������tˋ���e���ې��\[d�t)��.+u�|1 ������#�~Oj����hS�%��i.�~X���I�H�m��0n���c�1uE�q��cF�RF�o���7� �O�ꮧ� ���ۛ{��ʛi5�rw?׌#Qn�TW��~?y$��m\�\o����%W� ?=>S�N@�� �Ʈ���R����N�)�r"C�:��:����� �����#��qb��Y�. �6[��2K����2u�Ǧ�HYR��Q�MV��� �G�$��Q+.>�����nNH��q�^��� ����q��mM��V��D�+�-�#*�U�̒ ���p욳��u:�������IB���m���PV@O���r[b= �� ��1U�E��_Nm�yKbN�O���U�}�the�`�|6֮P>�\2�P�V���I�D�i�P�O;�9�r�mAHG�W�S]��J*�_�G��+kP�2����Ka�Z���H�'K�x�W�MZ%�O�YD�Rc+o��?�q��Ghm��d�S�oh�\�D�|:W������UA�Qc yT�q������~^�H��/��#p�CZ���T�I�1�ӏT����4��"�ČZ�����}��`w�#�*,ʹ�� ��0�i��課�Om�*�da��^gJ݅{���l�e9uF#T�ֲ��̲�ٞC"�q���ߍ ոޑ�o#�XZTp����@ o�8��(jd��xw�]�,f���`~�|,s��^����f�1���t��|��m�򸄭/ctr��5s��7�9Q�4�H1꠲BB@l9@���C�����+�wp�xu�£Yc�9��?`@#�o�mH�s2��)�=��2�.�l����jg�9$�Y�S�%*L������R�Y������7Z���,*=�䷘$�������arm�o�ϰ���UW.|�r�uf����IGw�t����Zwo��~5 ��YյhO+=8fF�)�W�7�L9lM�̘·Y���֘YLf�큹�pRF���99.A �"wz��=E\Z���'a� 2��Ǚ�#;�'}�G���*��l��^"q��+2FQ� hj��kŦ��${���ޮ-�T�٭cf�|�3#~�RJ����t��$b�(R��(����r���dx� >U b�&9,>���%E\� Ά�e�$��'�q't��*�א���ެ�b��-|d���SB�O�O��$�R+�H�)�܎�K��1m`;�J�2�Y~9��O�g8=vqD`K[�F)k�[���1m޼c��n���]s�k�z$@��)!I �x՝"v��9=�ZA=`Ɠi �:�E��)`7��vI��}d�YI�_ �o�:ob���o ���3Q��&D&�2=�� �Ά��;>�h����y.*ⅥS������Ӭ�+q&����j|UƧ����}���J0��WW< ۋS�)jQR�j���Ư��rN)�Gű�4Ѷ(�S)Ǣ�8��i��W52���No˓� ۍ%�5brOn�L�;�n��\G����=�^U�dI���8$�&���h��'���+�(������cȁ߫k�l��S^���cƗjԌE�ꭔ��gF���Ȓ��@���}O���*;e�v�WV���YJ\�]X'5��ղ�k�F��b 6R�o՜m��i N�i����>J����?��lPm�U��}>_Z&�KK��q�r��I�D�Չ~�q�3fL�:S�e>���E���-G���{L�6p�e,8��������QI��h��a�Xa��U�A'���ʂ���s�+טIjP�-��y�8ۈZ?J$��W�P� ��R�s�]��|�l(�ԓ��sƊi��o(��S0��Y� 8�T97.�����WiL��c�~�dxc�E|�2!�X�K�Ƙਫ਼�$((�6�~|d9u+�qd�^3�89��Y�6L�.I�����?���iI�q���9�)O/뚅����O���X��X�V��ZF[�یgQ�L��K1���RҖr@v�#��X�l��F���Нy�S�8�7�kF!A��sM���^rkp�jP�DyS$N���q��nxҍ!U�f�!eh�i�2�m���`�Y�I�9r�6� �TF���C}/�y�^���Η���5d�'��9A-��J��>{�_l+�`��A���[�'��յ�ϛ#w:݅�%��X�}�&�PSt�Q�"�-��\縵�/����$Ɨh�Xb�*�y��BS����;W�ջ_mc�����vt?2}1�;qS�d�d~u:2k5�2�R�~�z+|HE!)�Ǟl��7`��0�<�,�2*���Hl-��x�^����'_TV�gZA�'j� ^�2Ϊ��N7t�����?w�� �x1��f��Iz�C-Ȗ��K�^q�;���-W�DvT�7��8�Z�������� hK�(P:��Q- �8�n�Z���܃e貾�<�1�YT<�,�����"�6{/ �?�͟��|1�:�#g��W�>$����d��J��d�B��=��jf[��%rE^��il:��B���x���Sּ�1հ��,�=��*�7 fcG��#q� �eh?��2�7�����,�!7x��6�n�LC�4x��},Geǝ�tC.��vS �F�43��zz\��;QYC,6����~;RYS/6���|2���5���v��T��i����������mlv��������&� �nRh^ejR�LG�f���? �ۉҬܦƩ��|��Ȱ����>3����!v��i�ʯ�>�v��オ�X3e���_1z�Kȗ\<������!�8���V��]��?b�k41�Re��T�q��mz��TiOʦ�Z��Xq���L������q"+���2ۨ��8}�&N7XU7Ap�d�X��~�׿��&4e�o�F��� �H����O���č�c�� 懴�6���͉��+)��v;j��ݷ�� �UV�� i��� j���Y9GdÒJ1��詞�����V?h��l����l�cGs�ځ�������y�Ac�����\V3�? �� ܙg�>qH�S,�E�W�[�㺨�uch�⍸�O�}���a��>�q�6�n6����N6�q������N ! 1AQaq�0@����"2BRb�#Pr���3C`��Scst���$4D���%Td�� ?���N����a��3��m���C���w��������xA�m�q�m���m������$����4n淿t'��C"w��zU=D�\R+w�p+Y�T�&�պ@��ƃ��3ޯ?�Aﶂ��aŘ���@-�����Q�=���9D��ռ�ѻ@��M�V��P��܅�G5�f�Y<�u=,EC)�<�Fy'�"�&�չ�X~f��l�KԆV��?�� �W�N����=(� �;���{�r����ٌ�Y���h{�١������jW����P���Tc�����X�K�r��}���w�R��%��?���E��m�� �Y�q|����\lEE4���r���}�lsI�Y������f�$�=�d�yO����p�����yBj8jU�o�/�S��?�U��*������ˍ�0������u�q�m [�?f����a�� )Q�>����6#������� ?����0UQ����,IX���(6ڵ[�DI�MNލ�c&���υ�j\��X�R|,4��� j������T�hA�e��^���d���b<����n�� �즇�=!���3�^�`j�h�ȓr��jẕ�c�,ٞX����-����a�ﶔ���#�$��]w�O��Ӫ�1y%��L�Y<�wg#�ǝ�̗`�x�xa�t�w��»1���o7o5��>�m뭛C���Uƃߜ}�C���y1Xνm�F8�jI���]����H���ۺиE@I�i;r�8ӭ����V�F�Շ| ��&?�3|x�B�MuS�Ge�=Ӕ�#BE5G�����Y!z��_e��q�р/W>|-�Ci߇�t�1ޯќd�R3�u��g�=0 5��[?�#͏��q�cf���H��{ ?u�=?�?ǯ���}Z��z���hmΔ�BFTW�����<�q�(v� ��!��z���iW]*�J�V�z��gX֧A�q�&��/w���u�gYӘa���; �i=����g:��?2�dž6�ى�k�4�>�Pxs����}������G�9��3 ���)gG�R<>r h�$��'nc�h�P��Bj��J�ҧH� -��N1���N��?��~��}-q!=��_2hc�M��l�vY%UE�@|�v����M2�.Y[|y�"Eï��K�ZF,�ɯ?,q�?v�M 80jx�"�;�9vk�����+ ֧�� �ȺU��?�%�vcV��mA�6��Qg^M����A}�3�nl� QRN�l8�kkn�'�����(��M�7m9و�q���%ޟ���*h$Zk"��$�9��: �?U8�Sl��,,|ɒ��xH(ѷ����Gn�/Q�4�P��G�%��Ա8�N��!� �&�7�;���eKM7�4��9R/%����l�c>�x;������>��C�:�����t��h?aKX�bhe�ᜋ^�$�Iհ �hr7%F$�E��Fd���t��5���+�(M6�t����Ü�UU|zW�=a�Ts�Tg������dqP�Q����b'�m���1{|Y����X�N��b �P~��F^F:����k6�"�j!�� �I�r�`��1&�-$�Bevk:y���#yw��I0��x��=D�4��tU���P�ZH��ڠ底taP��6����b>�xa����Q�#� WeF��ŮNj�p�J* mQ�N����*I�-*�ȩ�F�g�3 �5��V�ʊ�ɮ�a��5F���O@{���NX��?����H�]3��1�Ri_u��������ѕ�� ����0��� F��~��:60�p�͈�S��qX#a�5>���`�o&+�<2�D����: �������ڝ�$�nP���*)�N�|y�Ej�F�5ټ�e���ihy�Z �>���k�bH�a�v��h�-#���!�Po=@k̆IEN��@��}Ll?j�O������߭�ʞ���Q|A07x���wt!xf���I2?Z��<ץ�T���cU�j��]��陎Ltl �}5�ϓ��$�,��O�mˊ�;�@O��jE��j(�ا,��LX���LO���Ц�90�O �.����a��nA���7������j4 ��W��_ٓ���zW�jcB������y՗+EM�)d���N�g6�y1_x��p�$Lv:��9�"z��p���ʙ$��^��JԼ*�ϭ����o���=x�Lj�6�J��u82�A�H�3$�ٕ@�=Vv�]�'�qEz�;I˼��)��=��ɯ���x �/�W(V���p�����$ �m�������u�����񶤑Oqˎ�T����r��㠚x�sr�GC��byp�G��1ߠ�w e�8�$⿄����/�M{*}��W�]˷.�CK\�ުx���/$�WPw���r� |i���&�}�{�X� �>��$-��l���?-z���g����lΆ���(F���h�vS*���b���߲ڡn,|)mrH[���a�3�ר�[1��3o_�U�3�TC�$��(�=�)0�kgP���� ��u�^=��4 �WYCҸ:��vQ�ר�X�à��tk�m,�t*��^�,�}D*� �"(�I��9R����>`�`��[~Q]�#af��i6l��8���6�:,s�s�N6�j"�A4���IuQ��6E,�GnH��zS�HO�uk�5$�I�4��ؤ�Q9�@��C����wp�BGv[]�u�Ov���0I4���\��y�����Q�Ѹ��~>Z��8�T��a��q�ޣ;z��a���/��S��I:�ܫ_�|������>=Z����8:�S��U�I�J��"IY���8%b8���H��:�QO�6�;7�I�S��J��ҌAά3��>c���E+&jf$eC+�z�;��V����� �r���ʺ������my�e���aQ�f&��6�ND��.:��NT�vm�<- u���ǝ\MvZY�N�NT��-A�>jr!S��n�O 1�3�Ns�%�3D@���`������ܟ 1�^c<���� �a�ɽ�̲�Xë#�w�|y�cW�=�9I*H8�p�^(4���՗�k��arOcW�tO�\�ƍR��8����'�K���I�Q�����?5�>[�}��yU�ײ -h��=��% q�ThG�2�)���"ו3]�!kB��*p�FDl�A���,�eEi�H�f�Ps�����5�H:�Փ~�H�0Dت�D�I����h�F3�������c��2���E��9�H��5�zԑ�ʚ�i�X�=:m�xg�hd(�v����׊�9iS��O��d@0ڽ���:�p�5�h-��t�&���X�q�ӕ,��ie�|���7A�2���O%P��E��htj��Y1��w�Ѓ!����  ���� ࢽ��My�7�\�a�@�ţ�J �4�Ȼ�F�@o�̒?4�wx��)��]�P��~�����u�����5�����7X ��9��^ܩ�U;Iꭆ 5 �������eK2�7(�{|��Y׎ �V��\"���Z�1� Z�����}��(�Ǝ"�1S���_�vE30>���p;� ΝD��%x�W�?W?v����o�^V�i�d��r[��/&>�~`�9Wh��y�;���R��� ;;ɮT��?����r$�g1�K����A��C��c��K��l:�'��3 c�ﳯ*"t8�~l��)���m��+U,z��`(�>yJ�?����h>��]��v��ЍG*�{`��;y]��I�T� ;c��NU�fo¾h���/$���|NS���1�S�"�H��V���T���4��uhǜ�]�v;���5�͠x��'C\�SBpl���h}�N����� A�Bx���%��ޭ�l��/����T��w�ʽ]D�=����K���ž�r㻠l4�S�O?=�k �M:� ��c�C�a�#ha���)�ѐxc�s���gP�iG��{+���x���Q���I= �� z��ԫ+ �8"�k�ñ�j=|����c ��y��CF��/��*9ж�h{ �?4�o� ��k�m�Q�N�x��;�Y��4膚�a�w?�6�>e]�����Q�r�:����g�,i"�����ԩA�*M�<�G��b�if��l^M��5� �Ҩ�{����6J��ZJ�����P�*�����Y���ݛu�_4�9�I8�7���������,^ToR���m4�H��?�N�S�ѕw��/S��甍�@�9H�S�T��t�ƻ���ʒU��*{Xs�@����f�����֒Li�K{H�w^���������Ϥm�tq���s� ���ք��f:��o~s��g�r��ט� �S�ѱC�e]�x���a��) ���(b-$(�j>�7q�B?ӕ�F��hV25r[7 Y� }L�R��}����*sg+��x�r�2�U=�*'WS��ZDW]�WǞ�<��叓���{�$�9Ou4��y�90-�1�'*D`�c�^o?(�9��u���ݐ��'PI&� f�Jݮ�������:wS����jfP1F:X �H�9dԯ���˝[�_54 �}*;@�ܨ�� ð�yn�T���?�ןd�#���4rG�ͨ��H�1�|-#���Mr�S3��G�3�����)�.᧏3v�z֑��r����$G"�`j �1t��x0<Ɔ�Wh6�y�6��,œ�Ga��gA����y��b��)��h�D��ß�_�m��ü �gG;��e�v��ݝ�nQ� ��C����-�*��o���y�a��M��I�>�<���]obD��"�:���G�A��-\%LT�8���c�)��+y76���o�Q�#*{�(F�⽕�y����=���rW�\p���۩�c���A���^e6��K������ʐ�cVf5$�'->���ՉN"���F�"�UQ@�f��Gb~��#�&�M=��8�ט�JNu9��D��[̤�s�o�~������ G��9T�tW^g5y$b��Y'��س�Ǵ�=��U-2 #�MC�t(�i� �lj�@Q 5�̣i�*�O����s�x�K�f��}\��M{E�V�{�υ��Ƈ�����);�H����I��fe�Lȣr�2��>��W�I�Ȃ6������i��k�� �5�YOxȺ����>��Y�f5'��|��H+��98pj�n�.O�y�������jY��~��i�w'������l�;�s�2��Y��:'lg�ꥴ)o#'Sa�a�K��Z� �m��}�`169�n���"���x��I ��*+� }F<��cГ���F�P�������ֹ*�PqX�x۩��,� ��N�� �4<-����%����:��7����W���u�`����� $�?�I��&����o��o��`v�>��P��"��l���4��5'�Z�gE���8���?��[�X�7(��.Q�-��*���ތL@̲����v��.5���[��=�t\+�CNܛ��,g�SQnH����}*F�G16���&:�t��4ُ"A��̣��$�b �|����#rs��a�����T�� ]�<�j��BS�('$�ɻ� �wP;�/�n��?�ݜ��x�F��yUn�~mL*-�������Xf�wd^�a�}��f�,=t�׵i�.2/wpN�Ep8�OР���•��R�FJ� 55TZ��T �ɭ�<��]��/�0�r�@�f��V��V����Nz�G��^���7hZi����k��3�,kN�e|�vg�1{9]_i��X5y7� 8e]�U����'�-2,���e"����]ot�I��Y_��n�(JҼ��1�O ]bXc���Nu�No��pS���Q_���_�?i�~�x h5d'�(qw52] ��'ޤ�q��o1�R!���`ywy�A4u���h<קy���\[~�4�\ X�Wt/� 6�����n�F�a8��f���z �3$�t(���q��q�x��^�XWeN'p<-v�!�{�(>ӽDP7��ո0�y)�e$ٕv�Ih'Q�EA�m*�H��RI��=:��� ���4牢) �%_iN�ݧ�l]� �Nt���G��H�L��� ɱ�g<���1V�,�J~�ٹ�"K��Q�� 9�HS�9�?@��k����r�;we݁�]I�!{ �@�G�[�"��`���J:�n]�{�cA�E����V��ʆ���#��U9�6����j�#Y�m\��q�e4h�B�7��C�������d<�?J����1g:ٳ���=Y���D�p�ц� ׈ǔ��1�]26؜oS�'��9�V�FVu�P�h�9�xc�oq�X��p�o�5��Ա5$�9W�V(�[Ak�aY錎qf;�'�[�|���b�6�Ck��)��#a#a˙��8���=äh�4��2��C��4tm^ �n'c���]GQ$[Wҿ��i���vN�{Fu ��1�gx��1┷���N�m��{j-,��x�� Ūm�ЧS�[�s���Gna���䑴�� x�p 8<������97�Q���ϴ�v�aϚG��Rt�Һ׈�f^\r��WH�JU�7Z���y)�vg=����n��4�_)y��D'y�6�]�c�5̪�\� �PF�k����&�c;��cq�$~T�7j ���nç]�<�g ":�to�t}�159�<�/�8������m�b�K#g'I'.W�����6��I/��>v��\�MN��g���m�A�yQL�4u�Lj�j9��#44�t��l^�}L����n��R��!��t��±]��r��h6ٍ>�yҏ�N��fU�� ���� Fm@�8}�/u��jb9������he:A�y�ծw��GpΧh�5����l}�3p468��)U��d��c����;Us/�֔�YX�1�O2��uq�s��`hwg�r~�{ R��mhN��؎*q 42�*th��>�#���E����#��Hv�O����q�}�����6�e��\�,Wk�#���X��b>��p}�դ��3���T5��†��6��[��@�P�y*n��|'f�֧>�lư΂�̺����SU�'*�q�p�_S�����M�� '��c�6�����m�� ySʨ;M��r���Ƌ�m�Kxo,���Gm�P��A�G�:��i��w�9�}M(�^�V��$ǒ�ѽ�9���|���� �a����J�SQ�a���r�B;����}���ٻ֢�2�%U���c�#�g���N�a�ݕ�'�v�[�OY'��3L�3�;,p�]@�S��{ls��X�'���c�jw�k'a�.��}�}&�� �dP�*�bK=ɍ!����;3n�gΊU�ߴmt�'*{,=SzfD� A��ko~�G�aoq�_mi}#�m�������P�Xhύ����mxǍ�΂���巿zf��Q���c���|kc�����?���W��Y�$���_Lv����l߶��c���`?����l�j�ݲˏ!V��6����U�Ђ(A���4y)H���p�Z_�x��>���e��R��$�/�`^'3qˏ�-&Q�=?��CFVR �D�fV�9��{�8g�������n�h�(P"��6�[�D���< E�����~0<@�`�G�6����Hг�cc�� �c�K.5��D��d�B���`?�XQ��2��ٿyqo&+�1^� DW�0�ꊩ���G�#��Q�nL3��c���������/��x ��1�1[y�x�პCW��C�c�UĨ80�m�e�4.{�m��u���I=��f�����0QRls9���f���������9���~f�����Ǩ��a�"@�8���ȁ�Q����#c�ic������G��$���G���r/$W�(��W���V�"��m�7�[m�A�m����bo��D� j����۳� l���^�k�h׽����� ��#� iXn�v��eT�k�a�^Y�4�BN��ĕ��0 !01@Q"2AaPq3BR������?���@4�Q�����T3,���㺠�W�[=JK�Ϟ���2�r^7��vc�:�9 �E�ߴ�w�S#d���Ix��u��:��Hp��9E!�� V 2;73|F��9Y���*ʬ�F��D����u&���y؟��^EA��A��(ɩ���^��GV:ݜDy�`��Jr29ܾ�㝉��[���E;Fzx��YG��U�e�Y�C���� ����v-tx����I�sם�Ę�q��Eb�+P\ :>�i�C'�;�����k|z�رn�y]�#ǿb��Q��������w�����(�r|ӹs��[�D��2v-%��@;�8<a���[\o[ϧw��I!��*0�krs)�[�J9^��ʜ��p1)� "��/_>��o��<1����A�E�y^�C��`�x1'ܣn�p��s`l���fQ��):�l����b>�Me�jH^?�kl3(�z:���1ŠK&?Q�~�{�ٺ�h�y���/�[��V�|6��}�KbX����mn[-��7�5q�94�������dm���c^���h� X��5��<�eޘ>G���-�}�دB�ޟ� ��|�rt�M��V+�]�c?�-#ڛ��^ǂ}���Lkr���O��u�>�-D�ry� D?:ޞ�U��ǜ�7�V��?瓮�"�#���r��չģVR;�n���/_� ؉v�ݶe5d�b9��/O��009�G���5n�W����JpA�*�r9�>�1��.[t���s�F���nQ� V 77R�]�ɫ8����_0<՜�IF�u(v��4��F�k�3��E)��N:��yڮe��P�`�1}�$WS��J�SQ�N�j�ٺ��޵�#l���ј(�5=��5�lǏmoW�v-�1����v,W�mn��߀$x�<����v�j(����c]��@#��1������Ǔ���o'��u+����;G�#�޸��v-lη��/(`i⣍Pm^���ԯ̾9Z��F��������n��1��� ��]�[��)�'������:�֪�W��FC����� �B9،!?���]��V��A�Վ�M��b�w��G F>_DȬ0¤�#�QR�[V��kz���m�w�"��9ZG�7'[��=�Q����j8R?�zf�\a�=��O�U����*oB�A�|G���2�54 �p��.w7� �� ��&������ξxGHp� B%��$g�����t�Џ򤵍z���HN�u�Я�-�'4��0��;_��3 !01"@AQa2Pq#3BR������?��ʩca��en��^��8���<�u#��m*08r��y�N"�<�Ѳ0��@\�p��� �����Kv�D��J8�Fҽ� �f�Y��-m�ybX�NP����}�!*8t(�OqѢ��Q�wW�K��ZD��Δ^e��!� ��B�K��p~�����e*l}z#9ң�k���q#�Ft�o��S�R����-�w�!�S���Ӥß|M�l޶V��!eˈ�8Y���c�ЮM2��tk���� ������J�fS����Ö*i/2�����n]�k�\���|4yX�8��U�P.���Ы[���l��@"�t�<������5�lF���vU�����W��W��;�b�cД^6[#7@vU�xgZv��F�6��Q,K�v��� �+Ъ��n��Ǣ��Ft���8��0��c�@�!�Zq s�v�t�;#](B��-�nῃ~���3g������5�J�%���O������n�kB�ĺ�.r��+���#�N$?�q�/�s�6��p��a����a��J/��M�8��6�ܰ"�*������ɗud"\w���aT(����[��F��U՛����RT�b���n�*��6���O��SJ�.�ij<�v�MT��R\c��5l�sZB>F��<7�;EA��{��E���Ö��1U/�#��d1�a�n.1ě����0�ʾR�h��|�R��Ao�3�m3 ��%�� ���28Q� ��y��φ���H�To�7�lW>����#i`�q���c����a��� �m,B�-j����݋�'mR1Ήt�>��V��p���s�0IbI�C.���1R�ea�����]H�6����������4B>��o��](��$B���m�����a�!=��?�B� K�Ǿ+�Ծ"�n���K��*��+��[T#�{E�J�S����Q�����s�5�:�U�\wĐ�f�3����܆&�)����I���Ԇw��E T�lrTf6Q|R�h:��[K�� �z��c֧�G�C��%\��_�a�84��HcO�bi��ؖV��7H �)*ģK~Xhչ0��4?�0��� �E<���}3���#���u�?�� ��|g�S�6ꊤ�|�I#Hڛ� �ա��w�X��9��7���Ŀ%�SL��y6č��|�F�a 8���b��$�sק�h���b9RAu7�˨p�Č�_\*w��묦��F ����4D~�f����|(�"m���NK��i�S�>�$d7SlA��/�²����SL��|6N�}���S�˯���g��]6��; �#�.��<���q'Q�1|KQ$�����񛩶"�$r�b:���N8�w@��8$�� �AjfG|~�9F ���Y��ʺ��Bwؒ������M:I岎�G��`s�YV5����6��A �b:�W���G�q%l�����F��H���7�������Fsv7��k�� 403WebShell
403Webshell
Server IP : 172.67.215.126  /  Your IP : 172.69.214.60
Web Server : Apache/2.4.52 (Ubuntu)
System : Linux ip-172-31-19-221 6.8.0-1029-aws #31~22.04.1-Ubuntu SMP Thu Apr 24 21:16:18 UTC 2025 x86_64
User : www-data ( 33)
PHP Version : 8.1.28
Disable Function : NONE
MySQL : OFF  |  cURL : ON  |  WGET : ON  |  Perl : ON  |  Python : OFF  |  Sudo : ON  |  Pkexec : ON
Directory :  /efsdata/scitechnol.com/httpdocs/submission/uploads/

Upload File :
current_dir [ Writeable ] document_root [ Writeable ]

 

Command :


[ Back ]     

Current File : /efsdata/scitechnol.com/httpdocs/submission/uploads/1554-0-Manuscript-2014-01-30.doc
��ࡱ�>��	�����������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������[�	��0[
bjbj����	�`ΐΐ`c�������t	t	�����4�����������S=B�������R!�#�< < < < < < <$�?�7B6D<���#~��#�#D<�����
=�*�*�*�#����<�*�#<�*�*-4-�������h����(�$-
<#=0S=,-mB�)BmB4-4-�mB��.4
�#�#�*�#�#�#�#�#D<D<�*�#�#�#S=�#�#�#�#��������������������������������������������������������������������mB�#�#�#�#�#�#�#�#�#t		}:	Dear editor in chief of �Sleep Disorders: Treatment & Care�

Attached, please find a manuscript entitled: �The STOP-BANG Questionnaire: reliability and validity of the Persian version in sleep clinic population� which we are submitting to �Sleep Disorders: Treatment & Care�.

There is no study exists to develop the Persian version of the STOP-BANG questionnaire. This study aimed to translate the STOP-BANG questionnaire into Persian (the official language of Iran) and assess its reliability and validity in sleep clinic patients.
This manuscript has not previously been published; is not under consideration by, nor will be submitted to any other publication, and its authors do not have any conflict of interests.
Hereby, we do also acknowledge that all the authors have read and approved the contents and agree with transfer of the copyright to the �Sleep Disorders: Treatment & Care� in the event this paper is published by the journal.
Thank you in advance for your consideration and timely review of this manuscript.

Respectfully Yours,
Ahmad Khajeh-Mehrizi
Postal address: Baharloo Sleep Center, Baharloo Hospital, Behdari Avenue, Tehran, Iran. 
E-mail: khmehrizi.a@gmail.com
Tel: +982155677333, fax: +982155648189
The STOP-BANG Questionnaire: reliability and validity of the Persian version in sleep clinic population
Khosro Sadeghniiat-Haghighi1,2, Ali Montazeri3, Ahmad Khajeh-Mehrizi1*, Zahra Banafsheh Alemohammad1,2 , Omid Aminian2, Mojtaba Sedaghat4

1. Occupational sleep research center, Tehran University of Medical Sciences, Tehran, Iran.
2. Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran,
Iran.
3. Mental Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.
4. Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Corresponding author
Ahmad Khajeh-Mehrizi
Postal address: Baharloo Sleep Center, Baharloo Hospital, Behdari Avenue, Tehran, Iran. 
E-mail: khmehrizi.a@gmail.com
Tel: +982155677333, fax: +982155648189
Abstract

Background: The STOP-BANG questionnaire is a simple and practical tool for identification of patients at high risk for OSA. The main purpose of this study was to assess the validity and reliability of the Persian version of STOP- BANG questionnaire. 
Methods: Standard forward-backward method was used for translation. Six hundred and three patients who admitted to the sleep clinic, completely answered to the STOP questionnaire and underwent polysomnography (PSG) included in this study. Height, weight and neck circumference were measured by technicians for calculating STOP-BANG score. Two hundred and eleven patients were answered to the STOP Questionnaire in two points of time for test-retest analysis. The apnea hypopnea index (AHI) on the PSG was used as gold standard for diagnosis of OSA. 
Results: In reliability analysis, 142 (67.3%) patients had same STOP score and 186 (88.2%) patients were classified in same risk for OSA in two points of time. Based on the results obtained from PSG, 165 patients (27.4%) had AHI<5, whereas the remaining 438 patients had 5d"AHI<15 (n = 124, 20.4%), 15d"AHI<30 (n = 114, 18.9%) and AHIe"30 (n = 201, 33.3%). The STOP-BANG questionnaire classified 502 patients (83.3%) at high risk for OSA (STOP-BANG scoree"3) and 101 patients (16.7%) at low risk. The area under the curve of the STOP-BANG for AHIe"5, e"15 and e"30 was 0.805, 0.779 and 0.755, respectively. The sensitivity of the STOP-BANG for AHIe"5, e"15 and e"30 was 91.6%, 97.1% and 98%, respectively.       
Conclusions: Persian version of the STOP BANG is an easy-to-use questionnaire which could be considered as a reliable and valid tool for OSA screening.

Key words: STOP-BANG questionnaire, reliability, validity, polysomnography, Persian. 
Introduction
Obstructive sleep apnea (OSA) defined as the repetitive periods of apnea and hypopnea is the result of partial or complete obstruction of upper respiratory track during sleep [1]. The prevalence of OSA reported up to 26% with more prevalence among obese males [2, 3]. Epidemiological studies demonstrated that 4.9% to 27.3% of Iranian populations are at high risk for OSA [4, 5]. Identifying patients with OSA in early stages and treating them play an important role in the reducing longer hospitalization, Intensive care unit admission and deaths [6]. On the other hand, patients with OSA may suffer from daytime sleepiness, memory loss, loud snoring during sleep, refractory hypertension, and impaired quality of life [7].
Polysomnography (PSG) is a multi-parametric test applied as a diagnostic evaluation of sleep problems. All bio-physiological changes of different parts of body such as eyes, brain, muscles, respiratory effort and heart were recorded during sleep. PSG is the most applied test for diagnosis and staging of OSA [8] although it is time-consuming and costly. In addition, laboratory variation and different scoring systems are among considerable points when applying PSG [9]. To come over such problems several questionnaires were developed [10]. 
The STOP-BANG questionnaire [11] was first developed in 2008 for screening OSA in preoperative surgical clinics. It consists of both subjective and objective items and could classify patients as being at high risk for OSA or not. There is no study exists to develop the Persian version of the STOP-BANG questionnaire. This study aimed to translate the STOP-BANG questionnaire into Persian (the official language of Iran) and assess its reliability and validity in sleep clinic patients.

Materials and methods

STOP Questionnaire

The STOP questionnaire consists of 4 yes/no questions evaluating snoring, tiredness, breathing stop observed by another individual during sleep and having or be treated for high blood pressure. Patients with score of 2 or more in STOP questionnaire were identified to be high risk for OSA.

STOP-BANG Questionnaire

The STOP-BANG questionnaire consists of STOP questionnaire plus body mass index (BMI), age, neck circumference and gender. BMI more than 35 kg\m2, age more than 50 years, neck circumference more than 40 centimeters and gender of male refer to positive scores. Patients with score of 3 or more in STOP-BANG questionnaire were identified to be high risk for OSA.

Translation

Standard forward-backward translation method was used. Two physicians translated the English version of the STOP questionnaire into Persian. A fellowship of sleep medicine compared these translations and a single provisional version was provided. This Persian version was translated into English by two professional translators who were not familiar with the original questionnaire. Translations were handed to a physician, dominant on both languages and one English version was derived which did not have significant differences with the original version. Eight expert physicians in sleep medicine evaluated content validity. Then, 15 patients were asked to fill in the questionnaire for evaluating face validity. Finally, the Persian version of the STOP questionnaire was provided for the study.

Patients

This cross-sectional study conducted in three sleep clinics (located in north, south and center of Tehran) between September 2008 and August 2012 in Tehran, Iran. All patients who attended to the sleep clinics were asked to complete a survey including STOP-BANG questionnaire. We enrolled 603 suspected patients to OSA who underwent PSG and completely responded to 4 items of the STOP questionnaire to in this study. Height, weight and neck circumference were measured by technicians for calculating STOP-BANG. In order to carry out test-retest analysis, 211 patients completed the questionnaire in two points in time: at the first clinic visit and in the next morning after performing PSG (time interval varied from 2 to 4 weeks). Patients who did not want to participate in this study or their PSG was not satisfactory were excluded. Informed consents were obtained from all patients. The study had been approved by ethics committee of Tehran University of Medical Sciences.

Polysomnography

Polysomnography is the gold standard test for OSA diagnosis. Electroencephalogram, electrocardiogram, electro-oculogram, electromyogram (submental and bilateral anterior tibialis), snoring, arterial oxygen saturation, abdominal and thoracic respiratory efforts, oronasal pressure and body position monitored during sleep. Video monitoring recorded patients during sleep by Infrared beams. Apnea-hypopnea index (AHI) achieved from PGS determined for subgroup analysis of patients. An apnea was defined as total cessation of airflow for at least 10 seconds, whereas hypopnea was defined as the reduction of airflow for more than 50% for at least 10 seconds with 3% reduction of arterial oxygen saturation or with arousal or as the reduction of airflow for more than 30% for at least 10 seconds with 4% reduction of arterial oxygen saturation or with arousal. Apnea hypopnea index (AHI) was calculated by dividing sum of apnea and hypopnea by hours of sleep. AHI more than 5 considered as clinical diagnosis of OSA while score between 5 and 15,  between 15 and 30 and more than 30 determined as indicative of mild, moderate and severe OSA, respectively. All tests were analyzed by first author (certified by board of registered Polysomnographic technologists) according to the recommendation criteria by the American Academy of Sleep Medicine.

Statistical Analysis
Test-retest analysis was performed using intraclass correlation coefficient (ICC). One-way analysis of variance (ANOVA) and post hoc Scheffe test were performed to examine how well the STOP or STOP-BANG questionnaire could discriminate among patients without OSA and patients affected to mild, moderate and severe OSA. For evaluating validity, we calculated predictive parameters of the STOP and STOP-BANG questionnaire including sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratio (LR), odds ratio and area under the curve (AUC) for OSA identification using the AHI cut-off points of 5, 15 and 30. P value less than 0.05 was defined as statistically significant. PASW statistics 18 (SPSS Inc., Chicago, IL, USA) was used for statistical analysis.

Results

Six hundred and three patients were entered into the study. Characteristics of patients are shown in Table 1. In test-retest analysis, 142 (67.3%) patients had same STOP score and 186 (88.2%) patients were classified in same risk for OSA in two points of time. The intraclass correlation coefficient (ICC) was 0.75 (95%CI: 0.69-0.80, p value<0.001).
According to the STOP questionnaire 468 patients (77.6%) were at high risk for OSA (STOP scoree"2) and 135 patients (22.4%) were at low risk. Whereas the STOP-BANG questionnaire classified 502 patients (83.3%) at high risk for OSA (STOP-BANG scoree"3) and 101 patients (16.7%) at low risk. Based on the results obtained from PSG, 165 of patients (27.4%) had AHI<5, whereas the remaining 438 patients had mild (n = 124, 20.4%), moderate (n = 114, 18.9%) and severe (n = 201, 33.3%) OSA. 
The percent of patients which STOP and STOP-BANG questionnaires classified as high risk for OSA, increased by rising in AHI score (Table 2). Also, patients with more severe forms of OSA had higher STOP and STOP-BANG score (Table 2). One-way ANOVA showed the difference of STOP and STOP-BANG score among patients with no, mild, moderate and severe OSA was significant overally (p value<0.001). Results of discriminant analysis are shown in Table 3.
Predictive parameters of the STOP and STOP-BANG questionnaires for diagnosis of OSA in AHI cut-off points of 5, 15 and 30 are shown in Table 4 and 5.

Discussion

In this study, we translated the STOP-BANG questionnaire into Persian and assessed its reliability and validity. We used the forwards-backward procedure for translation which is the suggested process for translating questionnaires. 
In test-retest analysis we found that 67.3 % of patients had the same STOP score in 2 to 4 weeks interval. Chung et al [11] assessed the test-retest agreement of the STOP questionnaire which 55 patients answered to questionnaire twice at a time interval of 1�27 days (median=8 days). They found that 96.4% of patients had the same STOP score upon retesting. This difference might be caused by larger sample and wider time interval in our study. One-way ANOVA showed that STOP-BANG questionnaire could discriminate patients without OSA from patients with OSA although the difference of STOP-BANG score was not significant between mild and moderate OSA as well as between moderate and severe OSA.   
More than 85% of individuals with OSA are never diagnosed and treated [12], therefore applying valid and reliable instruments for screening is essential. Currently, PSG is the gold standard test for OSA diagnosis. It needs laboratory setting to observe the case whole night while a trained technician should observe the patient and record the data. In real work setting, it is not applicable to utilize it for all patients at risk for OSA. In this way, an easy-use simple instrument for OSA identification should be considered. 
One of the most common questionnaires in this field is Berlin questionnaire which has three categories and 10 questions. It had wide range of sensitivity from 54% to 86% and the specificity from 43% to 87% among patients in different settings [13-15]. Chung et al [16] reported the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Berlin questionnaire at a cutoff of AHI greater than 5 to be as 68.9%, 56.4%, 77.9%, and 44.9%, respectively. Although it has only 10 questions, its scoring system is complex and long.
In Recent years, the STOP-BANG questionnaire was used broadly for screening OSA. We found sensitivity, specificity, PPV and NPV of STOP questionnaire for AHI e"5 as 86%, 46%, 81% and 54%, respectively. Also, we calculated area under the curve (AUC) as 0.74 at this point. Chung et al [11] in a study on surgical patients, found sensitivity, specificity, PPV, NPV and AUC of STOP questionnaire for AHI e" 5 as 65.6%, 60%, 78.4%, 44% and 0.703, respectively. Pecotic et al [17] evaluated Croatian version of STOP questionnaire in sleep clinic patients and reported sensitivity, specificity, PPV, NPV and AUC for AHI e" 5 as 96%, 83%, 61%, 95% and 0.84, respectively. A recent study of the STOP questionnaire in patients referred to sleep clinics reported sensitivity, specificity, PPV, NPV and AUC for AHI e" 5 as 74.6%, 34%, 79.2%, 28.3% and 0.607 respectively [18].
Our results are in compatible with previous studies that showed the STOP-BANG questionnaire in a population with high prevalence of OSA like patients referred to sleep clinic, performs with high sensitivity and negative predictive value and low specificity and positive predictive value especially for diagnosing moderate and severe forms of OSA [18-21]. Boynton et al [18] reported sensitivity, specificity, PPV, NPV and AUC of the STOP-BANG for AHI e" 15 as 93.2%, 40.5%, 58.2%, 87% and 0.746, respectively and for AHI e" 30 as 96.8%, 33.1%, 36.4%, 96.3% and 0.762, respectively. Ong et al [19] reported the sensitivity of 86.1%, 92.8%, and 95.6% for AHI>5, >15 and >30, respectively.  
The major limitation of our study is that we failed to include a sample from general population for validating the Persian version of the STOP-BANG questionnaire. In sleep clinic patients the prevalence of OSA is higher than general population which caused to difference in predictive parameters. Although a Brazilian study showed an acceptable performance of the STOP-BANG questionnaire for screening OSA in general population [22].
In conclusion, Persian version of the STOP BANG is an easy-to-use questionnaire which could be considered as a reliable and valid tool in screening for OSA. Further investigations need to assess the performance of the STOP-BANG for measuring OSA in community people. 

Acknowledgement
This research has been supported by Tehran University of Medical Sciences & health Services. 
References
1. The Report of an American Academy of Sleep Medicine Task Force (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed/?term=The+Report+of+an+American+Academy+of+Sleep+Medicine+Task+Force.+Sleep-related+breathing+disorders+in+adults%3A+recommendations+for+syndrome+definition+and+measurement+techniques+in+clinical+research" \o "Sleep."Sleep 22: 667-689.
2. Peppard PE, Young T, Barnet JH, Palta M, Hagen EW, et al. (2013) Increased Prevalence of Sleep-Disordered Breathing in Adults. Am J Epidemiol 177: 1006-1014. 
3. Young T, Peppard PE, Gottlieb DJ (2002) Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 165: 1217-1239. 
4. Amra B, Farajzadegan Z, Golshan M, Fietze I, Penzel T (2011) Prevalence of sleep apnea-related symptoms in a Persian population. Sleep Breath 15: 425-429.
5.  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Khazaie%20H%5BAuthor%5D&cauthor=true&cauthor_uid=21888458" Khazaie H,� HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Najafi%20F%5BAuthor%5D&cauthor=true&cauthor_uid=21888458" Najafi F,� HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Rezaie%20L%5BAuthor%5D&cauthor=true&cauthor_uid=21888458" Rezaie L,� HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Tahmasian%20M%5BAuthor%5D&cauthor=true&cauthor_uid=21888458" Tahmasian M,� HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Sepehry%20AA%5BAuthor%5D&cauthor=true&cauthor_uid=21888458" Sepehry AA et al. (2011) Prevalence of Symptoms and Risk of Obstructive Sleep Apnea Syndrome in the General Population. Arch Iran Med 14: 335-338.
6. Liao P, Yegneswaran B, Vairavanathan S, Zaki A, Chung F (2007) Respiratory complications among obstructive sleep apnea (OSA) patients who underwent surgery. Sleep 30: 582.
7. Kryger MH (2000) Diagnosis and management of sleep apnea syndrome. Clin Cornerstone 2:  39-47. 
8. Bloch KE (1997) Polysomnography: a systematic review. Technol Health Care 5: 285-305. 
9. Flemons WW, Douglas NJ, Kuna ST, Rodenstein DO, Wheatley J (2004) Access to diagnosis and treatment of patients with suspected sleep apnea. Am J Respir Crit Care Med 169: 668�672.
10. Abrishami A, Khajehdehi A, Chung F (2010) A systematic review of screening questionnaires for obstructive sleep apnea. Can J Anaesth 57: 423-438. 
11. Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S, et al. (2008) STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology 108: 812-821. 
12. Young T, Evans L, Finn L, Palta M (1997) Estimation of the clinically diagnosed proportion of sleep apnea syndrome in middle-aged men and women. Sleep 20: 705-706.
13. Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP(1999) Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 131:485�91 
14. Martinez D, da Silva RP, Klein C, � HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Fiori%20CZ%5BAuthor%5D&cauthor=true&cauthor_uid=21210233" Fiori CZ,� HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Massierer%20D%5BAuthor%5D&cauthor=true&cauthor_uid=21210233" Massierer D, et al. (2012) High risk for sleep apnea in the Berlin questionnaire and coronary artery disease. Sleep Breath 16: 89-94.
15. Ahmadi N, Chung SA, Gibbs A, Shapiro CM (2008) The Berlin questionnaire for sleep apnea in a sleep clinic population: Relationship to polysomnographic measurement of respiratory disturbance. Sleep Breath 12: 39-45. 
16. Chung F, Yegneswaran B, Liao P, Chung SA, Vairavanathan S et al. (2008) Validation of the Berlin Questionnaire and American Society of Anesthesiologists Checklist as Screening Tools for Obstructive Sleep Apnea in Surgical Patients. Anesthesiology 108:822�30 
17. Pecotic R, Dodig IP, Valic M, Ivkovic N, Dogas Z (2011) The evaluation of the Croatian version of the Epworth sleepiness scale and STOP questionnaire as screening tools for obstructive sleep apnea syndrome. Sleep Breath 16: 793-802.
18. Boynton G, Vahabzadeh A, Hammoud S, Ruzicka DL, Chervin RD (2013) Validation of the STOP-BANG Questionnaire among Patients Referred for Suspected Obstructive Sleep Apnea. J Sleep Disor: Treat Care 2:4.
19.  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Ong%20TH%5BAuthor%5D&cauthor=true&cauthor_uid=20419474" Ong�TH,� HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Raudha%20S%5BAuthor%5D&cauthor=true&cauthor_uid=20419474" Raudha S,� HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Fook-Chong%20S%5BAuthor%5D&cauthor=true&cauthor_uid=20419474" Fook-Chong S,� HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Lew%20N%5BAuthor%5D&cauthor=true&cauthor_uid=20419474" Lew N,� HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed?term=Hsu%20AA%5BAuthor%5D&cauthor=true&cauthor_uid=20419474" Hsu AA (2010) Simplifying�STOP-BANG: use of a simple questionnaire to screen for OSA in an Asian population.  HYPERLINK "http://www.ncbi.nlm.nih.gov/pubmed/20419474" \o "Sleep & breathing = Schlaf & Atmung." Sleep Breath 14: 371-376. 
20. Farney RJ, Walker BS, Farney RM, Snow GL, Walker JM (2011) The STOP-Bang equivalent model and prediction of severity of obstructive sleep apnea: relation to polysomnographic measurements of the apnea/hypopnea index. J Clin Sleep Med 7: 459-465B.
21. Vana KD, Silva GE, Goldberg R (2013) Predictive abilities of the STOP-Bang and Epworth Sleepiness Scale in identifying sleep clinic patients at high risk for obstructive sleep apnea. Res Nurs Health 36: 84-94.
22. Coelho FM, Pradella-Hallinan M, Palombini L, Tufik S, Bittencourt LR (2012) The STOP-BANG questionnaire was a useful tool to identify OSA during epidemiological study in S�o Paulo (Brazil). Sleep Med 13: 450-451. 
 Table 1:  characteristics of studied patients.
AHI<5 
5d"AHI<15 15d"AHI<30 AHIe"30 All patients Female, n (%)57 (34.7)32 (25.8)22 (19.3)41 (20.4)152 (25.2)Age (years)42.3�1446.1�10.748.4�13.347.1�11.845.8�12.7BMI (kg/m2)26.3�528.8�5.530�4.731.1�6.429.18�5.9Systolic blood pressure (mmHg)112.9�14.3119.9�12.1123.8�14.5123.5�14.6119.7�14.7Diastolic blood pressure (mmHg)74.9�10.778�10.680.4�14.881.5�11.778.7�12Neck circumference (cm)38�3.239.6�3.540.3�3.4441.2�3.439.7�3.6Mean SaO2 (%)94�2.393.2�1.891.8�4.888.9�8.791.7�6Lowest SaO2 (%)77.5�28.974.4�26,270�25.659.7�27.269.5�28.1AHI apnea hypopnea index, BMI body mass index



Table 2: The mean (standard deviation) of the STOP and STOP-BANG questionnaires and the classification of patients in various groups of AHI.
AHI<5 
(n=164)5d"AHI<15 (n=124)15d"AHI<30 (n=114)AHIe"30 (n=201)All patients (n=603)STOPScore, mean (SD)1.6 (0.9)2.2 (1.02)2.5 (0.9)2.8 (0.7)2.3 (1.03)Low risk, n (%)74 (46.6)32 (25.2)17 (14.9)12:;kyz������				
k
l
�
�
��Ƕ���o�aPa�P?�P�P�P hq_�hq_�CJOJQJ^JaJ h
�h�.;CJOJQJ^JaJh
�CJOJQJ^JaJ h�k�5�CJOJQJ\�^JaJ h�\�5�CJOJQJ\�^JaJ h� �5�CJOJQJ\�^JaJ&h
�h�.;5�CJOJQJ\�^JaJ h
�5�CJOJQJ\�^JaJ&h
�hS�5�CJOJQJ\�^JaJ&h
�h
�5�CJOJQJ\�^JaJ h
�hS�CJOJQJ^JaJ<=		
�
�,���3
�
����������������d��7$8$H$gd�3�$d��a$gd�k�$d��a$gd
�d��7$8$H$gd
�$dh�a$gdq_�$dh�a$gd�.;$dh�a$gd�k�$dh�a$gdS�Xy#$,<�������������ɷɧ��j�VE1&hw2�h�R�5�CJOJQJ\�^JaJ hS�5�CJOJQJ\�^JaJ&hw2�h
�5�CJOJQJ\�^JaJ)hw2�h
�B*CJOJQJ^JaJph�)h
�h
�B*CJOJQJ^JaJph$h
�h
�CJOJPJQJ^JaJh
�CJOJPJQJ^JaJ#h
�B*CJOJQJ^JaJph)hw2�h
�B*CJOJQJ^JaJph h
�h�.;CJOJQJ^JaJ h
�hS�CJOJQJ^JaJ����

(
2
3
E
F
N
Q
`
a
o
p
w
x
y
��dzǟ��ygyPyPygyP<&h�n�B*CJH*OJQJ^JaJph,hw2�hw2�B*CJH*OJQJ^JaJph#hw2�B*CJOJQJ^JaJph)hw2�hw2�B*CJOJQJ^JaJph h�k�5�CJOJQJ\�^JaJ&hw2�h�R�5�CJOJQJ\�^JaJ&h�\�h�\�5�CJOJQJ\�^JaJ&hw2�hS�5�CJOJQJ\�^JaJ h� �5�CJOJQJ\�^JaJ&hw2�h�5�CJOJQJ\�^JaJy
{
�
�
�
�
�
�
�
�
�
�
�
�
��`��ʻ����m�[F[F[F4F#h�3�B*CJOJQJ^JaJph)hw2�hw2�B*CJOJQJ^JaJph#hw2�B*CJOJQJ^JaJph&h�3�B*CJH*OJQJ^JaJph,hw2�hw2�B*CJH*OJQJ^JaJph)hw2�hw2�B*CJOJQJ^JaJphh�WyCJOJQJ^JaJh�WyCJH*OJQJ^JaJ#h�Wyh�WyCJH*OJQJ^JaJ h�Wyh�WyCJOJQJ^JaJ#h�M�B*CJOJQJ^JaJph�
�
z�`av��)34/U����������������������	d��gd�L�	d��gdq_�	d��gdh<9$d��a$gdw2�d��7$8$H$gd
�d��7$8$H$gdw2�`v�������()*23��Ұ���s�_Q=, h�n�5�CJOJQJ\�^JaJ&h�L�h�n�5�CJOJQJ\�^JaJhw2�CJOJQJ^JaJ&hw2�h�d�5�CJOJQJ\�^JaJ)hw2�hw2�B*CJOJQJ^JaJph�)h
�h
�B*CJOJQJ^JaJph$h
�h
�CJOJPJQJ^JaJh
�CJOJPJQJ^JaJ#h
�B*CJOJQJ^JaJph)hw2�hw2�B*CJOJQJ^JaJph/hw2�hw2�5�B*CJOJQJ\�^JaJph34>@DNO\�� 8abs����{��������^����ͼ�ͫ͝ͼͼͼ�~��͝ͼͼͼm_m_m_�_�h#mCJOJQJ^JaJ h�L�h#mCJOJQJ^JaJ h�L�hh<9CJOJQJ^JaJhh<9CJOJQJ^JaJhq_�CJOJQJ^JaJ h�L�hFQ�CJOJQJ^JaJ h�L�h
qxCJOJQJ^JaJhFQ�CJOJQJ^JaJ h�L�h�n�CJOJQJ^JaJ&h�L�hh<95�CJOJQJ\�^JaJ$�����<JRln���$24@X\d���!"48BHLMOPbh���������������ɸɸɸɸɸɸɪת�əəəəəəəɋ�}h�L�CJOJQJ^JaJh
qxCJOJQJ^JaJ h�a�hh<9CJOJQJ^JaJh#mCJOJQJ^JaJ h	�hh<9CJOJQJ^JaJhh<9CJOJQJ^JaJh�5�CJOJQJ^JaJ h�L�h
qxCJOJQJ^JaJh�5�OJQJ^J-���'-.f������ӿ���udVE4 h	�h��CJOJQJ^JaJ h	�h�}�CJOJQJ^JaJh�g�CJOJQJ^JaJ h	�hYMCJOJQJ^JaJ h	�h1q�CJOJQJ^JaJ h	�h�^�CJOJQJ^JaJ&h	�h�5�CJOJQJ\�^JaJ&h	�h�*�5�CJOJQJ\�^JaJ&h	�hU)E5�CJOJQJ\�^JaJ h�L�h�L�CJOJQJ^JaJh�L�CJOJQJ^JaJhFQ�CJOJQJ^JaJ���    :!;!S!T!�"�"�"�"�����������������d��7$8$H$gd�EDd��7$8$H$gd/~�d��7$8$H$gd�^�d��7$8$H$gd%\Md��7$8$H$gd�d��7$8$H$gd$�$d��a$gdbk
$d�a$gd�n��������������������± ����sb�Q�Q�s@ h	�h�s+CJOJQJ^JaJ h	�h)�CJOJQJ^JaJ h	�h�CJOJQJ^JaJ h	�hk�CJOJQJ^JaJh�EDCJOJQJ^JaJh�|SCJOJQJ^JaJ h	�h�PCJOJQJ^JaJ h	�h[-CJOJQJ^JaJh�M�CJOJQJ^JaJ h	�h�g�CJOJQJ^JaJh�g�CJOJQJ^JaJ h	�h��CJOJQJ^JaJ�����������-345678L]^n����΅������{m�m{\mK: h	�h�tCJOJQJ^JaJ h	�h�?�CJOJQJ^JaJ h	�h�1CJOJQJ^JaJh%\MCJOJQJ^JaJ h	�hhF	CJOJQJ^JaJ h	�h�W�CJOJQJ^JaJ h	�h.�CJOJQJ^JaJ h	�h�3�CJOJQJ^JaJ h	�h�~%CJOJQJ^JaJ h	�hbkCJOJQJ^JaJ h	�h�s+CJOJQJ^JaJhbkCJOJQJ^JaJnv������������!;K���пп���В�p_N= h	�h%�CJOJQJ^JaJ h	�h�K�CJOJQJ^JaJ h	�h�<�CJOJQJ^JaJ h	�h�X�CJOJQJ^JaJ h	�h�B�CJOJQJ^JaJ h	�hhF	CJOJQJ^JaJhbkCJOJQJ^JaJh%\MCJOJQJ^JaJ h	�h<CJOJQJ^JaJ h	�h�k�CJOJQJ^JaJh$�CJOJQJ^JaJ h	�h�6CJOJQJ^JaJKPSTijw�������������ڰ��q�\G\5�\�"h%\MCJOJQJ^JaJmH	sH	(h	�hv�CJOJQJ^JaJmH	sH	(h	�h7j>CJOJQJ^JaJmH	sH	(h	�h�%�CJOJQJ^JaJmH	sH	(h	�h�	1CJOJQJ^JaJmH	sH	(h	�hv=CJOJQJ^JaJmH	sH	(h	�h+?OCJOJQJ^JaJmH	sH	(h	�hhCJOJQJ^JaJmH	sH	(h	�h�KBCJOJQJ^JaJmH	sH	 h	�h�KBCJOJQJ^JaJ������	
@FGHIST`mn��ͼͫ��~�m\�\�\�K:K h	�h��CJOJQJ^JaJ h	�h��CJOJQJ^JaJ h	�hU"�CJOJQJ^JaJ h	�hFCJOJQJ^JaJhbkCJOJQJ^JaJh%\MCJOJQJ^JaJ h	�h%QdCJOJQJ^JaJ h	�h+n�CJOJQJ^JaJ h	�hj[�CJOJQJ^JaJ h	�h�CJOJQJ^JaJ h	�h+?OCJOJQJ^JaJ h	�h�l�CJOJQJ^JaJn������������������Ϳ��޿����o]H6#h�w>B*CJOJQJ^JaJph)h	�h�f�B*CJOJQJ^JaJph#h�`B*CJOJQJ^JaJph)h	�hHKB*CJOJQJ^JaJphh�`CJOJQJ^JaJ h	�hJh�CJOJQJ^JaJh`!MCJOJQJ^JaJhbkCJOJQJ^JaJh%\MCJOJQJ^JaJ h	�h�,CJOJQJ^JaJ h	�h��CJOJQJ^JaJ h	�hK*CJOJQJ^JaJ���	
 "$%&A����괢��~i�W��EW0)h	�hzy{B*CJOJQJ^JaJph#ho-9B*CJOJQJ^JaJph#h$�B*CJOJQJ^JaJph)h�w>hzy{B*CJOJQJ^JaJph#hzy{B*CJOJQJ^JaJph#h%\MB*CJOJQJ^JaJph#hFvB*CJOJQJ^JaJph#h�w>B*CJOJQJ^JaJph#hbkB*CJOJQJ^JaJph#hn�B*CJOJQJ^JaJph)h	�h�1B*CJOJQJ^JaJphAWuv�����"#CSVinop����������ucQ?-#h�`B*CJOJQJ^JaJph#hEB*CJOJQJ^JaJph#h�[B*CJOJQJ^JaJph#h$�B*CJOJQJ^JaJph)h	�h�B*CJOJQJ^JaJph#h%\MB*CJOJQJ^JaJph)h3LXh3LXB*CJOJQJ^JaJph#h3LXB*CJOJQJ^JaJph)h	�hzy{B*CJOJQJ^JaJph)hzy{hzy{B*CJOJQJ^JaJph#hzy{B*CJOJQJ^JaJphp|}����������   
   ���ƴ�퟊��u`uN�<#hiByB*CJOJQJ^JaJph#h%\MB*CJOJQJ^JaJph)h�5�B*CJOJQJ\�^JaJph)h$�5�B*CJOJQJ\�^JaJph)h	�h$�B*CJOJQJ^JaJph)h	�h�B*CJOJQJ^JaJph#h�\�B*CJOJQJ^JaJph)h�\�h�\�B*CJOJQJ^JaJph#hEB*CJOJQJ^JaJph#h$�B*CJOJQJ^JaJph     ! " / ; < = D ` � � � � � � � � � � � !!8!9!:!���۴�ۢƑ�������ۢjXFXFX#h�^�B*CJOJQJ^JaJph#hEB*CJOJQJ^JaJph)h	�hEB*CJOJQJ^JaJph#h /B*CJOJQJ^JaJph h	�hiByCJOJQJ^JaJ#hEB*CJOJQJ^JaJph#h%\MB*CJOJQJ^JaJph)h	�hiByB*CJOJQJ^JaJph#hiByB*CJOJQJ^JaJph#h�^�B*CJOJQJ^JaJph:!E!R!S!T!b!p!�!�!�!�!�!�!�!�!�!�!�!�!�!�!""f"o"�"�"�"�"���ɷ�ɥɥɥ�������|����jXjX#h�^�B*CJOJQJ^JaJph#h/~�B*CJOJQJ^JaJph,h /h /B*CJH*OJQJ^JaJph#h /B*CJOJQJ^JaJph#h/~�B*CJOJQJ^JaJph#hiByB*CJOJQJ^JaJph#h�^�B*CJOJQJ^JaJph#h%\MB*CJOJQJ^JaJph#hEB*CJOJQJ^JaJph�"�"�"�"�"�"<#=#n#v#�#�#%!%<%?%B%D%P%^%x%�%�%�%�%�%�%�%�%�%�%����ɻ��������������������n\n�#h /B*CJOJQJ^JaJph#hjAB*CJOJQJ^JaJph h /h�^�CJOJQJ^JaJht�CJOJQJ^JaJh�g�CJOJQJ^JaJhjACJOJQJ^JaJh�^�CJOJQJ^JaJ#h�^�B*CJOJQJ^JaJph#h/~�B*CJOJQJ^JaJph#h$�B*CJOJQJ^JaJph�"�%�%�%�%�)�)�)�)//*/L2M2������������w	d��gd�
$d�a$gdW�
$d�a$gd0Hd��7$8$H$gd�x�	d��gd�^�d��7$8$H$gdI$d��a$gdI$d��a$gd�Rd��7$8$H$gd/~�$d��a$gd�^�$d��a$gdt�
�%�%�%�%�%&&&&/&^&_&f&g&�&�&�&��Ʊ��u`�Nu��@2@h%\MCJOJQJ^JaJh�^�CJOJQJ^JaJ#h�c�B*CJOJQJ^JaJph)h	�h\q�B*CJOJQJ^JaJph#h��B*CJOJQJ^JaJph)h	�h<B*CJOJQJ^JaJph)h	�h�C�B*CJOJQJ^JaJph)h	�hi%B*CJOJQJ^JaJph)h$�h�^�B*CJOJQJ^JaJph#h/~�B*CJOJQJ^JaJph#h�^�B*CJOJQJ^JaJph�&�&�&�&�&�&�&E'�'�'�'�'�'((( ("(,(:(G(T(7)8)H)��Ƹ�����������rdr�S��r>)h	�h�;B*CJOJQJ^JaJph h�x�h�^�CJOJQJ^JaJh�RCJOJQJ^JaJhby�CJOJQJ^JaJh%\MCJOJQJ^JaJh�x�CJOJQJ^JaJhjACJOJQJ^JaJh�(�CJOJQJ^JaJh�^�CJOJQJ^JaJ#h�(�B*CJOJQJ^JaJph#h�^�B*CJOJQJ^JaJph)h	�h �B*CJOJQJ^JaJphH)I)J)O)a)i)k)p)�)�)�)�)�)�)�)�)�)�)*(*)*���شآ؍آآ�{�m_J�)h	�h�BB*CJOJQJ^JaJphh�x�CJOJQJ^JaJhICJOJQJ^JaJ#h�B*CJOJQJ^JaJph)h	�hAzIB*CJOJQJ^JaJph#hIB*CJOJQJ^JaJph#hby�B*CJOJQJ^JaJph#ht�B*CJOJQJ^JaJph)h	�h�;B*CJOJQJ^JaJph#h�^�B*CJOJQJ^JaJph)***;*D*E*^*�*�*�*�*�*�*�*�*�*�*�*�*�*++++)+<+C+[+\+�������ծ�������u���u�c�Q#h0HB*CJOJQJ^JaJph#ht�B*CJOJQJ^JaJph#h�TB*CJOJQJ^JaJph)h	�h��B*CJOJQJ^JaJph#h�g�B*CJOJQJ^JaJph#hIB*CJOJQJ^JaJph)h	�h�BB*CJOJQJ^JaJph)h	�hIB*CJOJQJ^JaJph)hIhIB*CJOJQJ^JaJph\+�+v,�,�,�,�,�,/-�-�-�-�-�-�-.
.7.;.F.U.V.}.~..�.�����Ŵ�������n[Mh�@�CJOJQJ^JaJ$h�g�h_�CJOJQJ^J_H)aJ'h�g�h_�CJOJQJZ�^J_H)aJ$h�g�hICJOJQJ^J_H)aJ h	�h�^�CJOJQJ^JaJh�^�CJOJQJ^JaJ h�g�h�g�CJOJQJ^JaJh�g�CJOJQJ^JaJh1X�CJOJQJ^JaJh0HCJOJQJ^JaJ h	�h0HCJOJQJ^JaJ�.�.�.�.�.////*/R/S/}/�/�/�/�/�/�/�/0�������qcqRDRDR�R�h�3�CJOJQJ^JaJ h�3�h�3�CJOJQJ^JaJh�d�CJOJQJ^JaJh0HCJOJQJ^JaJh0HCJOJQJ^J_H)aJ h	�h0HCJOJQJ^JaJh8�CJOJQJ^J_H)aJh�g�CJOJQJ^J_H)aJ$h�g�hICJOJQJ^J_H)aJh�g�CJOJQJ^JaJh�WyCJOJQJ^JaJ h�g�h_�CJOJQJ^JaJ000g0i0�0�0�1�1�1�12222(2)2L2T2U2����´¡��~i���[�J9 h�5�CJOJQJ\�^JaJ h�d�5�CJOJQJ\�^JaJh�d�CJOJQJ^JaJ)h	�h�d�B*CJOJQJ^JaJph#h�`B*CJOJQJ^JaJph h	�h�d�CJOJQJ^JaJ$h	�h�d�0JCJOJQJ^JaJh��CJOJQJ^JaJh0HCJOJQJ^JaJh�WyCJOJQJ^JaJ h�3�h�3�CJOJQJ^JaJ h�3�h�WyCJOJQJ^JaJM2U2V2�3�6Y8�8�8�8�8�9�<�>�@�G�K���������������d��7$8$H$gd<0*	d��gd"I�d��7$8$H$gd*=�	d��gdbk	d��gd�L�	d��gd=!�	d��gd�LG	d��gdh<9	d��gd�
0	d��gd�U2V2�2�2�2�2�2�2<3D3R3T3\3_3�3�3�3�3�3�3�3��Ϳ����v�v��c�cS�E�h3LXCJOJQJ^JaJh> zCJOJQJ^J_H)aJ$h��h> zCJOJQJ^J_H)aJh�
0CJOJQJ^JaJh^�CJOJQJ^JaJ h��h> zCJOJQJ^JaJhW�CJOJQJ^JaJh�WyCJOJQJ^JaJh�a�CJOJQJ^JaJ h	�hx�CJOJQJ^JaJhN�CJOJQJ^JaJ&h	�h�d�5�CJOJQJ\�^JaJ�3�3�34484:4L4n4p4v4�4�4�4�4�4�45>5H5V5X5d5j5|5�5�5�5�5�5R6������ޱޠ��В�������v�����eWh> zCJOJQJ^JaJ h> zh> zCJOJQJ^JaJh��CJOJQJ^JaJh3LXCJOJQJ^JaJh�@�CJOJQJ^JaJ h	�h�@�CJOJQJ^JaJ h	�h�5CJOJQJ^JaJhN�CJOJQJ^JaJhh<9CJOJQJ^JaJ h	�h�]�CJOJQJ^JaJ h	�h:<QCJOJQJ^JaJR6S6�6�6�6�6�6�6�7X8Y8�8�8�8�8�8�8�8�8�8�8�8�8���Ⱥ����}o�oaoSEoSoSoh=!�CJOJQJ^JaJh�LGCJOJQJ^JaJh�1�CJOJQJ^JaJh'Q/CJOJQJ^JaJ h�LGh�WyCJOJQJ^JaJ h�LGh�LGCJOJQJ^JaJ h�LGh7�CJOJQJ^JaJh7�OJQJ^Jh7�CJOJQJ^JaJh�WyCJOJQJ^JaJhHfCJOJQJ^JaJh> zCJOJQJ^JaJh�a�CJOJQJ^JaJ�8�8�8�8�8�8�9�9�9�9]:_:�:�:�:�:�:�:�;�;�;�<�<�<��ͼ������{�j�j�j�Y�K�=hkp<CJOJQJ^JaJh�L�CJOJQJ^JaJ h�LGh�L�CJOJQJ^JaJ h��h=!�CJOJQJ^JaJhbkCJOJQJ^JaJ h� �h=!�CJOJQJ^JaJh=!�CJOJQJ^JaJ&h	�h�d�5�CJOJQJ\�^JaJ h�3D5�CJOJQJ\�^JaJ h�d�5�CJOJQJ\�^JaJ h0H5�CJOJQJ\�^JaJ h	�h�H�CJOJQJ^JaJ�<�<�>???(?J?y?z?�?�?�?�?�?�?�?�?�?���± ���s��b�Q@/ h�a�h	x�CJOJQJ^JaJ h�a�hR*�CJOJQJ^JaJ h�a�hW�CJOJQJ^JaJ h�a�h$�CJOJQJ^JaJh*=�CJOJQJ^JaJh�9�CJOJQJ^JaJ h�a�h�l�CJOJQJ^JaJ h�a�h�o8CJOJQJ^JaJ h�a�h�xCJOJQJ^JaJ h�a�hcQ|CJOJQJ^JaJ h�a�hkcCJOJQJ^JaJhkp<CJOJQJ^JaJhbkCJOJQJ^JaJ�?�?�?�?�?�?�?�?@@@#@&@'@+@?@@@R@S@b@k@r@x@����п����������~m~�\K h�a�hwp�CJOJQJ^JaJ h�a�h>'�CJOJQJ^JaJ h�a�h�g�CJOJQJ^JaJ h�a�h�o\CJOJQJ^JaJ h�a�h��CJOJQJ^JaJ h�a�h@�CJOJQJ^JaJhv9CJOJQJ^JaJ h�a�hs\�CJOJQJ^JaJ h�a�h	x�CJOJQJ^JaJh*=�CJOJQJ^JaJ h�a�h*=�CJOJQJ^JaJx@�@�@�@�@�@�@�@�@�@�@4A5AlAmAzA}A���ͼK��{jYKY=h@yoCJOJQJ^JaJh"I�CJOJQJ^JaJ h�a�h�1CJOJQJ^JaJ h�a�h�#CJOJQJ^JaJh=!�CJOJQJ^JaJ h�a�h�l�CJOJQJ^JaJ h�a�hR&CJOJQJ^JaJ h�a�h[5�CJOJQJ^JaJ h�a�h�0�CJOJQJ^JaJ h�a�h4^�CJOJQJ^JaJ h�a�h*=�CJOJQJ^JaJ h�a�h�xCJOJQJ^JaJ}ABBBB6BRBTBVB~B�B�B�B�B�B�B�B�B�B�B�B�B�BCFC�C�C�C�C�C�C�C�C�C�C�C�C�C�C�CD������������������´�����‡‡�������v�v h�a�h�+�CJOJQJ^JaJ h�a�h�#CJOJQJ^JaJh�k�CJOJQJ^JaJhqx>CJOJQJ^JaJhv9CJOJQJ^JaJh�1CJOJQJ^JaJ h�a�h�1CJOJQJ^JaJh@yoCJOJQJ^JaJ h�a�h@yoCJOJQJ^JaJ(DDD D2DNDPDRDlDvD�D�D�D
EEE&E2E`EbEjElE|E�E�E�E�E�E�E�E�E�����´�ᣕ�ӄ�v��v�evӄӄ�e�T h�a�hrH!CJOJQJ^JaJ h�a�h�s�CJOJQJ^JaJh�k�CJOJQJ^JaJ h�a�h@yoCJOJQJ^JaJhqx>CJOJQJ^JaJ h�a�h7,&CJOJQJ^JaJh�,mCJOJQJ^JaJ h�a�h_�CJOJQJ^JaJh@yoCJOJQJ^JaJh�1CJOJQJ^JaJ h�a�h�mCJOJQJ^JaJ�E�E�E�E�E�E�E�E�EjF�F�F�F�F�FG
GGXGZG~G�G�GHHHHH��пббб����������~pbpQp h�a�h'|�CJOJQJ^JaJh[CJOJQJ^JaJh'|�CJOJQJ^JaJ h�a�h7,&CJOJQJ^JaJ h@yoh@yoCJOJQJ^JaJ h�a�h@yoCJOJQJ^JaJh@yoCJOJQJ^JaJ h�a�hK�CJOJQJ^JaJh�k�CJOJQJ^JaJ h�a�hrH!CJOJQJ^JaJ h�a�h�xCJOJQJ^JaJHHpH�HIII#I*I0I5I6I?IEIaIbIIJ
JJJJ&J*J8J:J>J@J�J�J�J�J�J�J�J�J�J�J�J�J�J�J�J�JKKKVKdKfK�K�K�K������������������������������������������򷦷����� h�a�hq4CJOJQJ^JaJ h�a�h�3~CJOJQJ^JaJ h�a�hZp[CJOJQJ^JaJh[CJOJQJ^JaJ h�a�h�CJOJQJ^JaJh<0*CJOJQJ^JaJh'|�CJOJQJ^JaJh�CJOJQJ^JaJ3�K�LMM�M�M�M�M�M�M�M�M�M�M�M�M�M�M�M�MNN9N�N�N�N�N��������䱣������ӣp�_�_UEhh<9hh<95�OJQJ\�^Jhh<9OJQJ^J h�a�h@�CJOJQJ^JaJ h�a�h�^�CJOJQJ^JaJ h�a�h�&CJOJQJ^JaJ h�a�h�m�CJOJQJ^JaJh�m�CJOJQJ^JaJ h�a�h��CJOJQJ^JaJ h�a�h�CJOJQJ^JaJ h�a�hm�CJOJQJ^JaJh�k�CJOJQJ^JaJh�7CJOJQJ^JaJ�K�M�N�N�NO%OQ�QSR�R�U�VWZWX�X^YZ�Z�������������������$d��a$gd�u�$d��a$gd�L�$d��a$gdq_�$d��a$gdh<9$d��a$gd�&	d��gd�m�d��7$8$H$gd�k��N�N�N�NOOO%O(OfOnO�O�O�P�PQQQQQQ
QQGQ�����Ҿ����l�lNl=������ h�L�hCn�CJOJQJ^JaJ;h�L�h�&0J>*B*CJOJQJ^JaJmHnHph�u)jh�L�h�&CJOJQJU^JaJ+h�L�hCn�CJOJQJ^JaJmHnHu+h�L�h�&CJOJQJ^JaJmHnHu h�L�h�&CJOJQJ^JaJ&h�&h�&5�CJOJQJ\�^JaJh�[OJQJ^Jhq_�OJQJ^Jhq_�hq_�OJQJ^Jhh<95�OJQJ\�^JGQTQ�Q�Q�Q�Q�Q�QFRGRPRQRSRTRURVR�R�R�R�R�R�R�R�RdSeS������������ͼ�������u`�`)jh�u�h�u�CJOJQJU^JaJ&h�u�hbk5�CJOJQJ\�^JaJ h�u�hCn�CJOJQJ^JaJ h�u�h�u�CJOJQJ^JaJ h�u�hbkCJOJQJ^JaJ h�u�hbkCJOJQJ^JaJ h�L�hbkCJOJQJ^JaJ h�L�h�&CJOJQJ^JaJ h�L�hCn�CJOJQJ^JaJeSnSoSpSqSrS�S�S�S�S�S�S�S[T\TdTeTfTgThT�T�T�T�T�T�T�TYUZUdUeUlUsUtU�U�ɰ�Ʉ��ɰ�Ʉ��ɰ�Ʉ��ɰ�Ʉ��Ʉv�e h�u�hbkCJOJQJ^JaJh�u�CJOJQJ^JaJ h�u�h�u�CJOJQJ^JaJ5h�u�h�u�0JCJOJQJ^JaJfHq�
����1h�u�h�u�CJOJQJ^JaJfHq�
����)jh�u�h�u�CJOJQJU^JaJAh�u�h�u�0J>*B*CJOJQJ^JaJfHph�q�
����"�U�U�U�U�U�U{V�V�V�V�V�V�V�V�V�V�VWWWWOWPWWWXWZW[WXXX
XXXXX�X�X_Y`YbYzY{Y�Y�Y�Y�YZ����○Ю��ᅬ���ᅬ�����ᅬ��������~�~�~�~ h�L�hkp<CJOJQJ^JaJ h�L�h�,mCJOJQJ^JaJhJ3ECJOJQJ^JaJ h�u�h�&CJOJQJ^JaJ h�L�h�&CJOJQJ^JaJh�u�CJOJQJ^JaJ h�L�hCn�CJOJQJ^JaJ h�L�hbkCJOJQJ^JaJ.Z�Z�Z�Z�Z�Z�ZO[P[X[Y[[[\[�[�[�[�[�[�[�[+\J\M\N\U\(])]+],].]/]X]v]8^<^l^���޿������������������������o^ h�L�h�&CJOJQJ^JaJ h�L�h�k�CJOJQJ^JaJ h�L�h�,mCJOJQJ^JaJ0h�u�h�u�0J>*B*CJOJQJ^JaJph�)jh�u�h�u�CJOJQJU^JaJ h�u�h�u�CJOJQJ^JaJh�u�CJOJQJ^JaJ h�u�h*=�CJOJQJ^JaJ h�L�h*=�CJOJQJ^JaJ#�ZU\1]8^%_�_>c8de�e2f4fBfDfXfnf~f�f�����������������d��$Ifgd�qd�$Ifgd�qd��$Ifd��$If$d��a$gd�m�	d��gd�L�$d��a$gd�L�$d��a$gd�u�l^m^s^t^_$_%_'_�_�_�_d`e`k`l`n`o`�`�`�`�`�`�`\a]aiajalama�a�a�a�a�a�aNbObUbVb���޿ޮޝ���o�����o�����o�����o�����o�0h�L�h[0J>*B*CJOJQJ^JaJph�)jh�L�h[CJOJQJU^JaJ h�L�h[CJOJQJ^JaJ h�L�h@yoCJOJQJ^JaJh�u�CJOJQJ^JaJ h�L�h�k�CJOJQJ^JaJ h�L�h�&CJOJQJ^JaJ h�L�h�a�CJOJQJ^JaJ&Vb]b�b�b!c"c.c/c3c4c8c:c>c�c�c<d
ee�e�e�e�e�e����̳�����ᢑ���obXH;hW15�OJQJ\�^Jh�[h�[5�OJQJ\�^Jh�&OJQJ^Jh�k�h�k�OJQJ^J h�L�h�k�CJOJQJ^JaJ h�L�h�CJOJQJ^JaJ h�L�h<0*CJOJQJ^JaJ h�L�h'|�CJOJQJ^JaJ0h�L�h[0J>*B*CJOJQJ^JaJph�)jh�L�h[CJOJQJU^JaJ h�L�h[CJOJQJ^JaJh�L�CJOJQJ^JaJ�e�e�eff.f0f2f�f�f�f�f�f�f�f�f�f�f�f�f�f�f�f�f�f�fggggggg g�g�g�g�ghhZh[h�h�h�h�h�h�h�h�h�h���������˹˹˹˹˹˹˹˹˹˹˹����ˮ��������ˣ���h�qh�a�OJQJ^Jh�qOJQJ^Jh�qH*OJQJ^Jh�a�H*OJQJ^Jh�a�H*OJQJ^Jh�{�OJQJ^Jh�a�CJaJh�a�OJQJ^Jh�[OJQJ^Jh3�OJQJ^Jh�WyOJQJ^Jhf-h�[OJQJ^J2�f�f�f�f�f2'''d��$If�kd$$If�l�ֈ����(�F �%D�DUD�D�D�
t��0��6������4�4�
lB�a�yt�a��f�fgg g���%�kd$$If�l��~ֈ����(�F �%DD�DUD�D�D�
t��0��6������4�4�
lB�a�yt�a�d��$If g8gHg\gpg�g�g������d��$If�g�g�g�g�g0%%%d��$If�kd$$If�l��~ֈ����(�F �%DD�DUD�D�D�
t��0��6������4�4�
lB�a�yt�a��g�g�ghh���'�kd$$If�l�ֈ����(�F �%DD�DUD�D�D�
t��0��6������4�4�
lB�a�yt�a�d��$Ifh#h.h9hDhOhZh������d��$IfZh[h{h�h�h2'''d��$If�kd$$If�l�ֈ����(�F �%DD�DUD�D�D�
t��0��6������4�4�
lB�a�yt�a��h�h�h�h�h���'�kd$$If�l�ֈ����(�F �%DD�DUD�D�D�
t��0��6������4�4�
lB�a�yt�a�d��$If�h�h�h�h�h�h�h������d��$If�h�h�hi
i2'''d��$If�kd $$If�l�ֈ����(�F �%DD�DUD�D�D�
t��0��6������4�4�
lB�a�yt�a�
iii&i'i���'�kd$$$If�l�ֈ����(�F �%DD�DUD�D�D�
t��0��6������4�4�
lB�a�yt�a�d��$If�h&i'i1i2i3i6igihi�i�i�i�i�i�i�i�i�i�i�i�ij jJjLjNj�j�j�j�������������y�y���hZ�P�Ph�l�OJQJ^Jh�"aCJOJQJ^JaJ hHEh�"aCJOJQJ^JaJh�"ah�"aOJQJ^Jh�"aOJQJ^Jh�ZwOJQJ^JhW15�OJQJ\�^Jh�Zw5�OJQJ\�^Jhf-h�a�OJQJ^Jh�h
h�qOJQJ^Jh�qOJQJ^Jh�qH*OJQJ^Jh�a�H*OJQJ^Jh�a�CJaJh�a�OJQJ^J'i7iAiKiSi]igi������d��$Ifgihi�i2%$d��a$gd�q�kd($$If�l�ֈ����(�F �%DD�DUD�D�D�
t��0��6������4�4�
lB�a�yt�a��i�i�i�iNjPj^jnj�j�j�j�j�����������	d�$Ifd�$Ifgd�a�d��$If$If$d��a$gd�"a$d��a$gd�Zw$d��a$gd�Wy�j�jk
k2,,$If�kd,	$$If�l�ֈ�1M�� �%?FF�F�FHF�
t��0�6������4�4�
lB�a�^�yt�DL�j�jkk6k�k�k�k�k�k�k�k�k�k�k�k�k�k�k�k�k�k�kl#.2578<?ABGJLXYhiz����������������������������������������������������Uh�a�OJQJ^Jh�l�OJQJ^Jh�DLOJQJ^Jh�"aCJaJh�"aCJOJQJ^J_H)aJh�"aOJQJ^Jh�ZwCJaJh�ZwOJQJ^Jh�l�CJaJ@
kkkkk����$If	$Ifgd�Zwkk6k2)	$Ifgd�3��kd5
$$If�l�ֈ�1M�� �%F?��H�
t��0�6������4�4�
lB�a�^�yt�DL6kJk`ktk�k�k�����	$Ifgd�3�d��$Ifgd�3��k�k�k�k2)#$If	$Ifgd�DL�kd>$$If�l�ֈ�1M�� �%F?��H�
t��0�6������4�4�
lB�a�^�yt�DL�k�k�k����$If	$Ifgd�l�	$Ifgd�a� (5.9)135 (22.3)High risk, n (%)91 (53.4)92 (74.8)97 (85.1)189 (94.1)468 (77.7)STOP-BANGScore, mean (SD)2.8 (1.3)3.8 (1.3)4.4 (1.1)4.7 (1.08)3.9 (1.4)Low risk, n (%)81 (44.7)28 (21.9)6 (5.3)4 (1.9)(101) 20.1High risk, n (%)111 (55.3)96 (78.1)108 (94.7)197 (98.1)(503) 79.9AHI apnea hypopnea index
Table 3: Results of discriminant analysis with one way analysis of variance and post hoc Scheffe test.

STOP questionnaireSTOP-BANG questionnaireF44.443.9P value Total<0.001<0.001P value between No &  Mild OSA<0.001<0.001P value between  No & Moderate OSA<0.001<0.001P value between  No & Severe OSA<0.001<0.001P value between Mild & Moderate OSA0.110.15P value  between Mild & Severe OSA <0.001<0.001P value  between Moderate & Severe OSA0.060.51OSA obstructive sleep apnea
Table 4: Predictive parameters of the STOP questionnaire for OSA identification in AHI cut-off points 5, 15 and 30.
AHI cut-off point51530Sensitivity86.3 (82.6-89.3)91.1 (87.2-93.8)94.1 (89.8-96.7)Specificity46.5 (38.6-54.6)37.1 (31.5-43)30.7 (26.2-35.6)Positive predictive value81.9 (78-85.2)61.5 (56.9-66)40.2 (36.6-45.9)Negative predictive value54.8 (46-63.3)79 (71-85.2)91.1 (84.8-94.9)Positive likelihood ratio1.61 (1.38-1.88)1.44 (1.31-1.6)1.36 (1.26-1.47)Negative likelihood ratio0.29 (0.21-0.39)0.24 (0.16-0.35)0.18 (0.1-0.34)Odds ratio5.51 (3.58-8.47)6.04 (3.76-9.7)7.19 (3.76-13.76)Area under the curve0.745 (0.698-0.792)0.721(0.678-0.763)0.704 (0.660-747)OSA obstructive sleep apnea, AHI apnea hypopnea index
Table 5: Predictive parameters of the STOP-BANG questionnaire for OSA identification in AHI cut-off points 5, 15 and 30.
AHI cut-off point51530Sensitivity91.6 (87-94.7)97.1 (92.8-98.8)98 (93.1-99.4)Specificity45.2 (35.6-55.2)35.2 (28.2-42.9)29.4 (23.5-36.1)Positive predictive value78.2 (72.5-83)56.9 (50.5-63)41.8 (35.7-48.1)Negative predictive value71.6 (59.2-81.4)93.3 (84-97.3)96.6 (88.6-99)Positive likelihood ratio1.67 (1.38-2.02)1.49 (1.33-1.68)1.38 (1.26-1.52)Negative likelihood ratio0.18 (0.11-0.20)0.08 (0.03-0.22)0.06 (0.01-0.36)Odds ratio9.09 (4.79-17.25)18.35 (6.44-52.24)20.86 (4.97-87.42)Area under the curve0.805 (0.753-0.858)0.779 (0.727-0.831)0.755 (0.7-0.809)OSA obstructive sleep apnea, AHI apnea hypopnea index


$.2,,$If�kdG$$If�l�ֈ�1M�� �%F?FF�F�FHF�
t��0�6������4�4�
lB�a�^�yt�DL.8BMX����$If	$Ifgd�l�XYcde0***$If�kdP
$$If�l��-ֈ�1M�� �%F?FF�F�FHF�
t��0�6������4�4�
lB�a�^�yt�DLefghi���,�kd]$$If�l�ֈ�1M�� �%F?��H�
t��0�6������4�4�
lB�a�^�yt�DL$Ifiz�����������d��$Ifgd�3�	$Ifgd�3�����2,,$If�kdf$$If�l�ֈ�1M�� �%F?��H�
t��0�6������4�4�
lB�a�^�yt�DL���������$If	$Ifgd�a�������������
$&)567NOPWXYZ���������������������켨��ud hW1h�CJOJQJ^JaJ hW1hW1CJOJQJ^JaJ h�xnh�CJOJQJ^JaJ hW15�CJOJQJ\�^JaJ&hW1h�5�CJOJQJ\�^JaJh�OJQJ^Jh�qOJQJ^JhHfOJQJ^Jh�DLOJQJ^Jh�ZwCJaJh�ZwOJQJ^Jh�l�OJQJ^J"���
2,,$If�kdo$$If�l�ֈ�1M�� �%F?FF�F�FHF�
t��0�6������4�4�
lB�a�^�yt�DL
*5����$If	$Ifgd�l�56OP0+$d��a$gd> zgd�q�kdx$$If�l��ֈ�1M�� �%F?FF�F�FHF�
t��0�6������4�4�
lB�a�^�yt�DLP�������������L���kd�$$If�l��F���^�%L~	K
t��0�6������������������4�4�
la�yt�3�dh�$Ifgd�3�	d��gd�DL	d��gdW1������������
$-.45;<=R_`fgmno������������������аааð���ð�ð���ð�ð���ð�ð���Èwа h�3�h�"aCJOJQJ^JaJ$h�3�h�"aCJOJQJ^J_H)aJ h�3�hW1CJOJQJ^JaJhW1$h�3�hW1CJOJQJ^J_H)aJh�3�hW1OJQJ^Jh�3�h�"aOJQJ^Jh�"aCJOJQJ^J_H)aJ$hW1h�CJOJQJ^J_H)aJ.����`����kd3$$If�l��F���^�%L~	K
t��0�6������������������4�4�
la�yt�3�dh�$Ifgd�3�.5<n```dh�$Ifgd�3��kd�$$If�l��F���^�%L~	K
t��0�6������������������4�4�
la�yt�3�<=`gnn```dh�$Ifgd�3��kd�$$If�l��F���^�%L~	K
t��0�6������������������4�4�
la�yt�3�no���n```dh�$Ifgd�3��kd=$$If�l��F���^�%L~	K
t��0�6������������������4�4�
la�yt�3������n```dh�$Ifgd�3��kd�$$If�l��F���^�%L~	K
t��0�6������������������4�4�
la�yt�3�����������'(,-13NOPQWYZ|}��O
U
W
X

�
�
�
X
���������������󴪠��y�l�l�l�y�l�l�lhf-h�[OJQJ^JhW15�OJQJ\�^Jhf-h�[5�OJQJ\�^Jh�OJQJ^Jh> zOJQJ^Jh�"aOJQJ^Jh�qOJQJ^JhW1h�3�hW1OJQJ^J h�3�hW1CJOJQJ^JaJ$h�3�hW1CJOJQJ^J_H)aJh�3�h�"aOJQJ^J&����n```dh�$Ifgd�3��kd�$$If�l��F���^�%L~	K
t��0�6������������������4�4�
la�yt�3�(-2n```dh�$Ifgd�3��kdG$$If�l��F���^�%L~	K
t��0�6������������������4�4�
la�yt�3�23OQ���ndSF55$d��$Ifa$gda7!$d��a$gdW1$d������a$gd�DL	d��gd�DL�kd�$$If�l��F���^�%L~	K
t��0�6������������������4�4�
la�yt�3���������M�����kd�$$If�l��\��C	{q�%����
t��0�6���������������������4�4�
la�yta7!$d��$Ifa$gda7! ,=L]^MMMM$d��$Ifa$gda7!�kdJ$$If�l��\��C	{q�%����
t��0�6���������������������4�4�
la�yta7!]^x���^MMMM$d��$Ifa$gda7!�kd�$$If�l��\��C	{q�%����
t��0�6���������������������4�4�
la�yta7!������^MMMM$d��$Ifa$gda7!�kd�$$If�l��\��C	{q�%����
t��0�6���������������������4�4�
la�yta7!��
		+	<	^MMMM$d��$Ifa$gda7!�kd?$$If�l��\��C	{q�%����
t��0�6���������������������4�4�
la�yta7!<	=	W	h	y	�	^MMMM$d��$Ifa$gda7!�kd�$$If�l��\��C	{q�%����
t��0�6���������������������4�4�
la�yta7!�	�	�	�	�	�	^MMMM$d��$Ifa$gda7!�kd�$$If�l��\��C	{q�%����
t��0�6���������������������4�4�
la�yta7!�	�	�	�	

^MMMM$d��$Ifa$gda7!�kd4$$If�l��\��C	{q�%����
t��0�6���������������������4�4�
la�yta7!

N
�
�
�
^QD33$d��$Ifa$gda7!$d��a$gdW1$d��a$gd�[�kd�$$If�l��\��C	{q�%����
t��0�6���������������������4�4�
la�yta7!�
�
�
�
�
�
��M�����kd�$$If�l��\��t	�T�%����
t��0�6���������������������4�4�
la�yta7!$d��$Ifa$gda7!+<M^^MMMM$d��$Ifa$gda7!�kd#$$If�l��\��t	�T�%����
t��0�6���������������������4�4�
la�yta7!^_y���^MMMM$d��$Ifa$gda7!�kd�$$If�l��\��t	�T�%����
t��0�6���������������������4�4�
la�yta7!������^MMMM$d��$Ifa$gda7!�kde $$If�l��\��t	�T�%����
t��0�6���������������������4�4�
la�yta7!��
/@^MMMM$d��$Ifa$gda7!�kd!$$If�l��\��t	�T�%����
t��0�6���������������������4�4�
la�yta7!@A[l}�^MMMM$d��$Ifa$gda7!�kd�!$$If�l��\��t	�T�%����
t��0�6���������������������4�4�
la�yta7!������^MMMM$d��$Ifa$gda7!�kdH"$$If�l��\��t	�T�%����
t��0�6���������������������4�4�
la�yta7!����
"
^MMMM$d��$Ifa$gda7!�kd�"$$If�l��\��t	�T�%����
t��0�6���������������������4�4�
la�yta7!"
#
Y
Z
[
^QQQ$d��a$gd�[�kd�#$$If�l��\��t	�T�%����
t��0�6���������������������4�4�
la�yta7!X
Y
[
��hb�OJQJ^Jh�^�OJQJ^J21�h:p�DL��/ ��=!��"��#��$��%�������21�h:p�DL��/ ��=!��"��#��$��%�������21�h:p�DL��/ ��=!��"��#��$��%�������$$If�!vh5��5�5�5��5�h5�c#v�#v#v#v�#vh#vc:V�l
t��0��6�5�5��5�U5��5��5��/�B�yt�a�$$If�!vh5��5�5�5��5�h5�c#v�#v#v#v�#vh#vc:V�l�~
t��0��6�5�5��5�U5��5��5��/�B�yt�a�$$If�!vh5��5�5�5��5�h5�c#v�#v#v#v�#vh#vc:V�l�~
t��0��6�5�5��5�U5��5��5��/�B�yt�a�$$If�!vh5��5�5�5��5�h5�c#v�#v#v#v�#vh#vc:V�l
t��0��6�5�5��5�U5��5��5��/�B�yt�a�$$If�!vh5��5�5�5��5�h5�c#v�#v#v#v�#vh#vc:V�l
t��0��6�5�5��5�U5��5��5��/�B�yt�a�$$If�!vh5��5�5�5��5�h5�c#v�#v#v#v�#vh#vc:V�l
t��0��6�5�5��5�U5��5��5��/�B�yt�a�$$If�!vh5��5�5�5��5�h5�c#v�#v#v#v�#vh#vc:V�l
t��0��6�5�5��5�U5��5��5��/�B�yt�a�$$If�!vh5��5�5�5��5�h5�c#v�#v#v#v�#vh#vc:V�l
t��0��6�5�5��5�U5��5��5��/�B�yt�a�$$If�!vh5��5�5�5��5�h5�c#v�#v#v#v�#vh#vc:V�l
t��0��6�5�5��5�U5��5��5��/�B�yt�a�$$If�^�!vh5�?5�5��5��5�H5��#v?#v#v�#v�#vH#v�:V�l
t��0�6�5�?5�5��5��5�H5��/�B�a�^�yt�DL$$If�^�!vh5�?5�5��5��5�H5��#v?#v#v�#v�#vH#v�:V�l
t��0�6�5�?5�5��5��5�H5��/�B�a�^�yt�DL$$If�^�!vh5�?5�5��5��5�H5��#v?#v#v�#v�#vH#v�:V�l
t��0�6�5�?5�5��5��5�H5��/�B�a�^�yt�DL$$If�^�!vh5�?5�5��5��5�H5��#v?#v#v�#v�#vH#v�:V�l
t��0�6�5�?5�5��5��5�H5��/�B�a�^�yt�DL$$If�^�!vh5�?5�5��5��5�H5��#v?#v#v�#v�#vH#v�:V�l�-
t��0�6�5�?5�5��5��5�H5��/�B�a�^�yt�DL$$If�^�!vh5�?5�5��5��5�H5��#v?#v#v�#v�#vH#v�:V�l
t��0�6�5�?5�5��5��5�H5��/�B�a�^�yt�DL$$If�^�!vh5�?5�5��5��5�H5��#v?#v#v�#v�#vH#v�:V�l
t��0�6�5�?5�5��5��5�H5��/�B�a�^�yt�DL$$If�^�!vh5�?5�5��5��5�H5��#v?#v#v�#v�#vH#v�:V�l
t��0�6�5�?5�5��5��5�H5��/�B�a�^�yt�DL$$If�^�!vh5�?5�5��5��5�H5��#v?#v#v�#v�#vH#v�:V�l�
t��0�6�5�?5�5��5��5�H5��/�B�a�^�yt�DL�$$If�!vh5�L5�~	5�K#vL#v~	#vK:V�l
t��0�6�5�L5�~	5�Kyt�3��$$If�!vh5�L5�~	5�K#vL#v~	#vK:V�l
t��0�6�5�L5�~	5�Kyt�3��$$If�!vh5�L5�~	5�K#vL#v~	#vK:V�l
t��0�6�5�L5�~	5�Kyt�3��$$If�!vh5�L5�~	5�K#vL#v~	#vK:V�l
t��0�6�5�L5�~	5�Kyt�3��$$If�!vh5�L5�~	5�K#vL#v~	#vK:V�l
t��0�6�5�L5�~	5�Kyt�3��$$If�!vh5�L5�~	5�K#vL#v~	#vK:V�l
t��0�6�5�L5�~	5�Kyt�3��$$If�!vh5�L5�~	5�K#vL#v~	#vK:V�l
t��0�6�5�L5�~	5�Kyt�3��$$If�!vh5�L5�~	5�K#vL#v~	#vK:V�l
t��0�6�5�L5�~	5�Kyt�3��$$If�!vh5�L5�~	5�K#vL#v~	#vK:V�l
t��0�6�5�L5�~	5�Kyt�3��$$If�!vh5��	5�8	5��	5�8	#v�	#v8	#v�	#v8	:V�l
t��0�65��yta7!�$$If�!vh5��	5�8	5��	5�8	#v�	#v8	#v�	#v8	:V�l
t��0�65��yta7!�$$If�!vh5��	5�8	5��	5�8	#v�	#v8	#v�	#v8	:V�l
t��0�65��yta7!�$$If�!vh5��	5�8	5��	5�8	#v�	#v8	#v�	#v8	:V�l
t��0�65��yta7!�$$If�!vh5��	5�8	5��	5�8	#v�	#v8	#v�	#v8	:V�l
t��0�65��yta7!�$$If�!vh5��	5�8	5��	5�8	#v�	#v8	#v�	#v8	:V�l
t��0�65��yta7!�$$If�!vh5��	5�8	5��	5�8	#v�	#v8	#v�	#v8	:V�l
t��0�65��yta7!�$$If�!vh5��	5�8	5��	5�8	#v�	#v8	#v�	#v8	:V�l
t��0�65��yta7!�$$If�!vh5��	5�8	5��	5�8	#v�	#v8	#v�	#v8	:V�l
t��0�65��yta7!�$$If�!vh5��	5�p	5�p	5�U	#v�	#vp	#vU	:V�l
t��0�65��yta7!�$$If�!vh5��	5�p	5�p	5�U	#v�	#vp	#vU	:V�l
t��0�65��yta7!�$$If�!vh5��	5�p	5�p	5�U	#v�	#vp	#vU	:V�l
t��0�65��yta7!�$$If�!vh5��	5�p	5�p	5�U	#v�	#vp	#vU	:V�l
t��0�65��yta7!�$$If�!vh5��	5�p	5�p	5�U	#v�	#vp	#vU	:V�l
t��0�65��yta7!�$$If�!vh5��	5�p	5�p	5�U	#v�	#vp	#vU	:V�l
t��0�65��yta7!�$$If�!vh5��	5�p	5�p	5�U	#v�	#vp	#vU	:V�l
t��0�65��yta7!�$$If�!vh5��	5�p	5�p	5�U	#v�	#vp	#vU	:V�l
t��0�65��yta7!�$$If�!vh5��	5�p	5�p	5�U	#v�	#vp	#vU	:V�l
t��0�65��yta7!n���������666666666vvvvvvvvv666666>666666666666666666666666666�6666666666�666666666666hH66666666666666666666666666666666666666666666666666666666666666666�62���� 0@P`p������2(�� 0@P`p������ 0@P`p������ 0@P`p������ 0@P`p������ 0@P`p������ 0@P`p��8X�V~$OJPJQJ^J_HmH	nH	sH	tH	J`�Jt�Normald��CJ_HaJmH	sH	tH	DA`�DDefault Paragraph FontRi@�R0Table Normal�4�
l4�a�(k �(
0No ListV^�V	�g�0Normal (Web)d���CJOJPJQJ^JaJ.X�.�g�@Emphasis6�]�.�o�.�|�0A5B*CJaJph"j��#j]4
�
Table Grid7:V�0P�2PQWwdescd��d�d[$\$CJOJPJQJ^JaJB'�AB
<0Comment ReferenceCJaJ<@R<<0Comment TextCJaJ:��a:<0Comment Text Char@jQR@
<0Comment Subject5�\�F�b�F<0Comment Subject Char5\R��R
<0Balloon Textd��CJOJQJ^JaJN���N<0Balloon Text CharCJOJQJ^JaJ6U`�6�&0	Hyperlink>*B*ph�B�O��B�u�apple-converted-spacePK!����[Content_Types].xml���j�0E����ж�r�(��΢Iw},��-j��4	��w�P�-t#bΙ{U�����T�U^h�d}㨫��)��*1P�'��	�^��W��0)��T�9<�l�#��$yi}��;�~@��(��H����u�*Dנz��/0�ǰ��$��X��3aZ����,�D0j~�3߶�b��~i>���3�\`�?�/�[���G��\�!�-�Rk.�s�Ի�..���a濭?��PK!�֧�6_rels/.rels���j�0���}Q��%v/��C/�}�(h"���O�
����=������ ����C?�h�v=��Ʌ��%[xp��{۵_�Pѣ<�1�H�0���O�R�Bd���JE�4b$��q_����6L�R�7`������0̞O��,�En7�Li�b��/�S���e��е�����PK!ky���theme/theme/themeManager.xml�M
� @�}�w��7c�(Eb�ˮ��C�AǠҟ����7��՛K
Y,�
�e�.���|,���H�,l����xɴ��I�sQ}#Ր���� ֵ+�!�,�^�$j=�GW��)�E�+&
8���PK!����Ptheme/theme/theme1.xml�YOo�6��w toc'vu�ر�-M�n�i���P�@�I}��úa��m�a[�إ�4�:lЯ�GR��X^�6؊�>$�������!)O�^�r�C$�y@�����/�yH*��񄴽)�޵��߻��UDb�`}"�qۋ�Jח���X^�)I`n�E���p)���li�V[]�1M<������O�P��6r�=���z�gb�Ig��u��S�eb��O������R�D۫����qu	�g��Z����o~ٺlAp�lx�pT0���+[}`j���zA��V�2�F���i�@�q�v�֬5\|��ʜ̭N��le�X�ds���jcs���7���f����
��W��+�Ն�7����`���g�Ș��J���j|��h(�K��D-����
dX��iJ�؇(��x$(��:��;�˹!�I_�T��S1�����?E��?�����?ZBΪm���U/������?�~����xY���'���y5�g&΋/����ɋ�>���G�M�Ge���D�����3Vq%'#q�����$�8��K�����)f�w9:ĵ��
x}r�x����w���r�:\TZaG�*�y8I�j�bR��c|XŻ�ǿ�I
u3KG�nD1�NIB�s���
��R��u���K>V�.EL+M2�#'�f��i~�V��vl�{u8��z��H�
�*���:�(W�☕
~��J�T�e\O*�tHG��HY��}KN�P�*ݾ˦���TѼ�9/#��A7�qZ��$*c?���qU��n��w�N��%��O��i�4=3ڗP��
����1�P�m\\9���������Mؓ�2a�D�]�;Yt�\��[x����]�}Wr��|�]��g-���
eW�
�)6-r��CS�j��
i�d	�DЇA�ΜIqbJ#x�꺃6k���#��A�Sh��&ʌt(Q�%��p%m��&]�caSl=�X�����\P�1�Mh�9�M��V�dDA��aV�B��[݈fJ�íP|8�քA�V^��f
�H��n���-��"�d>�z��n��NJ�	�ة�>�b���&����2��v����Kyϼ��D:����,AGm��\nz��i�Ù��.uχYC�6�OMf��3o�r��$��5�����NH�T[XF64�T,ќ���M0�E)`#�5�XY�`�פ;��%�1�U�٥m;���R>QD����D�cp�U�'��&LE�/p���m���%]�����8fi��r�S4�d7y\�`�J�n���ί�I�R��3U�~7+���׸#��m�q�BiD���������i*�L6�9�m�Y&���i���HE��=(K&�N!V�.K�e�LD�ĕ�{D	����vEꦚde��NƟ��e�(�MN9ߜR�6����&3(��a���/D��U�z�<�{ˊ�Y��ȳ����V���)�9�Z[��4^n��5���!J��?��Q�3�eBo�C����M����m<�.�vp�����IY�f���Z�Y_p�[�=al-�Y�}Nc͙���ŋ4vfa��vl����'S��A�8�|�*u�{��-�ߟ0%M0�7%����<���ҍ���PK!
ѐ��'theme/theme/_rels/themeManager.xml.rels��M
�0���wooӺ�&݈Э���5
6?$Q��
�,.�a��i����c2�1h�:�q��m��@RN��;d�`��o7�g�K(M&$R(.1�r'J��ЊT���8��V�"��AȻ�H�u}��|�$�b{��P����8�g/]�QAsم(����#��L�[������PK-!����[Content_Types].xmlPK-!�֧�6+_rels/.relsPK-!ky���theme/theme/themeManager.xmlPK-!����P�theme/theme/theme1.xmlPK-!
ѐ��'�	theme/theme/_rels/themeManager.xml.relsPK]�
<?xml version="1.0" encoding="UTF-8" standalone="yes"?>
<a:clrMap xmlns:a="http://schemas.openxmlformats.org/drawingml/2006/main" bg1="lt1" tx1="dk1" bg2="lt2" tx2="dk2" accent1="accent1" accent2="accent2" accent3="accent3" accent4="accent4" accent5="accent5" accent6="accent6" hlink="hlink" folHlink="folHlink"/>U[V]`c`����4`����h`�����y
`3���nK�n�Ap :!�"�%�&H))*\+�.0U2�3R6�8�<�?x@}AD�EHH�K�NGQeS�UZl^Vb�e�h�j��X
[
689:<=>?ABCDEFGHIJKLNOPQRSTVWXYZ[\]^_`acdefgijkw|�����
�"M2�K�Z�f�f g�g�ghZh�h�h�h
i'igi�i�j
kk6k�k�k.Xei���
5P�<n��2�]��<	�	�	
�
^��@��"
[
7;@MUbhlmnopqrstuvxyz{}~����������������������������������������?AA�BiCsCvC�C�C�C`DiDlD�D�D�D^EiE�JTK]K`K�K�K�OiPpPsP�P�P�PaQnQqQ�Q�Q�QSRZR�R&S3S`cX���X��X��X��X��X��X��X��X��X��X��X��X��X���8�@�����������0�(	�
��B
�S����	?��`c��8
OLE_LINK16
OLE_LINK17	OLE_LINK5	OLE_LINK6
OLE_LINK13	OLE_LINK7	OLE_LINK8
OLE_LINK26
OLE_LINK27	OLE_LINK9
OLE_LINK10
OLE_LINK11
OLE_LINK12	OLE_LINK3	OLE_LINK4
OLE_LINK42
OLE_LINK43
OLE_LINK55
OLE_LINK56
OLE_LINK14
OLE_LINK15	OLE_LINK1	OLE_LINK2
OLE_LINK47
OLE_LINK48
OLE_LINK44
OLE_LINK45
OLE_LINK46
OLE_LINK51
OLE_LINK52
OLE_LINK20
OLE_LINK21
OLE_LINK38
OLE_LINK39
OLE_LINK33
OLE_LINK34
OLE_LINK28
OLE_LINK29
OLE_LINK40
OLE_LINK41
OLE_LINK36
OLE_LINK37
OLE_LINK53
OLE_LINK54
OLE_LINK57
OLE_LINK58
OLE_LINK59
OLE_LINK60
_Hlk378372996
OLE_LINK24
OLE_LINK25
OLE_LINK18
OLE_LINK19
_Hlk319662213
OLE_LINK22
OLE_LINK23�����vv�������&�&v'v'�(�(�)�)�)A*A*^,^,�,�,�-�-..�0�0�7�7�=�=�E�E�E�EV�W�W�X�X,Y``bc	

 !"#$%&'()*+,-./01234567::�33��))))��!!���&�&�'�'Z)Z)�)�)�)�*�*v,v,�,�,�-�-5.5.�0�0z8z8@>@>�E�E�F�FSVXX,Y,Y�Y8`8`bc+<DS[fm39������|��������	�	��]e������E N P ^ ` i � � � � 6#>#�$�$S%]%�%�%_)i)----9-�7�7�;�;A A9A>A�A�A�A�A2B8B9B=B[B_BcBoBsBzB~B�B�B�BjCqCvC�C�CgDlD�D�DfE�E	F
FFF"F�F�F�F�FG'G>GEGbGiG�G�G�G�G�G�GH#H'H1H�H�H�H�H�H�H�I�IJJJ J%J+J9J?J�J�J�JZK`K�K^LdL�L�LCMNMdMqMANHNLNQNVN[N_NfNjNoN9OCOGONOROYO^OeO�O�OjPmPsP�P�PfQGSMS]ScS�S�STT!T%TATET�TU"U3U7U@UDUIUMUXUwXXE[M[i[u[�[�[OcWcbcOQ !�+�+�A�A-B/B_G�G�G�GyN|N�UV�X+YU[�[V]�]T`�`bc333333333333323�/	/	8	s	�	�	UU!"���������>?�B�B�B�B�ByE�E�E�F�F�F�F�J�J�J�K�K�KNLOLRLSLO)Obc(5U~����������������^��`���.��������^��`���.��p����p^�p`���.��@����@^�@`���.������^�`���.��������^��`���.��������^��`���.��������^��`���.��P����P^�P`���.(5U���������(=�^�1W uhuh�u3�u3�(AZ*
=
d?��^�U"�6�@�1W !C�3ET��"�&+UK�/U"�6!C��W�7d�n�`�G�@��;�S3ETB#@s�&+U�(AZ7�f�nKc7�f��"mjh�(=� ������������d�nB#@s�W�7��y�`�G�=G�Fj3�DU+X�`�|y�~���R�&�4�l�^�1�FvE�1�E�T�o�+�[I|(�,�H�SAtl
	"	31	hF	�U	�
�"
A+
nq
hy
=QS�[
]4
E
L
!u
�]2�:�;�>�\�akc�~?[-�1c�� @EqG��SqWF�s�_P|�i%�zFub�m�|[�B6Q"ZWI�[mY�i�9�L��6�dB�-D�t�K*Zo�xs-�5�7v=DT2 FL �M �\ �!�!a7!rH!�m!\#�$�%,%'%�=%�~%R&7,&HP&�')"'�"'�_'�e'3
)�)�$)+D)�E)tq)�*<0*�Y*+`*d*5B+nD+�L+�s+�_,M-�.-.�.S".Q:.�/ /^"/�4/'Q/Y/�
0W1�	1�121I1	a1�2�m2f,3:3;3$T3�_340:4�g4q4)5[650h5�66b6�o8�q8p9
9o-9h<9�?9v9�:�0:?i:�*;�.;�:;�D;@I;�<<pI<�d<n<kp<�w=�^>7j>�w>qx>�?�&?_^?�?@�M@�d@jAo%A�B (B�KB�sB�CnC�C&C�nCcCj#Dr3D�3D�EDo(EU)EJ3E�FF�FC5F�*G�<G�LG	H0H(%HD'H�[I�dIjjIAzI�;J@*KHK�QK�"L�DL�kL�M�MYM`!M�)M^UM%\MDmMmVN�|N+?O�P�
P"IP:<Q(UQ�R�KR�RSOSwHS�IS�|S�T�
TOiTT�U�NV�NV�;WhW^qW�
X�1X3LX9:YgYKZZ:[IG[^L[�k[Zp[({[+\�1\PI\�Y\�l\�o\�][]
`]b5^dK^�{^�7_#`�K`g`�r`�`na�"a�$a�:a�Oagba�b}b�b�6b{nboPc@8dS;d�;d~Nd%QdrTd�kd�nd�sd�le�leHf~Bg�cg(xgh�4h9Bi�vi�{jykbk� lEFl#m�,m�,m?Km�$o-7o�Co�Po�`o.oo@yo�zp�q
*qOq%oqm`r�r.srhs�it�tt�u�u�Muv5v�w�DwQWw�ZwchwW	x;x�>x
qxxx^:y;yiByCSy�Wy�by<z> z�vzzy{cQ|�z|}�3~�L~��#!%�')M�dWk?�W�_�
�O��!��V�t��y�:��d�Rt���,��A�Ej������M��}��/��3�r&��&��'��2�*4�P	��4^��c��k��m� ��1��F�.[��f��V�`�by���45��^�j��l���
�$�U�JY�\(�/-���D����X�1q���(��C�j[�;j���5G��G�$��(��k��l�	x����)�s-����&F�"I��M�sa����&��m�wp��
�#��L�MU�Q{����*��a�%|��F=��Q�X_��@��}�.�Z��t��D�o�R*��,�	L�m�+n�Cn��D�N�Z��s��|������9�$=��L�=!�/P�vQ��\��/�%?��(��.��]��f��G�FQ��u�����6��E��s�|N�D��5�-X������|�7=��W��c�Jh�S{�
�^�6����H��*��i��m��2E�+x���G����8��@���F��n�*��7�8�Q}�P��"��+��+�x���t��B�$��C�1#��S� V������&�s1��k����X��]�o?��]� &��3��\�j�D�R&��u��0��R�U��\����;�Ef��g�1}��U"�;G�hZ��i��
�A��r�X>��K�}t��C��O�~k��@��^�a��&��:��G�1a��c+���>'�� �Z5�u��#��&��&��q��x��S��T�!i��|�/~���$��`��~����&��g�Cn��r��6�A�$n��n�n��>�1X�v��^��g�n�v�)��3�[5�	=��Z�s\�}�K��>��?�oA�RJ����=��E��H����%��H����H��S�l�d'�G.�����w2�*=��P�[�M[�e2�90�pG�	�S�W����W��^�q_��X�k�!-�O{�4�,O��8�b�C
��@��V�'�@��"�(0�$J�_�����0+��3��M��^���;��B�sM��U�3X�&[��[��g��[�m��E��I��K��M��Z��{�i�#���%�N/��I�n^��l�$�S���MT��Z�����@�(a��Q�>
�O��W��NS�Wn���I'�C)��d����<�/B��m�)B�vv��*��0��Q��k�
l�� �$"�bT�\q�'|�W�$�F�Q��w��z��M�^Y��"�}(��S�N��X�`cbc�@��������
*+�6�7�8�9;<VWYZ`cX@XXX0@X4Xl@XBXDXFX�@XJX�@XfX�@XjX@��Unknown������������	G��*�Ax�	�Times New Roman5��Symbol3.��* ��ArialW��TimesNewRomanMS MinchoK�TimesNewRomanPSMT7�� �@B Mitra7.���{ @�Calibri5.��*�[`�)�TahomaA���� B�Cambria Math"q���h�����!�)��T2����T2�!���n���20.c.c2�q���XR	�$P����������������������U)E2!xx���20User����Oh��+'��0P�������	��

$08@H�20NormalUser19Microsoft Office Word@6v�#@j�z��@��H����T����՜.��+,��D��՜.��+,��,�hp|�������
���IHC�2.cTitle� 8@_PID_HLINKS�AHT#8',http://www.ncbi.nlm.nih.gov/pubmed/20419474�	>Y$_http://www.ncbi.nlm.nih.gov/pubmed?term=Hsu%20AA%5BAuthor%5D&cauthor=true&cauthor_uid=20419474�	(!^http://www.ncbi.nlm.nih.gov/pubmed?term=Lew%20N%5BAuthor%5D&cauthor=true&cauthor_uid=20419474�	Gpehttp://www.ncbi.nlm.nih.gov/pubmed?term=Fook-Chong%20S%5BAuthor%5D&cauthor=true&cauthor_uid=20419474�	
{ahttp://www.ncbi.nlm.nih.gov/pubmed?term=Raudha%20S%5BAuthor%5D&cauthor=true&cauthor_uid=20419474�	>M_http://www.ncbi.nlm.nih.gov/pubmed?term=Ong%20TH%5BAuthor%5D&cauthor=true&cauthor_uid=20419474�	Iydhttp://www.ncbi.nlm.nih.gov/pubmed?term=Massierer%20D%5BAuthor%5D&cauthor=true&cauthor_uid=21210233�	J*ahttp://www.ncbi.nlm.nih.gov/pubmed?term=Fiori%20CZ%5BAuthor%5D&cauthor=true&cauthor_uid=21210233�	>\chttp://www.ncbi.nlm.nih.gov/pubmed?term=Sepehry%20AA%5BAuthor%5D&cauthor=true&cauthor_uid=21888458�	Bqdhttp://www.ncbi.nlm.nih.gov/pubmed?term=Tahmasian%20M%5BAuthor%5D&cauthor=true&cauthor_uid=21888458�	e	ahttp://www.ncbi.nlm.nih.gov/pubmed?term=Rezaie%20L%5BAuthor%5D&cauthor=true&cauthor_uid=21888458�	gahttp://www.ncbi.nlm.nih.gov/pubmed?term=Najafi%20F%5BAuthor%5D&cauthor=true&cauthor_uid=21888458�	3bhttp://www.ncbi.nlm.nih.gov/pubmed?term=Khazaie%20H%5BAuthor%5D&cauthor=true&cauthor_uid=21888458�	3,�http://www.ncbi.nlm.nih.gov/pubmed/?term=The+Report+of+an+American+Academy+of+Sleep+Medicine+Task+Force.+Sleep-related+breathing+disorders+in+adults%3A+recommendations+for+syndrome+definition+and+measurement+techniques+in+clinical+research�		

 !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~���������������������������������������������������������������������������������������������������������������������������������������������������������������������Root Entry��������	�F��h���Data
�������������+$1Table���������}BWordDocument
�����`SummaryInformation(�������������DocumentSummaryInformation8���������MsoDataStore��������`��g����h��F���1B��REKO�V��U1�F�A==2��������`��g����h��Item
����	�����Properties������������UCompObj����
y����������������	����������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������<b:Sources SelectedStyle="\APA.XSL" StyleName="APA" xmlns:b="http://schemas.openxmlformats.org/officeDocument/2006/bibliography" xmlns="http://schemas.openxmlformats.org/officeDocument/2006/bibliography"></b:Sources><?xml version="1.0" encoding="UTF-8" standalone="no"?>
<ds:datastoreItem ds:itemID="{6CAF7917-7018-4244-8E91-5B7F51B9459C}" xmlns:ds="http://schemas.openxmlformats.org/officeDocument/2006/customXml"><ds:schemaRefs><ds:schemaRef ds:uri="http://schemas.openxmlformats.org/officeDocument/2006/bibliography"/></ds:schemaRefs></ds:datastoreItem>��
����	�F'Microsoft Office Word 97-2003 Document
MSWordDocWord.Document.8�9�q

Youez - 2016 - github.com/yon3zu
LinuXploit