EP3991163A1 - Cpr training manikin - Google Patents
Cpr training manikinInfo
- Publication number
- EP3991163A1 EP3991163A1 EP20742644.6A EP20742644A EP3991163A1 EP 3991163 A1 EP3991163 A1 EP 3991163A1 EP 20742644 A EP20742644 A EP 20742644A EP 3991163 A1 EP3991163 A1 EP 3991163A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- manikin
- foam body
- head
- torso
- exercise
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
- 238000012549 training Methods 0.000 title claims abstract description 29
- 239000006260 foam Substances 0.000 claims abstract description 80
- 238000002680 cardiopulmonary resuscitation Methods 0.000 claims abstract description 28
- 210000001562 sternum Anatomy 0.000 claims abstract description 21
- 230000006835 compression Effects 0.000 claims abstract description 13
- 238000007906 compression Methods 0.000 claims abstract description 13
- 230000007274 generation of a signal involved in cell-cell signaling Effects 0.000 claims description 15
- 210000000038 chest Anatomy 0.000 claims description 12
- 238000004088 simulation Methods 0.000 claims description 6
- 150000001875 compounds Chemical class 0.000 claims description 5
- 230000003287 optical effect Effects 0.000 claims description 4
- 229920001169 thermoplastic Polymers 0.000 claims description 3
- 239000004416 thermosoftening plastic Substances 0.000 claims description 3
- JOYRKODLDBILNP-UHFFFAOYSA-N Ethyl urethane Chemical compound CCOC(N)=O JOYRKODLDBILNP-UHFFFAOYSA-N 0.000 claims description 2
- 239000004743 Polypropylene Substances 0.000 claims description 2
- 239000004793 Polystyrene Substances 0.000 claims description 2
- NTXGQCSETZTARF-UHFFFAOYSA-N buta-1,3-diene;prop-2-enenitrile Chemical compound C=CC=C.C=CC#N NTXGQCSETZTARF-UHFFFAOYSA-N 0.000 claims description 2
- 239000003086 colorant Substances 0.000 claims description 2
- 238000004049 embossing Methods 0.000 claims description 2
- 238000011156 evaluation Methods 0.000 claims description 2
- 229920001568 phenolic resin Polymers 0.000 claims description 2
- -1 polypropylene Polymers 0.000 claims description 2
- 229920001155 polypropylene Polymers 0.000 claims description 2
- 229920002223 polystyrene Polymers 0.000 claims description 2
- 229920002635 polyurethane Polymers 0.000 claims description 2
- 239000004814 polyurethane Substances 0.000 claims description 2
- 229920000915 polyvinyl chloride Polymers 0.000 claims description 2
- 239000004800 polyvinyl chloride Substances 0.000 claims description 2
- 230000005236 sound signal Effects 0.000 claims description 2
- 239000006263 elastomeric foam Substances 0.000 claims 1
- 229920002725 thermoplastic elastomer Polymers 0.000 claims 1
- 239000006269 thermoset foam Substances 0.000 claims 1
- 239000000463 material Substances 0.000 description 6
- 238000013461 design Methods 0.000 description 5
- 238000007639 printing Methods 0.000 description 5
- 230000006378 damage Effects 0.000 description 4
- QVGXLLKOCUKJST-UHFFFAOYSA-N atomic oxygen Chemical compound [O] QVGXLLKOCUKJST-UHFFFAOYSA-N 0.000 description 2
- 210000004556 brain Anatomy 0.000 description 2
- 238000013016 damping Methods 0.000 description 2
- 229920001971 elastomer Polymers 0.000 description 2
- 229910052760 oxygen Inorganic materials 0.000 description 2
- 239000001301 oxygen Substances 0.000 description 2
- 238000012360 testing method Methods 0.000 description 2
- 208000010496 Heart Arrest Diseases 0.000 description 1
- 239000008280 blood Substances 0.000 description 1
- 210000004369 blood Anatomy 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 239000000806 elastomer Substances 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 239000006261 foam material Substances 0.000 description 1
- 230000002427 irreversible effect Effects 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 238000012544 monitoring process Methods 0.000 description 1
- 238000003825 pressing Methods 0.000 description 1
- 230000004083 survival effect Effects 0.000 description 1
- 229920001187 thermosetting polymer Polymers 0.000 description 1
Classifications
-
- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
- G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
- G09B23/288—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine for artificial respiration or heart massage
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
- A61H31/004—Heart stimulation
- A61H31/005—Heart stimulation with feedback for the user
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/50—Control means thereof
- A61H2201/5058—Sensors or detectors
- A61H2201/5061—Force sensors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/50—Control means thereof
- A61H2201/5058—Sensors or detectors
- A61H2201/5084—Acceleration sensors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/50—Control means thereof
- A61H2201/5058—Sensors or detectors
- A61H2201/5092—Optical sensor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
- A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
- A61H2201/50—Control means thereof
- A61H2201/5097—Control means thereof wireless
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
- A61M16/0051—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes with alarm devices
Definitions
- the invention relates to a manikin for cardiopulmonary resuscitation simulation, comprising a foam body which carries a schematic structure of a human torso with or without a head and consists of a singular foam, a signal generating unit being arranged within the foam body, which is located in an area below of the sternum of the torso with or without a head is localized in the foam body and which is exposed to pressure at a depth of 3 cm to 8 cm on the
- the sternum area of the torso with or without a head sends a signal with a pressure period in a time interval of 100ms to 1000ms, as well as the
- CPR cardiopulmonary resuscitation
- US 2007/0292828 A1 is known from the prior art, which describes a training manikin for cardiopulmonary resuscitation (CPR) which has a structure with a plurality of foam layers which are attached to one another and which are in the shape of a human torso or are cut without a head. It will also be a
- Sound generating unit disclosed in a section of the Foam layers is disposed in a location in a region of the center of the sternum, the sound generating unit being configured to generate an audible signal when the portion of the foam layers is pressed with a force sufficient for CPR.
- Manikin is simulated using a pneumatic or hydraulic piston.
- US 2017/0193857 A1 describes how the elasticity of the body of a CPR training manikin can be controlled by rubber bands and a heart-lung simulation can be carried out.
- the publication does not contain any information about the problem of the depth of pressure and the required damping properties of the material of the manikin.
- a manikin for cardiopulmonary resuscitation simulation with a very robust structure which comprises a foam body that is provided with a cover or imprint in the form of a human torso with or without a head and which has a signal generation unit within the foam body, the foam body consisting of a singular foam, the signal generation unit in an area below the reference or
- Imprint that corresponds to the sternum of the torso with or without a head is arranged and the signal generating unit sends a signal on pressure at a pressure depth of four to five cm on the sternum area of the imprint.
- the publication does not mention the sending of a signal only with a corresponding pressure duration of 100 ms to 1000 ms.
- From US 5 540 592 A is a sensor system for monitoring
- Resuscitation exercise known which can be inserted into a training manikin. Both the printing depth and the duration of the printing processes can be recorded and evaluated. Sending a optical signal by LED's or laser is not described.
- EP 3 370 220 A1 describes a system for testing heart-lungs
- a signal generation unit shows the result of the tests with regard to sufficient pressure depth and frequency on a display.
- the object of the invention is therefore to develop an inexpensive CPR training manikin that can be used in large numbers (> 10,000) for. B. in schools and other facilities can be used inexpensively and without problems in the application.
- the manikin according to the invention should make do with as few different materials as possible and in particular consist of only one foam compound, the foam having to have such damping properties and elastic properties that the depth of pressure required for CPR at a certain level
- the subject matter of the invention therefore comprises, as a training device for CPR, as a basis a foam body which is provided with a schematic structure in the form of a human torso with or without a head. It is provided that the foam body consists only of a single foam, i.e. that the foam body is composed only of a foam compound or a foam layer.
- Such a configuration of the subject matter of the invention is provided in order to minimize the costs for the training device and to simplify the handling of the training device as much as possible; in particular, no damage in partial areas of the training device should result in the device being damaged
- foam compound can also have areas with different compressive strength, i. it is possible that the foam connection laterally or proximally on the foam body is stronger or weaker
- the compressive strength can be in the range of
- Foam body consists of a foam compound, which is softer at the edges and in the middle, especially in the area of a
- the foam body can accordingly also consist of two elements with different compressive strengths, the foam connection being the same.
- CPR training is particularly important for the area of the heart in the middle of the rib cage (in the area of the sternum) to be exerted with a certain amount of pressure or pressure depth
- a signal generation unit within the foam body, which is below the imprint in the area of the Sternum of the torso with or without a head is located and which, from a certain pressure depth, which corresponds to a certain pressure level, sends an acoustic and / or optical signal and / or indicates that a pressure pulse sufficient for CPR has been exerted on the center of the chest.
- the pressure depth or pressure strength must be maintained over a certain time interval.
- the signal of the signal generation unit should be from a printing depth of 3 cm to 8 cm, with a printing duration in one
- Time interval from 100ms to 1000ms can be transmitted.
- a signal for a deeper pressure depth and longer pressure duration can be used to simulate CPR in stronger people, while a signal for a lesser one
- Pressure depth and shorter pressure duration can be used to simulate a CPR on the body of a child or a very slim person in order to take into account the respective physiological or anatomical conditions.
- the signal generation unit sends out a signal at a pressure depth of 5 cm to 6 cm, whereby the pressure duration should encompass a time interval of 400 ms to 600 ms in order to simulate a pressure pulse on the middle of the chest that is sufficient for CPR .
- the subject matter of the invention can be used in particular for standardized simulation of CPR on the body of an average adult.
- the foam body should be designed as a cushion or rectangular base and, for example, have dimensions of the foam body in an area of 30 cm x 50 cm x 7 cm, the edges of the pillow-shaped or rectangular
- Foam body can be rounded radially.
- the design of the base of the present invention as a small pillow or a small rectangle is due to the ease of handling a pillow or rectangular one
- the edges of the foam body can be rounded.
- the edges could be flanged or turned over laterally from the outside inwards, as a result of which a radially circumferential fold is generated.
- the foam body of the manikin according to the invention should be a
- Compression hardness in a range of a volume weight (RG) 30 to 50 which should ensure that the pressure depth in a range of 3 cm to 8 cm can be achieved so that a force of 3.0 kPa to 5.0 kPa Depth of pressure of about 1/3 of the chest diameter is achieved.
- the volume weight indicates how many kilograms of material was used per cubic meter of foam. This amount determines the
- the compressive strength (kPa) indicates how much force is necessary to compress the foam by approx. 40% (normal height).
- the foam body according to the invention consists of a thermoplastic, elastomeric or
- thermosetting foam examples include, for example but not limited to, polystyrene, polypropylene and polyvinyl chloride, polyurethane, acrylonitrile butadiene, and phenoplasts.
- the foam body has a cover or print that encompasses the torso with or without the head of a human body.
- the cover can be designed as a pillow cover that completely encloses the foam body and on the one
- Imprint of a human torso with or without a head is applied or the schematic structure of a torso with or without a head is embedded or woven into the structure of the pillowcase.
- the cover can be provided with a zipper, Velcro fastener or buttons that attach to the cover are arranged and ensure fixation on the foam body.
- An imprint can also be arranged directly on the surface of the foam body, the schematic structure of a body being embossed in the sense of blind embossing or areas in the foam body
- the entire imprint or parts of the imprint can, however, also be applied to the surface of the foam body in the form of a film, in particular the film that can be applied can be made of thermoplastic
- Urethane-based (TPU) elastomers are made.
- application is to be understood as a lamination-like application of an imprint or parts of an imprint, wherein the material to be applied can represent a film which has areas with elements of a torso with or without a head, which forms the surface of the foam body.
- the manikin Since, for training purposes for an efficient FILW, the manikin has to experience a certain depth of pressure localized as possible in the area of the printed or applied sternum, the manikin has a marking in the area of the sternum that can, for example, have a square, circular or heart-shaped cross-section, which the contact surface for the area during a chest compressions.
- the size of the marking is variable and, if necessary, depends on the particular configurations, in particular the size and compressive strength of the foam body of the manikin, as well as the physical ones
- the manikin has an analog or digital signal generation unit below the schematic structure in the area of the sternum, which sends or displays a corresponding signal when a corresponding pressure depth is reached.
- an analog or digital signal generation unit below the schematic structure in the area of the sternum, which sends or displays a corresponding signal when a corresponding pressure depth is reached.
- According to the invention are under an analog or digital
- Signal generating unit with a bell, bell or a sensor
- Evaluation unit transmits for example by means of an app to understand. It is also possible to use the manikin in the area below the
- the illuminants emitting the light are embedded in the foam body and can also be present in a manikin in combination with the devices for generating analog or digital sound signals.
- the configuration of the manikin according to the invention in the sum of its features makes it particularly suitable as an inexpensive and easily handled training device for cardiopulmonary resuscitation exercises.
- FIG. 1 shows a schematic top view of a manikin 1 for heart-lung resuscitation simulation, the base being a rectangular or pillow-shaped foam body 2, which has a cover 3 or imprint 3 in the form of a human torso with or without a head.
- a cover 3 or imprint 3 in the form of a human torso with or without a head.
- an area with a marking 5 is indicated which is intended to represent the area of the sternum that is intended to serve as a support surface for the hand or hands, if a
- Chest compressions are performed.
- a signal generation unit 4 is shown schematically, which when a
- the sternum area of the cover 3 or imprint 3 sends a sound and / or light signal when the pressure is 100 ms to 1000 ms.
- FIG. 2 shows a sketch of the area of the torso without the head of the exercise manikin 1, the marking 5 being designed as a heart-shaped support surface for the hand or hands for a chest compressions.
- the image of the torso is designed as an imprint 3.
- the foam body 2 of Exercise manikin 1 is designed as a singular foam connection, but can also have areas with different compressive strength, ie it is possible that the foam connection is laterally or proximally on the
- Foam body 2 is made stronger or weaker.
- Chest compressions vary from the rest of the foam body. Below the marking 5 of the foam body 2 is a
- Signal generation unit 4 arranged, which when reaching a
- the ideal pressure point for the chest compressions is here marked with an x within the marking 5.
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Cardiology (AREA)
- Heart & Thoracic Surgery (AREA)
- Physics & Mathematics (AREA)
- General Physics & Mathematics (AREA)
- General Health & Medical Sciences (AREA)
- Mathematical Physics (AREA)
- Educational Technology (AREA)
- Algebra (AREA)
- Computational Mathematics (AREA)
- Medical Informatics (AREA)
- Mathematical Analysis (AREA)
- Mathematical Optimization (AREA)
- Chemical & Material Sciences (AREA)
- Pure & Applied Mathematics (AREA)
- Business, Economics & Management (AREA)
- Educational Administration (AREA)
- Medicinal Chemistry (AREA)
- Theoretical Computer Science (AREA)
- Emergency Medicine (AREA)
- Pulmonology (AREA)
- Epidemiology (AREA)
- Pain & Pain Management (AREA)
- Physical Education & Sports Medicine (AREA)
- Rehabilitation Therapy (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Percussion Or Vibration Massage (AREA)
Abstract
Description
Claims
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE102019117441.4A DE102019117441A1 (en) | 2019-06-27 | 2019-06-27 | CPR training manikin |
PCT/DE2020/100557 WO2020259764A1 (en) | 2019-06-27 | 2020-06-26 | Cpr training manikin |
Publications (1)
Publication Number | Publication Date |
---|---|
EP3991163A1 true EP3991163A1 (en) | 2022-05-04 |
Family
ID=71670022
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP20742644.6A Withdrawn EP3991163A1 (en) | 2019-06-27 | 2020-06-26 | Cpr training manikin |
Country Status (4)
Country | Link |
---|---|
US (1) | US20220262275A1 (en) |
EP (1) | EP3991163A1 (en) |
DE (1) | DE102019117441A1 (en) |
WO (1) | WO2020259764A1 (en) |
Families Citing this family (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP4064249A1 (en) * | 2021-03-25 | 2022-09-28 | Ambu A/S | A training manikin |
CN114569434B (en) * | 2022-03-03 | 2023-02-07 | 吉林大学 | Department of respiration uses chest compression device based on human bionical mechanism |
Family Cites Families (18)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5295835A (en) * | 1992-08-12 | 1994-03-22 | The Seaberg Company, Inc. | Training manikin for cardio-pulmonary resuscitation having nested infant-size manikin |
US5515563A (en) * | 1995-01-03 | 1996-05-14 | Chao; Dwight W. | Body pillow having interchangeable covers |
JP3626087B2 (en) * | 2000-10-31 | 2005-03-02 | 株式会社京都科学 | Auscultation practice model |
US7223103B2 (en) * | 2003-09-12 | 2007-05-29 | Trainikins, Inc. | CPR training device |
AU2006214863B2 (en) * | 2005-02-15 | 2011-11-17 | Laerdal Medical As | Standalone system for assisting in a life-saving situation |
NO324803B1 (en) * | 2006-05-10 | 2007-12-10 | Laerdal Medical As | breast Simulator |
US8827719B2 (en) * | 2006-05-31 | 2014-09-09 | Emory University | Resuscitation manikins and methods of using the same |
BRPI0718623B1 (en) * | 2006-11-14 | 2019-03-26 | Koninklijke Philips N.V. | CARDIOPULMONARY RESUSCITATION THERAPY SYSTEM |
US8034006B2 (en) * | 2007-06-15 | 2011-10-11 | Board Of Regents, The University Of Texas System | Cardiopulmonary resuscitation sensor |
US8622940B2 (en) * | 2008-01-02 | 2014-01-07 | University Of Florida Research Foundation, Inc. | Device for assisting cardiac pulmonary resuscitation |
KR101864808B1 (en) * | 2011-07-20 | 2018-06-05 | 레스퍼러토리 모션 인코포레이티드 | Impedance measuring devices and methods for emergency cardiovascular care |
US20160133160A1 (en) * | 2012-05-07 | 2016-05-12 | Zoll Medical Corporation | Rescue Performance Metric |
US20150325148A1 (en) * | 2013-07-16 | 2015-11-12 | I.M.Lab Inc. | Cardio pulmonary resuscitation (cpr) training simulation system and method for operating same |
KR101609808B1 (en) * | 2015-01-12 | 2016-04-06 | 주식회사 제이피 | Mannequin for educating cardiopulmonary resuscitation, apparatus and method for simulating cardiopulmonary resuscitation |
KR101605383B1 (en) * | 2015-11-04 | 2016-03-22 | 주식회사 씨유네트웍스 | Manikin for cpr training |
US10482791B2 (en) * | 2015-12-31 | 2019-11-19 | Protrainings, LLC | Single use mannequin having chest compression feedback mechanism for use in simulated cardiopulmonary resuscitation (CPR) training |
US9805623B1 (en) * | 2016-04-08 | 2017-10-31 | I.M.Lab Inc. | CPR training system and method |
EP3370220B1 (en) * | 2017-03-03 | 2019-06-12 | Pinga Group bvba | System for the formative testing of cardiopulmonary resuscitation skills |
-
2019
- 2019-06-27 DE DE102019117441.4A patent/DE102019117441A1/en active Pending
-
2020
- 2020-06-26 EP EP20742644.6A patent/EP3991163A1/en not_active Withdrawn
- 2020-06-26 WO PCT/DE2020/100557 patent/WO2020259764A1/en active Application Filing
- 2020-06-26 US US17/621,968 patent/US20220262275A1/en active Pending
Also Published As
Publication number | Publication date |
---|---|
DE102019117441A1 (en) | 2020-12-31 |
US20220262275A1 (en) | 2022-08-18 |
WO2020259764A1 (en) | 2020-12-30 |
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18D | Application deemed to be withdrawn |
Effective date: 20240111 |