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V
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, pp.
338
~
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8938
,
D
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S
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T
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:
R
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c
e
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d
N
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R
e
vi
s
e
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O
c
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20, 2025
A
c
c
e
pt
e
d
J
a
n 10, 2026
Cervica
l
ca
n
cer
is
a
for
m
of
ca
n
cer
th
a
t
develops
i
n
th
e
cells
of
th
e
cervix,
th
e
lower
par
t
of
th
e
ut
er
u
s
th
a
t
co
nn
ec
t
s
th
e
ut
er
u
s
t
o
th
e
vagi
n
a
.
Early
det
ec
t
io
n
is
esse
nt
ial
for
i
m
provi
n
g
th
e
c
h
a
n
c
es
of
recovery
fro
m
cervical
can
cer
.
O
n
e
m
e
th
od
for
early
de
t
ec
t
io
n
is
colposcopy
i
m
age
a
n
alysis,
a
m
edical
proced
u
re
th
a
t
exa
m
i
n
es
th
e
cervix
a
n
d
cap
tu
res
i
m
ages
for
evalu
a
t
io
n.
T
h
ese
i
m
ages
were
a
n
alyzed
t
o
observe
color
c
h
a
n
ges
af
t
er
th
e
visu
al
i
n
spec
t
io
n
wi
th
ace
t
ic
acid
(VIA)
process
.
However
,
th
is
a
n
alysis
requ
ires
experie
n
ced
a
n
d
specially
t
rai
n
ed
m
edical
perso
nn
el
.
To
address
th
is
c
h
alle
n
ge
,
a
sys
t
e
m
th
a
t
ca
n
a
ut
o
m
a
t
ically
classify
cervical
ca
n
cer
im
ages
is
n
eeded
.
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h
erefore,
researc
h
ers
proposed
desig
n
i
n
g
a
n
d
developi
n
g
an
A
n
droid
m
obile
applica
t
io
n
t
o
e
n
able
early
de
t
ec
t
io
n
of
cervical
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n
cer
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si
n
g
th
e
co
n
vol
ut
io
n
al
n
e
u
ral
n
e
t
work
(CNN)
algori
thm.
T
h
e
CNN
m
odel
was
t
es
t
ed
u
si
n
g
t
es
t
da
ta
t
o
eval
u
a
t
e
i
t
s
perfor
m
a
n
ce
.
T
h
e
op
t
i
m
ized
CNN
m
odel
ut
ilizi
n
g
th
e
ResNe
t
50
arc
h
i
t
ec
tu
re
ac
h
ieved
86%
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es
t
acc
u
racy
,
85%
precision,
a
n
d
87%
recall
.
T
h
e
t
es
t
res
u
l
t
s
i
n
dica
t
e
th
a
t
th
e
m
odel'
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acc
u
racy
is
co
n
sis
t
e
nt
before
a
n
d
af
t
er
i
t
s
i
m
ple
m
e
nt
a
t
io
n
o
n
th
e
m
obile
applica
t
io
n
,
con
fir
m
i
n
g
th
e
effec
t
ive
n
ess
of
bo
th
th
e
m
odel
a
n
d
i
t
s
i
m
ple
m
e
nt
a
t
io
n
as
diagn
os
t
ic
t
ools.
K
e
y
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or
d
s
:
C
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a
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onvol
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i
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ua
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on
This
is
an
open
access
article
under
the
CC
BY
-
SA
license
.
C
or
r
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s
pon
di
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g A
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r
v
i
c
a
l
c
a
nc
e
r
s
c
r
e
e
ni
ng.
G
e
ne
r
a
l
i
z
e
d
l
i
ne
a
r
m
od
e
l
i
ng
,
s
pe
c
i
f
i
c
a
l
l
y
us
i
ng
m
od
i
f
i
e
d P
oi
s
s
on
r
e
g
r
e
s
s
i
on a
nd ba
c
kw
a
r
d
va
r
i
a
bl
e
e
l
i
m
i
n
a
t
i
o
n, w
a
s
e
m
p
l
oye
d t
o
i
de
nt
i
f
y pr
e
va
l
e
n
c
e
r
a
t
i
o
s
a
nd
de
t
e
r
m
i
ne
t
he
f
a
c
t
o
r
s
a
s
s
o
c
i
a
t
e
d
w
i
t
h i
nt
e
n
t
i
o
ns
t
o
und
e
r
go
c
e
r
v
i
c
a
l
c
a
nc
e
r
s
c
r
e
e
n
i
ng.
N
a
r
t
e
y
e
t
a
l
.
[
5]
u
t
i
l
i
z
e
d
t
he
ne
s
t
e
d
m
ul
t
i
pl
e
x
pol
ym
e
r
a
s
e
c
ha
i
n
r
e
a
c
t
i
on
(
N
M
-
P
C
R
)
m
e
t
hod
t
o
de
t
e
c
t
hu
m
a
n
pa
pi
l
l
o
m
a
vi
r
u
s
(
H
P
V
)
i
nf
e
c
t
i
ons
i
n
c
e
r
v
i
c
a
l
s
a
m
pl
e
s
.
T
o
a
s
c
e
r
t
a
i
n
t
he
r
e
l
a
t
i
ons
h
i
p
be
t
w
e
e
n
t
he
r
i
s
k
of
c
e
r
vi
c
a
l
c
a
nc
e
r
a
nd
H
P
V
i
nf
e
c
t
i
on,
t
he
y
a
pp
l
i
e
d
l
og
i
s
t
i
c
r
e
gr
e
s
s
i
on
a
na
l
ys
i
s
.
G
e
br
e
m
e
s
k
e
l
a
nd
G
e
br
e
t
a
t
i
o
s
[
6
]
c
onduc
t
e
d
s
t
udi
e
s
on
hum
a
n
i
m
m
unod
e
f
i
c
i
e
nc
y
vi
r
u
s
(
H
I
V
)
-
i
nf
e
c
t
e
d
w
om
e
n
i
n
s
e
ve
r
a
l
publ
i
c
hos
p
i
t
a
l
s
i
n
T
i
gr
a
y.
T
w
o
s
pe
c
i
f
i
c
s
t
udi
e
s
w
e
r
e
c
a
r
r
i
e
d
out
:
one
f
oc
u
s
e
d
on
H
I
V
-
i
nf
e
c
t
e
d
w
om
e
n
w
ho
di
d
not
ha
ve
a
c
c
e
s
s
t
o
c
e
r
v
i
c
a
l
c
a
nc
e
r
s
c
r
e
e
ni
ng
f
a
c
i
l
i
t
i
e
s
,
a
nd
t
h
e
ot
he
r
on
t
hos
e
w
ho
di
d
r
e
c
e
i
ve
s
uc
h
s
c
r
e
e
ni
ng
s
.
T
he
r
e
s
ul
t
s
f
r
o
m
bot
h
gr
oups
w
e
r
e
t
he
n a
na
l
y
z
e
d us
i
ng
l
i
ne
a
r
r
e
g
r
e
s
s
i
on t
o c
o
m
pa
r
e
t
he
out
c
o
m
e
s
.
A
l
kha
m
i
s
e
t
al
.
[
7]
w
e
r
e
c
onduc
t
e
d
t
o
m
e
a
s
ur
e
t
he
p
r
e
va
l
e
n
c
e
of
c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
ni
ng
a
nd
t
o
i
de
nt
i
f
y
pr
e
d
i
c
t
i
ve
f
a
c
t
or
s
a
m
ong
s
e
xua
l
l
y
a
c
t
i
ve
w
om
e
n
i
n
S
a
udi
A
r
a
b
i
a
.
T
he
t
a
r
ge
t
popul
a
t
i
on
i
nc
l
ude
d
a
dul
t
w
om
e
n
a
ge
d
21 t
o
65
ye
a
r
s
w
ho
ha
d
be
e
n
s
e
xua
l
l
y
a
c
t
i
ve
a
nd
ha
d
not
und
e
r
gone
a
hys
t
e
r
e
c
t
om
y.
T
he
r
e
s
e
a
r
c
h
e
r
s
pe
r
f
o
r
m
e
d a
n a
na
l
ys
i
s
us
i
ng
m
u
l
t
i
v
a
r
i
a
t
e
l
ogi
s
t
i
c
r
e
gr
e
s
s
i
on. B
e
ye
ne
e
t
al
.
[
8]
w
e
r
e
c
onduc
t
e
d on
t
he
r
ol
e
of
m
e
n
i
n
e
nc
ou
r
a
gi
ng t
he
i
r
w
i
ve
s
t
o
unde
r
go
c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
ni
ng.
T
h
i
s
r
e
s
e
a
r
c
h t
ook
pl
a
c
e
i
n
E
t
hi
opi
a
,
w
he
r
e
w
om
e
n
i
n
l
ow
-
i
nc
o
m
e
c
oun
t
r
i
e
s
of
t
e
n
f
a
c
e
r
e
s
i
s
t
a
nc
e
f
r
om
t
he
i
r
hu
s
ba
nds
r
e
ga
r
di
ng
t
hi
s
s
c
r
e
e
ni
ng.
T
he
r
e
s
e
a
r
c
h
t
e
a
m
ga
t
he
r
e
d
s
t
a
t
i
s
t
i
c
s
on
m
e
n'
s
c
ont
r
i
but
i
ons
,
w
hi
c
h
w
e
r
e
t
he
n
a
na
l
yz
e
d
us
i
ng
l
i
ne
a
r
r
e
g
r
e
s
s
i
on.
T
he
s
t
udy'
s
r
e
s
ul
t
s
i
nf
or
m
e
d
t
he
d
e
ve
l
op
m
e
nt
of
a
s
t
r
a
t
e
gi
c
pl
a
n
t
o
i
nvol
ve
hus
ba
nds
i
n
s
uppor
t
i
ng
t
he
i
r
pa
r
t
ne
r
s
t
o pa
r
t
i
c
i
pa
t
e
i
n c
e
r
v
i
c
a
l
c
a
n
c
e
r
s
c
r
e
e
ni
ng. B
a
i
e
t
al
.
[
9]
c
onduc
t
e
d r
e
s
e
a
r
c
h ut
i
l
i
z
i
ng
16S
r
i
bos
om
a
l
(
r
R
N
A
)
s
e
que
nc
i
ng
t
e
c
hnol
ogy
a
nd
m
e
t
a
ge
nom
i
c
s
t
o
a
na
l
yz
e
va
g
i
na
l
m
i
c
r
oo
r
ga
ni
s
m
s
a
nd
s
c
r
e
e
n f
o
r
c
e
r
v
i
c
a
l
c
a
nc
e
r
ba
s
e
d on t
he
i
r
ba
c
t
e
r
i
a
l
pr
e
s
e
nc
e
.
N
a
m
u
t
undu
e
t
a
l
.
[
10]
i
de
nt
i
f
y
va
r
i
o
us
ba
r
r
i
e
r
s
r
e
l
a
t
e
d
t
o
he
a
l
t
h
f
a
c
i
l
i
t
i
e
s
,
c
o
m
m
u
ni
t
y
i
nt
e
r
a
c
t
i
o
ns
,
i
nt
e
r
pe
r
s
on
a
l
r
e
l
a
t
i
on
s
hi
ps
,
a
nd
i
ndi
vi
d
ua
l
f
a
c
t
o
r
s
,
e
n
a
bl
i
ng
f
a
c
i
l
i
t
a
t
or
s
t
o c
o
m
pr
e
he
n
d
a
n
d
a
ppl
y m
os
t
e
f
f
e
c
t
i
ve
m
e
t
hod
s
f
o
r
i
m
p
r
ov
i
ng
a
c
c
e
s
s
t
o
c
e
r
v
i
c
a
l
c
a
nc
e
r
s
c
r
e
e
n
i
ng
f
o
r
t
h
e
pe
o
pl
e
of
U
ga
nda
.
K
a
r
e
n
a
a
nd
F
a
l
du
[
1
1]
c
onduc
t
e
d a
s
t
udy t
o e
va
l
ua
t
e
hos
pi
t
a
l
nur
s
e
s
'
know
l
e
dge
a
nd r
e
s
pons
e
s
t
o c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
n
i
ng i
n I
ndi
a
.
K
i
m
e
t
a
l
.
[
12
]
r
e
s
e
a
r
c
h
e
d
gl
yoxa
l
a
s
e
-
01
(
G
L
01)
e
xp
r
e
s
s
i
on
f
o
r
de
t
ox
i
f
y
i
ng
m
e
t
hyl
g
l
yoxa
l
t
o
a
s
s
e
s
s
t
he
r
ol
e
of
G
L
01
i
n
c
e
r
vi
c
a
l
c
a
nc
e
r
m
e
t
a
bol
i
s
m
.
A
s
t
udy
w
a
s
c
onduc
t
e
d
by
A
gé
nor
e
t
al
.
[
13]
t
o
e
xa
m
i
ne
t
he
de
a
t
h
r
a
t
e
f
r
o
m
c
e
r
vi
c
a
l
c
a
nc
e
r
a
nd
r
a
c
i
s
m
.
T
he
r
e
s
e
a
r
c
h
hi
gh
l
i
gh
t
e
d
t
he
di
s
p
a
r
i
t
i
e
s
i
n
he
a
l
t
h
s
e
r
vi
c
e
s
a
va
i
l
a
bl
e
t
o
m
i
nor
i
t
y
gr
oup
s
i
n
t
he
U
ni
t
e
d
S
t
a
t
e
s
.
D
a
t
a
a
na
l
y
s
i
s
w
a
s
pe
r
f
or
m
e
d
us
i
ng
a
t
h
e
m
a
t
i
c
a
na
l
ys
i
s
a
ppr
oa
c
h.
L
e
i
e
t
al
.
[
14]
r
e
s
e
a
r
c
he
d t
he
r
o
l
e
of
s
t
e
m
c
e
l
l
s
i
n de
ve
l
opi
ng c
e
r
v
i
c
a
l
c
a
nc
e
r
. T
he
s
t
udy e
xa
m
i
ne
d t
he
e
f
f
e
c
t
s
of
z
i
nc
oxi
d
e
on
c
e
r
v
i
c
a
l
c
a
nc
e
r
s
t
e
m
c
e
l
l
s
a
nd
i
t
s
r
e
l
a
t
i
ons
hi
p
w
i
t
h
f
e
r
r
opt
o
s
i
s
,
i
nt
e
nd
i
ng
t
o
de
t
e
r
m
i
ne
w
he
t
he
r
z
i
nc
ox
i
de
c
a
n
i
nh
i
bi
t
t
he
p
r
ol
i
f
e
r
a
t
i
on
o
f
c
e
r
v
i
c
a
l
c
a
n
c
e
r
c
e
l
l
s
.
L
a
r
t
e
y
e
t
al
.
[
15
]
r
e
s
e
a
r
c
he
d
H
P
V
t
e
s
t
i
ng
a
m
ong
G
ha
na
i
a
n
w
om
e
n.
A
s
ur
ve
y
w
a
s
c
onduc
t
e
d
us
i
ng
pe
r
s
ona
l
t
e
l
e
phone
s
t
o
ga
t
he
r
i
nf
o
r
m
a
t
i
on
a
bout
c
e
r
v
i
c
a
l
c
a
nc
e
r
.
T
he
a
na
l
ys
i
s
w
a
s
pe
r
f
o
r
m
e
d
us
i
ng
t
he
F
i
s
c
he
r
t
e
s
t
.
M
a
nt
u
l
a
a
nd
T
oe
f
y
[
16]
e
xa
m
i
ne
d
m
a
l
e
i
nvo
l
ve
m
e
nt
i
n
c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
ni
ng
pr
og
r
a
m
s
f
r
om
t
he
pe
r
s
pe
c
t
i
ve
of
w
om
e
n
i
n
Z
i
m
ba
bw
e
.
T
hi
s
qua
l
i
t
a
t
i
v
e
s
t
udy
i
n
c
l
ude
d
i
nput
f
r
o
m
bo
t
h
w
om
e
n
a
nd
he
a
l
t
h
s
e
r
v
i
c
e
p
r
ovi
de
r
s
i
n
t
he
r
e
g
i
on.
D
a
t
a
a
na
l
y
s
i
s
ut
i
l
i
z
e
d a
t
he
m
a
t
i
c
a
pp
r
oa
c
h s
uppo
r
t
e
d by A
T
L
A
S
s
of
t
w
a
r
e
.
O
ur
r
e
s
e
a
r
c
h
ha
s
e
xt
e
n
s
i
ve
l
y
di
s
c
u
s
s
e
d
t
he
u
s
e
of
a
r
t
i
f
i
c
i
a
l
i
nt
e
l
l
i
ge
nc
e
-
b
a
s
e
d
i
m
a
ge
s
t
o
e
nha
nc
e
di
a
gnos
e
s
,
i
nc
l
ud
i
ng
t
he
i
de
nt
i
f
i
c
a
t
i
on
of
l
e
ukoc
yt
e
s
,
A
l
z
he
i
m
e
r
'
s
di
s
e
a
s
e
,
a
nd
o
t
he
r
c
ond
i
t
i
ons
[
17
]
–
[
20]
.
R
e
c
e
nt
s
t
ud
i
e
s
ha
ve
u
t
i
l
i
z
e
d
a
dva
nc
e
d
c
onvol
u
t
i
ona
l
ne
ur
a
l
ne
t
w
or
k
(
C
N
N
)
a
r
c
hi
t
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or
m
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de
vi
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.
W
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a
r
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ur
r
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t
l
y r
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r
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p
a
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[
19]
.
T
hi
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pa
pe
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w
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f
oc
us
on
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Evaluation Warning : The document was created with Spire.PDF for Python.
I
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I
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J
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V
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338
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349
340
2.
M
E
T
H
O
D
2.1. I
n
i
t
i
a
l
d
at
a p
r
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s
s
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n
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T
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s
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w
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c
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s
t
s
o
f
f
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s
t
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ps
:
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t
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t
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m
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t
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t
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a
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t
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t
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pr
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hods
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m
p
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t
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l
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xt
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m
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l
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2.1.1. D
at
a c
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da
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s
[
21]
.
T
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da
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ous
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m
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or
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r
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a
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i
gur
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1 s
how
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n e
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m
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t
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e
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h.
F
i
gu
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1(
a
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pr
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nt
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m
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ge
o
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e
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n
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l
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ond
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i
gur
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1(
b)
d
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x a
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e
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d by c
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nc
e
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.
(
a
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F
i
gur
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1. E
xa
m
p
l
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m
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ge
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t
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us
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(
a
)
nor
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a
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on a
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(
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m
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l
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ondi
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t
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l
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l
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gh
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on
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t
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C
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ge
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nk
[
22]
,
w
hi
c
h
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nc
l
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d
200
c
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s
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s
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nd
913
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[
23]
.
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R
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pa
r
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m
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w
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ype
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m
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w
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c
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a
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a
c
h
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ve
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e
a
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h
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m
u
m
of
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e
r
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pe
r
f
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d.
T
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om
b
i
na
t
i
on
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r
a
m
e
t
e
r
s
t
ha
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l
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t
a
c
c
u
r
a
c
y
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i
l
l
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t
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he
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.
I
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F
i
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6,
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t
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of
pa
r
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how
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c
ur
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c
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f
t
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r
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t
r
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r
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t
i
ons
.
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f
i
na
l
r
e
s
u
l
t
s
of
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m
ode
l
a
nd
hype
r
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r
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t
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r
s
a
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n
F
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r
e
6.
S
ubs
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qu
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nt
l
y,
t
he
m
ode
l
w
a
s
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e
-
t
r
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he
s
e
a
d
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us
t
e
d
pa
r
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m
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t
e
r
s
,
a
c
hi
e
vi
ng a
n
a
c
c
ur
a
c
y o
f
100%
w
i
t
h
a
va
l
i
da
t
i
on a
c
c
ur
a
c
y of
89%
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
S
N
:
2252
-
8938
I
nt
J
A
r
t
i
f
I
nt
e
l
l
,
V
ol
. 15, N
o. 1, F
e
br
ua
r
y 2026
:
338
-
349
344
F
i
gur
e
6. R
e
s
ul
t
s
of
m
ode
l
f
i
t
t
i
ng a
nd hyp
e
r
pa
r
a
m
e
t
e
r
t
un
i
ng
T
he
m
ode
l
w
i
l
l
be
e
va
l
ua
t
e
d
t
o
de
t
e
r
m
i
ne
i
t
s
e
f
f
e
c
t
i
ve
n
e
s
s
i
n
c
l
a
s
s
i
f
yi
ng
da
t
a
.
T
hi
s
e
va
l
ua
t
i
on
i
s
pe
r
f
or
m
e
d
by
c
a
l
c
ul
a
t
i
ng
t
he
a
c
c
ur
a
c
y
va
l
ue
a
nd
ge
ne
r
a
t
i
ng
a
c
l
a
s
s
i
f
i
c
a
t
i
on
r
e
po
r
t
,
w
hi
c
h
i
nc
l
ude
s
pr
e
c
i
s
i
on,
r
e
c
a
l
l
,
a
nd
F
1
-
s
c
or
e
s
de
r
i
ve
d
f
r
om
t
he
c
on
f
us
i
on
m
a
t
r
i
x.
A
c
onf
us
i
on
m
a
t
r
i
x
i
s
a
t
a
bl
e
us
e
d
t
o
a
s
s
e
s
s
t
he
pe
r
f
or
m
a
nc
e
o
f
m
a
c
hi
ne
l
e
a
r
ni
ng
a
nd
de
e
p
l
e
a
r
ni
ng
m
ode
l
s
.
I
t
c
ons
i
s
t
s
of
f
our
c
om
pone
n
t
s
:
i
)
t
r
ue
pos
i
t
i
ve
(
T
P
)
:
t
hi
s
i
nd
i
c
a
t
e
s
t
ha
t
t
he
m
ode
l
'
s
pr
e
d
i
c
t
i
on
a
nd
a
c
t
u
a
l
va
l
ue
a
r
e
a
l
s
o
c
or
r
e
c
t
;
i
i
)
t
r
ue
n
e
ga
t
i
ve
(
T
N
)
:
t
hi
s
i
ndi
c
a
t
e
s
t
ha
t
t
he
m
ode
l
'
s
pr
e
di
c
t
i
on i
s
c
o
r
r
e
c
t
w
hi
l
e
t
he
a
c
t
ua
l
va
l
ue
i
s
i
n
c
or
r
e
c
t
;
i
i
i
)
f
a
l
s
e
pos
i
t
i
ve
(
F
P
)
:
t
hi
s
i
ndi
c
a
t
e
s
t
ha
t
t
he
m
od
e
l
'
s
pr
e
di
c
t
i
on i
s
i
nc
o
r
r
e
c
t
,
but
t
he
a
c
t
ua
l
va
l
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i
s
c
o
r
r
e
c
t
;
a
nd
i
v
)
f
a
l
s
e
ne
ga
t
i
ve
(
F
N
)
:
t
hi
s
i
ndi
c
a
t
e
s
t
ha
t
t
he
m
ode
l
'
s
p
r
e
di
c
t
i
on
a
nd
a
c
t
ua
l
va
l
ue
a
r
e
a
l
s
o
i
n
c
or
r
e
c
t
.
T
h
i
s
f
r
a
m
e
w
or
k
a
l
l
ow
s
f
o
r
a
c
om
pr
e
he
ns
i
ve
a
s
s
e
s
s
m
e
n
t
of
t
h
e
m
ode
l
'
s
pe
r
f
or
m
a
nc
e
.
F
i
gur
e
7
s
how
s
t
w
o
l
e
a
di
ng
l
a
be
l
s
:
"
t
r
ue
,"
w
hi
c
h
i
ndi
c
a
t
e
s
t
he
a
c
t
ua
l
va
l
ue
s
,
a
nd
"
pr
e
di
c
t
e
d
,"
w
hi
c
h
r
e
pr
e
s
e
nt
s
t
he
r
e
s
u
l
t
s
ge
ne
r
a
t
e
d
by
t
h
e
m
ode
l
.
T
he
l
a
b
e
l
s
"
a
bnor
m
a
l
"
a
nd "
nor
m
a
l
"
a
l
s
o c
l
a
s
s
i
f
y t
he
i
m
a
ge
da
t
a
. T
he
c
onf
us
i
on m
a
t
r
i
x r
e
s
ul
t
s
s
how
T
P
va
l
ue
of
29, T
N
va
l
ue
of
30,
F
P
va
l
ue
of
5,
a
nd
F
N
va
l
ue
of
4.
W
e
u
s
e
t
he
a
c
c
u
r
a
c
y
f
o
r
m
ul
a
s
how
n
i
n
(
1
)
t
o
e
v
a
l
ua
t
e
t
he
a
c
c
ur
a
c
y
o
f
t
he
m
ode
l
'
s
pr
e
d
i
c
t
i
ons
.
B
y
s
ub
s
t
i
t
ut
i
ng t
he
l
a
be
l
v
a
l
ue
s
i
n
t
o
(
1
)
,
w
e
obt
a
i
n
a
n
a
c
c
ur
a
c
y
r
e
s
ul
t
of
86%
. T
he
m
ode
l
ha
s
c
l
a
s
s
i
f
i
e
d
t
he
t
e
s
t
da
t
a
i
m
a
ge
s
a
c
c
u
r
a
t
e
l
y.
=
+
+
+
+
×
100%
(
1)
F
i
gur
e
7. C
onf
us
i
on
m
a
t
r
i
x
N
e
xt
,
w
e
c
a
l
c
ul
a
t
e
t
he
pr
e
c
i
s
i
on
va
l
ue
t
o
de
t
e
r
m
i
ne
how
m
a
ny
opt
i
m
i
s
t
i
c
pr
e
di
c
t
i
on
s
a
r
e
a
c
c
u
r
a
t
e
f
r
om
a
l
l
pos
i
t
i
ve
p
r
e
di
c
t
i
ons
us
i
ng
(
2)
.
B
y
s
ubs
t
i
t
ut
i
ng
t
he
l
a
be
l
va
l
ue
s
i
n
(
2)
,
a
pr
e
c
i
s
i
on
va
l
ue
o
f
85%
i
s
de
r
i
ve
d.
T
he
pr
e
c
i
s
i
on
va
l
ue
r
e
s
u
l
t
s
i
ndi
c
a
t
e
t
ha
t
t
he
m
ode
l
c
a
n
e
f
f
e
c
t
i
ve
l
y
pr
e
di
c
t
pos
i
t
i
ve
i
m
a
ge
s
us
i
ng
a
c
t
ua
l
v
a
l
ue
s
.
N
e
x
t
,
w
e
c
a
l
c
u
l
a
t
e
t
he
r
e
c
a
l
l
va
l
ue
t
o
de
t
e
r
m
i
ne
how
m
a
ny
pos
i
t
i
v
e
i
ns
t
a
nc
e
s
a
r
e
c
o
r
r
e
c
t
l
y
pr
e
di
c
t
e
d f
r
o
m
a
l
l
t
he
a
c
t
ua
l
pos
i
t
i
ve
i
ns
t
a
n
c
e
s
, ut
i
l
i
z
i
ng
(
3)
.
=
+
×
100%
(
2)
=
+
×
100%
(
3)
Evaluation Warning : The document was created with Spire.PDF for Python.
I
nt
J
A
r
t
i
f
I
nt
e
l
l
I
S
S
N
:
2252
-
8938
D
e
e
p l
e
ar
ni
ng
-
ba
s
e
d c
e
r
v
i
c
al
c
an
c
e
r
de
t
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c
t
i
on v
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a c
o
l
pos
c
opy
i
m
age
s
i
nt
e
gr
at
e
d
i
nt
o
…
(
R
e
t
no Supr
i
y
ant
i
)
345
B
y e
nt
e
r
i
ng t
he
l
a
b
e
l
va
l
ue
i
n (
3)
, w
e
ge
t
a
r
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c
a
l
l
va
l
ue
of
87%
. T
he
r
e
c
a
l
l
va
l
u
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r
e
s
ul
t
s
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nd
i
c
a
t
e
t
ha
t
t
he
m
ode
l
c
a
n
pr
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di
c
t
pos
i
t
i
ve
i
m
a
ge
s
w
e
l
l
f
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om
e
a
c
h
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t
i
ve
i
m
a
ge
.
W
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a
l
s
o
m
e
a
s
u
r
e
t
he
va
l
u
e
of
t
he
F1
-
s
c
or
e
, w
hi
c
h i
s
a
c
om
bi
n
e
d m
e
a
s
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r
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of
pr
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c
i
s
i
on a
nd r
e
c
a
l
l
,
t
o de
s
c
r
i
be
t
he
ba
l
a
nc
e
be
t
w
e
e
n t
he
t
w
o us
i
ng
(
4)
. B
y i
nput
t
i
ng
t
he
l
a
be
l
va
l
ue
s
i
n
t
o
(
4
)
, w
e
obt
a
i
n a
n F
1
-
s
c
o
r
e
of
85%
. T
hi
s
r
e
s
u
l
t
i
nd
i
c
a
t
e
s
t
ha
t
t
he
r
e
i
s
no
i
m
ba
l
a
nc
e
i
s
s
ue
i
n
t
he
m
ode
l
.
T
hus
,
ba
s
e
d
on t
he
a
c
c
u
r
a
c
y
a
nd
c
l
a
s
s
i
f
i
c
a
t
i
on
r
e
po
r
t
va
l
ue
s
,
w
e
c
a
n c
onc
l
ude
t
ha
t
t
he
C
N
N
us
i
ng
t
he
R
e
s
N
e
t
-
50
a
r
c
h
i
t
e
c
t
ur
e
pe
r
f
or
m
s
w
e
l
l
,
a
c
h
i
e
vi
ng
a
n a
c
c
ur
a
c
y
o
f
86%
.
T
he
r
e
f
or
e
,
t
he
m
ode
l
i
s
r
e
a
dy
f
or
i
m
pl
e
m
e
nt
a
t
i
on
i
n t
he
A
ndr
o
i
d m
ob
i
l
e
a
pp
l
i
c
a
t
i
on.
1
−
=
2
×
×
+
×
100%
(
4)
F
a
i
l
ur
e
a
na
l
ys
i
s
i
s
e
s
s
e
nt
i
a
l
i
n
di
a
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t
i
c
a
ppl
i
c
a
t
i
ons
.
O
ut
o
f
t
he
n
i
ne
i
de
nt
i
f
i
e
d
e
r
r
or
s
,
s
i
x
w
e
r
e
FN
(
a
bnor
m
a
l
i
m
a
ge
s
i
nc
or
r
e
c
t
l
y
c
l
a
s
s
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f
i
e
d
a
s
us
ua
l
)
a
nd
t
h
r
e
e
w
e
r
e
FP
(
no
r
m
a
l
i
m
a
ge
s
i
n
c
or
r
e
c
t
l
y
c
l
a
s
s
i
f
i
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d
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s
a
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m
a
l
)
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E
xa
m
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t
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of
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he
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c
a
s
e
s
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ve
a
l
e
d t
ha
t
t
he
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e
e
r
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oc
c
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r
r
e
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n
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m
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s
w
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r
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m
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l
l
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l
y
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r
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he
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s
e
s
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nt
l
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s
pl
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l
a
r
t
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f
a
c
t
s
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s
uc
h
a
s
une
ve
n
l
i
ght
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ng
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s
ha
dow
a
r
e
a
s
,
w
hi
c
h
t
he
m
ode
l
m
i
s
i
n
t
e
r
p
r
e
t
e
d
a
s
s
i
gns
o
f
a
bnor
m
a
l
i
t
i
e
s
.
T
hi
s
a
na
l
y
s
i
s
h
i
ghl
i
ght
s
t
he
ne
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A
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T
r
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35
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T
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2
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36
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3
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37
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l
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m
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l
T
r
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4
A
A
C
Z
A
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l
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F
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l
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e
38
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l
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m
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l
T
r
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5
A
A
D
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A
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m
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l
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l
T
r
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39
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l
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l
T
r
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6
A
A
D
I
A
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a
l
A
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m
a
l
T
r
ue
40
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or
m
a
l
N
or
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a
l
T
r
ue
7
A
A
D
K
A
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a
l
N
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F
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l
s
e
41
A
E
A
N
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a
l
N
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m
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l
T
r
ue
8
A
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A
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a
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F
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l
s
e
42
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E
I
N
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a
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l
T
r
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9
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a
l
A
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m
a
l
T
r
ue
43
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E
G
N
or
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a
l
N
or
m
a
l
T
r
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10
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m
a
l
A
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m
a
l
T
r
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44
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V
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a
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N
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m
a
l
T
r
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11
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a
l
T
r
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45
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E
W
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a
l
N
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m
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l
T
r
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12
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A
D
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m
a
l
A
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m
a
l
T
r
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46
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or
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l
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m
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l
T
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13
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U
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l
A
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m
a
l
T
r
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47
A
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E
N
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l
N
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m
a
l
T
r
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14
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l
A
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m
a
l
T
r
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48
A
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I
N
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l
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or
m
a
l
T
r
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15
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m
a
l
T
r
ue
49
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H
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l
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l
T
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16
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l
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l
T
r
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50
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K
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or
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l
T
r
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17
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Y
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l
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r
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51
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l
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r
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18
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E
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m
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T
r
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52
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l
T
r
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19
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m
a
l
T
r
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53
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L
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m
a
l
T
r
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20
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H
N
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a
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m
a
l
T
r
ue
54
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a
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a
l
T
r
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21
A
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l
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m
a
l
T
r
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55
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N
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m
a
l
T
r
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22
A
A
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S
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a
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m
a
l
T
r
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56
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or
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a
l
N
or
m
a
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T
r
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23
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m
a
l
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m
a
l
T
r
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57
AHR
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a
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N
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m
a
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T
r
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24
AAHS
A
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m
a
l
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m
a
l
T
r
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58
AHT
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a
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N
or
m
a
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r
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25
A
A
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m
a
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m
a
l
T
r
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59
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m
a
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T
r
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26
A
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m
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s
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60
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B
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m
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r
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27
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m
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l
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r
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61
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r
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28
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m
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r
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62
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l
s
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29
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m
a
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A
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m
a
l
T
r
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63
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a
l
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m
a
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r
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30
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A
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m
a
l
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m
a
l
T
r
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64
A
I
H
N
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m
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m
a
l
T
r
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31
A
A
J
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m
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m
a
l
T
r
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65
A
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m
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l
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r
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32
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m
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r
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66
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m
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r
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33
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m
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r
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67
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r
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34
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[
1]
A
.
M
a
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hi
s
,
U
. D
.
S
m
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t
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V
. C
r
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r
,
T
.
L
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e
,
a
n
d
S
.
S
u
t
he
r
,
“
A
n
e
pi
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m
i
ol
ogi
c
a
l
s
t
ud
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o
f
c
e
r
vi
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a
nc
e
r
t
r
e
nd
s
a
m
ong
w
om
e
n
w
i
t
h hum
a
n i
m
m
unod
e
f
i
c
i
e
nc
y vi
r
us
,”
H
e
al
t
hc
ar
e
, vol
. 12, no. 12, 2024, d
oi
:
10.3390
/
he
a
l
t
hc
a
r
e
12121178.
[
2]
V
.
C
ha
n
d
r
a
n
e
t
al
.
,
“
D
i
a
gno
s
i
s
of
c
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r
v
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a
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c
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nc
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r
ba
s
e
d
on
e
ns
e
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b
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e
d
e
e
p
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a
r
n
i
ng
ne
t
w
or
k
us
i
ng
c
o
l
pos
c
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i
m
a
ge
s
,”
B
i
oM
e
d
R
e
s
e
ar
c
h I
nt
e
r
nat
i
onal
, vol
. 2021, no. 1, 2021, d
oi
:
10.1155
/
2021/
5584004.
[
3]
Y
.
A
.
Z
i
ya
d
e
t
al
.
,
“
D
e
t
e
r
m
i
na
nt
s
of
c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
n
i
ng
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m
ong
f
e
m
a
l
e
he
a
l
t
h
pr
of
e
s
s
i
on
a
l
s
i
n
H
a
r
a
r
T
ow
n,
E
a
s
t
e
r
n
E
t
hi
opi
a
:
a
c
r
os
s
-
s
e
c
t
i
ona
l
s
t
ud
y,”
I
nf
e
c
t
i
ous
D
i
s
e
as
e
s
i
n
O
bs
t
e
t
r
i
c
s
and
G
y
ne
c
o
l
ogy
,
vol
.
2024,
no.
1,
2024,
d
oi
:
10.1155/
2024/
1430978.
[
4]
R
.
K
a
ba
n
d
a
,
A
.
K
i
c
onc
o,
A
.
R
ona
l
d
,
K
.
M
.
M
.
B
e
ye
r
,
a
nd
S
.
A
.
J
ohn,
“
C
or
r
e
c
t
i
on:
c
or
r
e
l
a
t
e
s
of
i
nt
e
nt
i
on
t
o
s
c
r
e
e
n
f
or
c
e
r
v
i
c
a
l
c
a
nc
e
r
a
m
ong
a
d
ul
t
w
om
e
n
i
n
K
yot
e
r
a
D
i
s
t
r
i
c
t
,
C
e
nt
r
a
l
U
ga
nd
a
:
a
c
om
m
uni
t
y
ba
s
e
d
c
r
os
s
-
s
e
c
t
i
ona
l
s
t
ud
y,”
B
M
C
W
om
e
n’
s
H
e
al
t
h
, vol
. 24, no. 1, 2024, d
oi
:
10.1186/
s
12905
-
024
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03155
-
3.
[
5]
Y
.
N
a
r
t
e
y
e
t
al
.
,
“
H
um
a
n
pa
p
i
l
l
om
a
v
i
r
us
g
e
not
ype
d
i
s
t
r
i
but
i
on
a
m
ong
w
om
e
n
w
i
t
h
a
nd
w
i
t
hout
c
e
r
vi
c
a
l
c
a
nc
e
r
:
i
m
p
l
i
c
a
t
i
on
f
or
va
c
c
i
na
t
i
on a
nd
s
c
r
e
e
ni
ng
i
n G
ha
na
,”
P
L
O
S O
N
E
, vol
. 18, no. 1, 2023,
d
oi
:
10.1371/
j
our
na
l
.pone
.0280437.
[
6]
T
.
G
.
G
e
br
e
m
e
s
ke
l
a
nd
M
.
Z
.
G
e
br
e
t
a
t
i
os
,
“
D
e
t
e
r
m
i
na
nt
s
of
c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
ni
ng
ut
i
l
i
z
a
t
i
on
a
m
ong
H
I
V
-
pos
i
t
i
ve
w
om
e
n,
i
n
publ
i
c
ge
ne
r
a
l
hos
p
i
t
a
l
s
of
C
e
nt
r
a
l
Z
one
,
T
i
gr
a
y,
E
t
hi
opi
a
,
2020:
c
a
s
e
-
c
ont
r
ol
s
t
ud
y,”
P
L
O
S
O
N
E
,
vol
.
18,
no.
12,
2023,
d
oi
:
10.1371/
j
our
na
l
.pone
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[
7]
F
.
H
.
A
l
kha
m
i
s
,
Z
.
A
.
S
.
A
l
a
bba
s
,
J
.
E
.
A
l
M
ul
h
i
m
,
F
.
F
.
A
l
a
bd
ul
m
ohs
i
n,
M
.
H
.
A
l
s
ha
qa
q
i
q,
a
nd
E
.
A
.
A
l
a
l
i
,
“
P
r
e
va
l
e
n
c
e
a
nd
pr
e
d
i
c
t
i
ve
f
a
c
t
or
s
of
c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
ni
ng
i
n
S
a
ud
i
A
r
a
bi
a
:
a
na
t
i
onw
i
d
e
s
t
u
d
y,”
C
ur
e
us
,
vol
.
358,
no.
11,
2023,
d
oi
:
10.7759/
c
ur
e
us
.49331.
[
8]
D
.
A
.
B
e
ye
ne
,
S
.
G
. A
ye
l
e
,
H
.
D
.
W
ubne
h,
a
n
d
A
.
W
.
T
s
i
ge
,
“
M
a
l
e
s
uppor
t
f
or
c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
n
i
ng
i
n
D
e
br
e
B
e
r
ha
n
C
i
t
y
E
t
hi
opi
a
a
c
om
m
un
i
t
y ba
s
e
d
c
r
os
s
s
e
c
t
i
ona
l
s
ur
ve
y,”
Sc
i
e
nt
i
f
i
c
R
e
por
t
s
, vo
l
. 14, no. 1, 2024, d
oi
:
10.1038/
s
41598
-
024
-
69439
-
8.
[
9]
B
.
B
a
i
,
G
.
T
ue
r
xun,
A
.
T
ue
r
d
i
,
R
.
M
a
i
m
a
i
t
i
,
Y
.
S
un,
a
nd
A
.
A
bu
d
uke
r
i
m
u,
“
A
na
l
ys
i
s
of
va
gi
na
l
f
l
or
a
d
i
ve
r
s
i
t
y
a
nd
s
t
u
d
y
on t
he
r
ol
e
of
P
or
phy
r
om
ona
s
a
s
a
c
c
ha
r
ol
yt
i
c
a
i
n
pr
o
m
ot
i
ng I
L
-
1β
i
n
r
e
gu
l
a
t
i
ng c
e
r
vi
c
a
l
c
a
nc
e
r
,”
Sc
i
e
n
t
i
f
i
c
R
e
por
t
s
,
vol
.
14, no.
1, 2024,
d
oi
:
10.1038/
s
41598
-
024
-
73146
-
9.
[
10]
J
.
N
a
m
ut
und
u
e
t
al
.
,
“
B
a
r
r
i
e
r
s
a
nd
f
a
c
i
l
i
t
a
t
or
s
of
c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
n
i
ng
l
i
t
e
r
a
c
y
a
m
ong
r
ur
a
l
w
om
e
n
w
i
t
h
H
I
V
a
t
t
e
n
d
i
ng
r
ur
a
l
publ
i
c
he
a
l
t
h
f
a
c
i
l
i
t
i
e
s
i
n
E
a
s
t
C
e
nt
r
a
l
U
ga
nd
a
:
a
qua
l
i
t
a
t
i
ve
s
t
ud
y
us
i
ng
t
he
i
nt
e
gr
a
t
e
d
m
o
d
e
l
of
he
a
l
t
h
l
i
t
e
r
a
c
y,”
B
M
C
W
om
e
n’
s
H
e
al
t
h
, vol
. 24, no. 1, 2024, d
oi
:
10.1186/
s
12905
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024
-
03340
-
4.
[
11]
Z
.
V
. K
a
r
e
na
a
nd
P
. S
.
F
a
l
d
u,
“
A
c
r
os
s
-
s
e
c
t
i
ona
l
s
t
ud
y
on
know
l
e
d
ge
,
a
t
t
i
t
u
d
e
,
a
n
d
pr
a
c
t
i
c
e
s
r
e
l
a
t
e
d
t
o
c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
ni
ng
a
m
ong
t
he
nur
s
i
ng
s
t
a
f
f
i
n
a
T
e
r
t
i
a
r
y
C
a
r
e
H
os
pi
t
a
l
i
n
t
he
W
e
s
t
e
r
n
R
e
gi
on
of
I
nd
i
a
,”
C
ur
e
us
,
vol
.
16,
no.
1,
2024,
d
oi
:
10.7759/
c
ur
e
us
.51566.
[
12]
J.
-
Y
.
K
i
m
e
t
al
.
,
“
G
l
yoxa
l
a
s
e
1:
e
m
e
r
g
i
ng
bi
om
a
r
ke
r
a
nd
t
he
r
a
pe
ut
i
c
t
a
r
ge
t
i
n
c
e
r
vi
c
a
l
c
a
nc
e
r
pr
ogr
e
s
s
i
on,”
P
L
O
S
O
N
E
,
vol
.
19,
no. 6, 2024, d
oi
:
10.1371/
j
our
na
l
.pone
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[
13]
M
.
A
gé
nor
e
t
al
.
,
“
B
a
r
r
i
e
r
s
t
o
a
nd
oppor
t
uni
t
i
e
s
f
or
a
d
va
nc
i
ng
r
a
c
i
a
l
e
qui
t
y
i
n
c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
n
i
ng
i
n
t
he
U
ni
t
e
d
S
t
a
t
e
s
,”
B
M
C
W
om
e
n’
s
H
e
al
t
h
, vol
. 24, no. 1, 2024, d
oi
:
10.1186
/
s
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024
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7.
[
14]
J.
-
Y
.
L
e
i
,
S
.
-
X
.
L
i
,
F
.
L
i
,
H
.
L
i
,
a
nd
Y
.
-
S
.
L
e
i
,
“
Z
i
nc
oxi
d
e
na
nopa
r
t
i
c
l
e
r
e
gu
l
a
t
e
s
t
he
f
e
r
r
opt
os
i
s
,
p
r
ol
i
f
e
r
a
t
i
on,
i
nva
s
i
on
a
nd
s
t
e
a
m
i
ne
s
s
of
c
e
r
vi
c
a
l
c
a
nc
e
r
by
m
i
R
-
506
-
3p/
C
D
164
s
i
gna
l
i
ng,”
C
anc
e
r
N
anot
e
c
hnol
ogy
,
vol
.
13,
no.
1,
2022,
d
oi
:
10.1186/
s
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022
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x.
[
15]
A
.
A
.
A
.
-
L
a
r
t
e
y
e
t
al
.
,
“
E
f
f
e
c
t
i
ve
ne
s
s
of
a
c
ul
t
ur
a
l
l
y
t
a
i
l
or
e
d
t
e
xt
m
e
s
s
a
gi
ng
pr
ogr
a
m
f
or
pr
om
ot
i
ng
c
e
r
vi
c
a
l
c
a
nc
e
r
s
c
r
e
e
n
i
ng
i
n
A
c
c
r
a
, G
ha
na
:
a
qua
s
i
-
e
xpe
r
i
m
e
nt
a
l
t
r
i
a
l
,”
B
M
C
W
om
e
n’
s
H
e
al
t
h
, vol
. 24, no. 1, 2024, d
oi
:
10.1186
/
s
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023
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02867
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2.
[
16]
F
.
M
a
nt
ul
a
a
nd
Y
.
T
oe
f
y,
“
W
om
e
n
a
nd
he
a
l
t
h
pr
ovi
d
e
r
s
’
pe
r
s
pe
c
t
i
ve
s
on
m
a
l
e
s
uppor
t
f
or
c
e
r
vi
c
a
l
c
a
n
c
e
r
s
c
r
e
e
ni
ng
i
n
G
w
a
nd
a
d
i
s
t
r
i
c
t
, Z
i
m
ba
bw
e
,”
P
L
O
S O
N
E
, vol
. 18, no. 10, 2023, d
oi
:
10.1371/
j
our
na
l
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[
17]
M
. A
l
qa
a
f
e
t
al
.
, “
D
i
s
c
ove
r
i
ng na
t
ur
a
l
p
r
od
uc
t
s
a
s
pot
e
nt
i
a
l
i
nhi
b
i
t
or
s
of
S
A
R
S
-
C
oV
-
2 s
pi
ke
pr
ot
e
i
ns
,”
Sc
i
e
nt
i
f
i
c
R
e
por
t
s
,
vol
. 15,
no. 1, 2025, d
oi
:
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s
41598
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024
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83637
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4.
[
18]
M
. A
l
qa
a
f
e
t
al
.
,
“
N
e
ur
a
l
n
e
t
w
or
k
-
ba
s
e
d
a
na
l
ys
i
s
of
m
a
m
m
ogr
a
phy
i
m
a
ge
s
f
or
i
d
e
nt
i
f
yi
ng br
e
a
s
t
c
a
nc
e
r
hi
s
t
ol
og
i
c
a
l
s
ubt
ype
s
,”
i
n
2024
I
E
E
E
I
nt
e
r
nat
i
onal
C
onf
e
r
e
nc
e
on
F
u
t
ur
e
M
ac
h
i
ne
L
e
ar
n
i
ng
and
D
at
a
Sc
i
e
nc
e
(
F
M
L
D
S)
,
S
yd
ne
y,
A
us
t
r
a
l
i
a
:
I
E
E
E
,
2024,
pp. 474
–
480
,
d
oi
:
10.1109/
F
M
L
D
S
63805.2024.00088.
[
19]
R
.
S
upr
i
ya
nt
i
,
A
.
S
.
A
r
ya
nt
o,
M
.
I
. A
kba
r
,
E
.
S
u
t
r
i
s
na
,
a
nd
M
.
A
l
qa
a
f
,
“
T
he
e
f
f
e
c
t
o
f
f
e
a
t
ur
e
s
c
om
bi
na
t
i
on
on
c
ol
os
c
opy
i
m
a
ge
s
of
c
e
r
vi
c
a
l
c
a
nc
e
r
us
i
ng
t
he
s
uppor
t
ve
c
t
or
m
a
c
hi
ne
m
e
t
ho
d
,”
I
A
E
S
I
nt
e
r
nat
i
ona
l
J
our
nal
of
A
r
t
i
f
i
c
i
a
l
I
nt
e
l
l
i
ge
nc
e
,
vol
.
13,
no.
3,
pp. 2614
–
2622, 2024, d
oi
:
10.11591/
i
j
a
i
.v13.i
3.pp2614
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2622.
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