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Many changes are invisible at first but detectable through routine blood tests

For example, an 83-year-old patients chest X-ray showed dense consolidations (indicating pneumonia) just one day after aspiration occurred due to loss of airway reflexes after a stroke

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Phase 1: Item development Step 1: Identification of domains and item generation The study was guided by a theoretical framework drawing on a list of domains for initial conceptualization of the construct dependence 24,25