%PDF-1.4 % 320 0 obj <> endobj 308 0 obj <> endobj 307 0 obj <>stream Acrobat Distiller 8.1.0 (Windows) Arbortext Advanced Print Publisher 10.0.1465/W Unicode 2024-11-21T17:25:28-08:00 2016-04-13T22:15:55+05:30 2024-11-21T17:25:28-08:00 application/pdf doi:; untitled uuid:33f1514b-96b6-4007-9d5a-9ba3b15c71c5 uuid:e6e980f8-1dd1-11b2-0a00-b800c8b5b7ff http://dx.doi.org/ 2016-04-13 false http://bmjopen.bmj.com 2016-04-13 true http://bmjopen.bmj.com endstream endobj 321 0 obj <> endobj 198 0 obj <> endobj 304 0 obj <> endobj 306 0 obj <> endobj 322 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/Properties<>/Shading<>/XObject<>>>/Rotate 0/Thumb 219 0 R/Type/Page>> endobj 1 0 obj <>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/Thumb 220 0 R/Type/Page>> endobj 56 0 obj <>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/Thumb 221 0 R/Type/Page>> endobj 70 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageB]/Properties<>/XObject<>>>/Rotate 0/Thumb 222 0 R/Type/Page>> endobj 79 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC]/Properties<>/XObject<>>>/Rotate 0/Thumb 223 0 R/Type/Page>> endobj 87 0 obj <>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/Thumb 224 0 R/Type/Page>> endobj 96 0 obj <>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/Thumb 225 0 R/Type/Page>> endobj 123 0 obj <>/Font<>/ProcSet[/PDF/Text]/Properties<>>>/Rotate 0/Thumb 226 0 R/Type/Page>> endobj 615 0 obj <>stream HWr8}WQܒhl9&eRD6%);o7nXw<ZFsN_x#o./Ѷ~s"z#2Zݽan$\~Xh}L<יD.߉l3=}7n4Z.\:/zA<_C"?=5~{QFTh6"[m qg1Z} 9NRw 0.Sh܈W!ΚzSɟ >ͧdp4%.Dㇼ@Tbc79pͮ: 4 0RJU;m:egQMTU`'W?~{ XsŎFKE*rVq64]ա>ժc""Hύ$k` =I&/ 3ݕN*z>(f֟y%4Bb67~$I|Ixƨ?!BoA0`pP`j;##)s^ ©rh>< -r_pqr䬳Qx-LuHm?q>nAL<3 &X\ _L ojf^`_;NG_.[-;@(Ŀ^Aʵ1S(- FtFdѳΡܿ4T37SQnЉ3^̏``8E+(qRMY@ 神 ץbc Ֆ ?.N|1 zĎ4Uω}zNMGEHK@Zl`LvA4K`m" g4Q=?G G6bdF}2 Q(y/<2Il]oP r87673uDGC96+A䒦|[I9}X?dHslq N\WSe!>~6ő) ٠0k^oXydW˪vZYkJr" C{\q3]˟V|`>dT)')=/ ;MV )3d}ٕ ,^GR ԃq>5|%Q[bap઴S3oӦ1 ('Q% /`PQkZkPTe*'%f8Y%CR8Cῐ(|OlO-*鶆wWf9KSVrtB $;|iʱ@ 4Z[?qS'n-&]$qO؀Dژ(qJ?"Q&'bE}(E.6|նԶE%*H[hAirM]YXA5q~Se|PEK}Lb GAz8~H@"Ѝ&|LWe+0 vac"5wǏóP~jSI%!o*XIPB3d6 Fn~UkԳ(nxȝ)Ml" Cd֊̲B>JH^"g5wl47sg1naQDݮT ݸnt:F?v$`rMCc`D?s 7uurmUF[_Ч7G ݥd"yIt'P]wRqGze ;j Ñ?P/}^?ln_tLL9s kƂ:S\#rda\{]ֽLqHY"@ZGi16-F Yi1/q$^96IQ@&CC}mX=&tNKSJPFZL쏁_V)*ΑĽʦ̱6 VFU=7 $ɲlv~LjǴEم%`!4YTtf iV[ZHWIGz?gP Vu# oHqYrUPp OG oz홁 P阡BsG sb1,+Ȣ)ZM[_h}_%:)kTl@"IRV{rme(R(G:kMIeWdQtu3_LЬ̄@2q0ֽ {-SSIM.ENS! w}6ZQ *PZ:Bҹj[(~ _0J&?0~;Q_jk@;/GҖ^< ~o'b52^ D0WUwS1x QA+jWLx}L1'A3ߚfe~/1\_zUlZbXKطg[[N8$KܰsQڶ:OGqME<]00bǠ$^>'!F;`0wsS6b}[xu!OkY54*imXUvFm{d. C@(AzlG+QʃQ<|#hAZYhEJ0!&9rSkEPqmnFp q$v' ? &;J}~hfU[hZ Itr;7 SBW9D=v>dW_C 'd#ؐ0]I^ѳSN|<:g);o~[<ϹcI,^$$8 y_UHlx4藔SC 5S[B++[ \+N1 'PNCv<<AKJm{5m$'+E*M=)(el*/ 8.ej,_=-|uc`(u73%ȲS=v9u=(@,sI8TCsKT=Az( *C'(cAC֨g6hxߦ3aX7 4{㴐:;E=>0[5_#<bvhuKH}ScZw[v.䚄hu=Kjnde.^G `Nڟ?,*@cϘ~. +=C๡/ۿ0ėeVGK|Yw殅:v}$~这D[źD5DQZA+Q&m0}On|#š߯ԅ ޺u"VhNm($w)Ѐ ¢6Q,g|p":iQ4)pb*immV*uiq!8"sJx{*-NNfU.H)Ut?2f8ʮ*mֺpv6[Lbʓ!O ~΀,N.K⡅<q p7xxd'gg};N uuտԩc ą8_;픝pW$hP"dVSv=jqe I[ kjPÒr]n԰`@-+,-l-E0jT7SaAܘA ;yBO4S C#2X m'Gs5qјdp^Bߨ ~KbCW.u7k\7rZjyo2E wz9Ec#Q_^k!LA@™]UI̔՞ LjEDR ;>ӑ&Kws![Ax!kt]Hp_Jl2 B҂T=!Zl^0   LDȭQ6%D#YQM~+0m`iH{}ډOtpDp;E:kM.K͡s$ʁ쁸/P)k bþ;891fK 5cɞAx'4?YWKŀ~ʇ3?X?,ʵ/gYs 3 YrEԕ:]vf6fD/_ w[HgcVJ3rp@8NG#reU3%][EQ)n gC5l{+JMr԰4D_$p֮i#]R: lO;Vt 8V/e0Q*BQ"oy89$"Ɏ_AF6PZ\BuUА]'tݥyoNo؄6J%P7/]6ǰQG=좴Pj}3mu')yR%6Z,Ԏvgn{9l%Llz[9x,g]SSPtPp@bb؁ۧ#_l6c_pǬ>[^kc"ˣTLB]Em^x2Z6V `+*"o3B $SOI o!pU7GGϴ@l 3>{j=kfV|`Kḧ.o3 FGm%q?Fخށ m%>Z1^-<d)$X6ߌpxldndOd[ɻ395zc,G?0}*S-r"#l2R>!RQ~ϻe(NF6)HglAQ_Myq?D'٩hJEVJq1 } p |,`J8Kbb<I{H*{Tw'[af骨R!Aˇ)Dx?I=q{vF5T v+ 4v$`5rQɧF0sFt RR)Ll2LEu/r?['0׊i| %Mgkn~9Htl[EQ+!w~TXzQR`eHPEkʾVM;\y-3 ϙ\ߒoȦ9m,&/sz ˌZ)D[wy^(/Nx+? ָVڄ