6057bcebe7b8e197280ac083506bca01 brainsci-11-01233-v3.pdf bec48ebbfec29b371d66d5e9e27e54929cd02d51 brainsci-11-01233-v3.pdf 777336704b8fc79ef3f8c0911546770b2be0b27ddb1d1d4fd00c369532b83b05 brainsci-11-01233-v3.pdf Title: Secondary Impacts of COVID-19 Pandemic in Fatigue, Self-Compassion, Physical and Mental Health of People with Multiple Sclerosis and Caregivers: The Teruel Study Subject: The secondary impacts of the COVID-19 pandemic are distress triggers and risk factors for mental health. Conversely, self-compassion skills and compassionate thoughts/behaviors towards suffering may contribute to their alleviation. Both psychological constructs are interrelated in life-threatening diseases such as multiple sclerosis (MS). The Teruel Study retrospectively evaluated the impact of strict confinement on the 44 people with MS of this Spanish province and 24 caregivers, specifically assessing (1) fears and perceptions; (2) self-compassion (people with MS) and compassion (caregivers); (3) physical and mental health, and fatigue. Despite better housing conditions, people with MS considered confinement very difficult to handle, more than their caregivers, but they were less afraid of COVID-19 and worsening of MS. Still, they recognized worse health than before confinement. Reclusion and lack of walks were the worst of confinement. Caregivers also referred to lack of leisure and uncertainty–fear. All agreed the best was staying with the family, but some found ‘nothing’ positive. Self-compassion remained moderate–high and strongly correlated with their moderate levels of social function, vitality, physical role, and global health. Physical and cognitive fatigue scores were high, and self-compassion negatively correlated with them, explaining a 19% variance in global health. The high compassion of the caregivers did not correlate with any variable. Keywords: secondary impact; COVID-19; multiple sclerosis; caregivers; fears; health; HRQoL; self-compassion; compassion; fatigue Author: Lydia Giménez-Llort, Juan José Martín-González and Sara Maurel Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Sep 24 11:31:40 2021 CEST ModDate: Fri Sep 24 11:36:22 2021 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 18 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 959526 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- ARIQJE+VnURWPalladioL Type 1 Custom yes yes no 10 0 AGGHDK+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 IPGVBO+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 TTBTMN+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 IOJCNK+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 SLUQMQ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 58 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 62 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 66 0 SDTJCC+URWPalladioL-BoldItal Type 1 Custom yes yes no 87 0 OBNLCA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 104 0 OBNLCC+PalatinoLinotype TrueType WinAnsi yes yes no 107 0 OBNLCE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 110 0 OBNLCA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 121 0 OBNLCC+PalatinoLinotype TrueType WinAnsi yes yes no 124 0 OBNLCE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 127 0 OBNLCA+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 141 0 OBNLCC+PalatinoLinotype TrueType WinAnsi yes yes no 144 0 OBNLCE+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 147 0 FXXUVH+CMSY10 Type 1 Builtin yes yes no 154 0 HQEJCW+VnURWPalladioL-Italic Type 1 Custom yes yes no 180 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-07-06 02:33:38 CEST RepresentationInformation: brainsci-11-01233-v3.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-07-05 17:40:06 CEST Size: 959526 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 406 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Children: Item: Title: Sample and Experimental Design Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Procedures and Variables of Study Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Evaluation Instruments Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: Statistics Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Sociodemographic Descriptives of People with MS and Caregivers Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: COVID-19, Confinement and Fears Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Fatigue, Self-Compassion, and Compassion in People with MS and Caregivers Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Correlations between Self-Compassion in People with MS and Compassion in Caregivers with Physical and Mental Health, including Fatigue Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Regression Analysis of Self-Compassion in People with MS, and Compassion in Caregivers Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Discussion and Implications Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Children: Item: Title: Sociodemography, COVID-19 Confinement and Fears Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Fatigue, Self-Compassion, and Compassion in People with MS and Caregivers Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Item: Title: Limitations Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@76a3e297 Info: Title: Secondary Impacts of COVID-19 Pandemic in Fatigue, Self-Compassion, Physical and Mental Health of People with Multiple Sclerosis and Caregivers: The Teruel Study Author: Lydia Giménez-Llort, Juan José Martín-González and Sara Maurel Subject: The secondary impacts of the COVID-19 pandemic are distress triggers and risk factors for mental health. Conversely, self-compassion skills and compassionate thoughts/behaviors towards suffering may contribute to their alleviation. Both psychological constructs are interrelated in life-threatening diseases such as multiple sclerosis (MS). The Teruel Study retrospectively evaluated the impact of strict confinement on the 44 people with MS of this Spanish province and 24 caregivers, specifically assessing (1) fears and perceptions; (2) self-compassion (people with MS) and compassion (caregivers); (3) physical and mental health, and fatigue. Despite better housing conditions, people with MS considered confinement very difficult to handle, more than their caregivers, but they were less afraid of COVID-19 and worsening of MS. Still, they recognized worse health than before confinement. Reclusion and lack of walks were the worst of confinement. Caregivers also referred to lack of leisure and uncertainty fear. All agreed the best was staying with the family, but some found ‘nothing’ positive. Self-compassion remained moderate high and strongly correlated with their moderate levels of social function, vitality, physical role, and global health. Physical and cognitive fatigue scores were high, and self-compassion negatively correlated with them, explaining a 19% variance in global health. The high compassion of the caregivers did not correlate with any variable. Keywords: secondary impact; COVID-19; multiple sclerosis; caregivers; fears; health; HRQoL; self-compassion; compassion; fatigue Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Sep 24 11:31:40 CEST 2021 ModDate: Fri Sep 24 11:36:22 CEST 2021 ID: 0xc26542bfe33455cae8206751b6ad26c1, 0xc26542bfe33455cae8206751b6ad26c1 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: IPGVBO+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 122 FontDescriptor: FontName: IPGVBO+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: HQEJCW+VnURWPalladioL-Italic FontSubset: true FirstChar: 161 LastChar: 243 FontDescriptor: FontName: HQEJCW+VnURWPalladioL-Italic Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: SDTJCC+URWPalladioL-BoldItal FontSubset: true FirstChar: 78 LastChar: 114 FontDescriptor: FontName: SDTJCC+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: TTBTMN+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: TTBTMN+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: ARIQJE+VnURWPalladioL FontSubset: true FirstChar: 129 LastChar: 243 FontDescriptor: FontName: ARIQJE+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: FXXUVH+CMSY10 FontSubset: true FirstChar: 0 LastChar: 0 FontDescriptor: FontName: FXXUVH+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: IOJCNK+VnURWPalladioL-Bold FontSubset: true FirstChar: 161 LastChar: 189 FontDescriptor: FontName: IOJCNK+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: AGGHDK+URWPalladioL-Ital FontSubset: true FirstChar: 2 LastChar: 121 FontDescriptor: FontName: AGGHDK+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 35, 759, 174, 795 Annotation: Subtype: Link Rect: 515, 759, 560, 795 Annotation: Subtype: Link Rect: 149, 641, 161, 654 Annotation: Subtype: Link Rect: 54, 346, 154, 355 Annotation: Subtype: Link Rect: 35, 336, 89, 343 Annotation: Subtype: Link Rect: 35, 162, 97, 184 Annotation: Subtype: Link Rect: 153, 89, 154, 98 Annotation: Subtype: Link Rect: 35, 77, 147, 86 Annotation: Subtype: Link Rect: 309, 206, 316, 215 ActionDest: 174 Annotation: Subtype: Link Rect: 288, 168, 295, 177 ActionDest: 174 Annotation: Subtype: Link Rect: 296, 168, 303, 177 ActionDest: 174 Annotation: Subtype: Link Rect: 461, 155, 468, 164 ActionDest: 174 Annotation: Subtype: Link Rect: 214, 118, 221, 127 ActionDest: 174 Annotation: Subtype: Link Rect: 431, 92, 438, 102 ActionDest: 174 Annotation: Subtype: Link Rect: 315, 68, 322, 76 ActionDest: 174 Annotation: Subtype: Link Rect: 325, 67, 332, 76 ActionDest: 177 Annotation: Subtype: Link Rect: 121, 17, 273, 28 Annotation: Subtype: Link Rect: 406, 17, 558, 28 Annotation: Subtype: Link Rect: 35, 458, 87, 477 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 421, 686, 428, 695 ActionDest: 174 Annotation: Subtype: Link Rect: 431, 686, 443, 695 ActionDest: 177 Annotation: Subtype: Link Rect: 356, 624, 368, 633 ActionDest: 177 Annotation: Subtype: Link Rect: 266, 599, 278, 608 ActionDest: 177 Annotation: Subtype: Link Rect: 481, 573, 493, 582 ActionDest: 177 Annotation: Subtype: Link Rect: 192, 561, 204, 570 ActionDest: 177 Annotation: Subtype: Link Rect: 544, 536, 556, 545 ActionDest: 177 Annotation: Subtype: Link Rect: 283, 498, 295, 507 ActionDest: 177 Annotation: Subtype: Link Rect: 453, 461, 465, 469 ActionDest: 177 Annotation: Subtype: Link Rect: 465, 460, 477, 469 ActionDest: 177 Annotation: Subtype: Link Rect: 439, 423, 451, 432 ActionDest: 177 Annotation: Subtype: Link Rect: 451, 423, 463, 432 ActionDest: 177 Annotation: Subtype: Link Rect: 189, 360, 201, 369 ActionDest: 177 Annotation: Subtype: Link Rect: 225, 234, 236, 244 ActionDest: 177 Annotation: Subtype: Link Rect: 459, 209, 471, 218 ActionDest: 177 Annotation: Subtype: Link Rect: 294, 134, 306, 143 ActionDest: 177 Annotation: Subtype: Link Rect: 309, 134, 321, 143 ActionDest: 177 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 323, 583, 335, 592 ActionDest: 177 Annotation: Subtype: Link Rect: 335, 583, 347, 592 ActionDest: 177 Annotation: Subtype: Link Rect: 318, 168, 330, 177 ActionDest: 177 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 479, 710, 491, 719 ActionDest: 177 Annotation: Subtype: Link Rect: 328, 697, 340, 706 ActionDest: 177 Annotation: Subtype: Link Rect: 242, 597, 254, 606 ActionDest: 177 Annotation: Subtype: Link Rect: 532, 597, 544, 606 ActionDest: 177 Annotation: Subtype: Link Rect: 312, 546, 324, 556 ActionDest: 177 Annotation: Subtype: Link Rect: 392, 534, 404, 543 ActionDest: 177 Annotation: Subtype: Link Rect: 229, 459, 241, 468 ActionDest: 177 Annotation: Subtype: Link Rect: 365, 446, 377, 455 ActionDest: 177 Annotation: Subtype: Link Rect: 378, 446, 390, 455 ActionDest: 177 Annotation: Subtype: Link Rect: 291, 421, 303, 430 ActionDest: 177 Annotation: Subtype: Link Rect: 245, 371, 256, 380 ActionDest: 184 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 378, 691, 385, 703 ActionDest: 84 Annotation: Subtype: Link Rect: 449, 159, 456, 171 ActionDest: 84 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 224, 544, 231, 556 ActionDest: 94 Annotation: Subtype: Link Rect: 235, 544, 242, 556 ActionDest: 131 Annotation: Subtype: Link Rect: 488, 531, 495, 543 ActionDest: 94 Annotation: Subtype: Link Rect: 519, 493, 526, 505 ActionDest: 94 Annotation: Subtype: Link Rect: 307, 443, 314, 455 ActionDest: 94 Annotation: Subtype: Link Rect: 387, 380, 394, 392 ActionDest: 94 Annotation: Subtype: Link Rect: 438, 305, 445, 317 ActionDest: 94 Annotation: Subtype: Link Rect: 430, 255, 437, 267 ActionDest: 94 Annotation: Subtype: Link Rect: 479, 205, 486, 217 ActionDest: 131 Page: Sequence: 7 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 217, 379, 223, 391 ActionDest: 131 Annotation: Subtype: Link Rect: 243, 379, 250, 391 ActionDest: 151 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 291, 470, 298, 482 ActionDest: 131 Annotation: Subtype: Link Rect: 377, 284, 384, 296 ActionDest: 151 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 371, 594, 378, 606 ActionDest: 158 Annotation: Subtype: Link Rect: 214, 569, 221, 581 ActionDest: 158 Annotation: Subtype: Link Rect: 481, 333, 493, 342 ActionDest: 184 Annotation: Subtype: Link Rect: 323, 220, 334, 229 ActionDest: 177 Annotation: Subtype: Link Rect: 335, 220, 347, 229 ActionDest: 184 Annotation: Subtype: Link Rect: 347, 220, 359, 229 ActionDest: 184 Annotation: Subtype: Link Rect: 545, 220, 557, 229 ActionDest: 184 Annotation: Subtype: Link Rect: 201, 82, 213, 91 ActionDest: 184 Annotation: Subtype: Link Rect: 214, 82, 226, 91 ActionDest: 184 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 375, 584, 387, 593 ActionDest: 184 Annotation: Subtype: Link Rect: 391, 496, 403, 505 ActionDest: 184 Annotation: Subtype: Link Rect: 285, 433, 297, 443 ActionDest: 184 Annotation: Subtype: Link Rect: 297, 434, 309, 443 ActionDest: 184 Annotation: Subtype: Link Rect: 357, 346, 364, 355 ActionDest: 174 Annotation: Subtype: Link Rect: 367, 346, 379, 355 ActionDest: 177 Annotation: Subtype: Link Rect: 236, 333, 248, 342 ActionDest: 184 Annotation: Subtype: Link Rect: 486, 233, 493, 242 ActionDest: 174 Annotation: Subtype: Link Rect: 496, 233, 508, 242 ActionDest: 177 Annotation: Subtype: Link Rect: 544, 220, 556, 229 ActionDest: 184 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 265, 735, 277, 744 ActionDest: 184 Annotation: Subtype: Link Rect: 281, 697, 293, 706 ActionDest: 184 Annotation: Subtype: Link Rect: 482, 634, 494, 643 ActionDest: 184 Annotation: Subtype: Link Rect: 379, 609, 391, 618 ActionDest: 184 Annotation: Subtype: Link Rect: 421, 597, 433, 606 ActionDest: 184 Annotation: Subtype: Link Rect: 302, 572, 314, 581 ActionDest: 184 Annotation: Subtype: Link Rect: 311, 534, 323, 543 ActionDest: 184 Annotation: Subtype: Link Rect: 523, 446, 535, 455 ActionDest: 177 Annotation: Subtype: Link Rect: 282, 346, 294, 355 ActionDest: 184 Annotation: Subtype: Link Rect: 221, 182, 233, 192 ActionDest: 177 Annotation: Subtype: Link Rect: 307, 170, 319, 179 ActionDest: 184 Annotation: Subtype: Link Rect: 494, 82, 506, 91 ActionDest: 184 Page: Sequence: 13 Annotations: Annotation: Subtype: Link Rect: 223, 710, 235, 719 ActionDest: 184 Annotation: Subtype: Link Rect: 437, 647, 449, 656 ActionDest: 184 Annotation: Subtype: Link Rect: 261, 547, 273, 556 ActionDest: 184 Annotation: Subtype: Link Rect: 210, 496, 222, 505 ActionDest: 184 Annotation: Subtype: Link Rect: 328, 496, 340, 505 ActionDest: 184 Annotation: Subtype: Link Rect: 313, 471, 325, 480 ActionDest: 184 Annotation: Subtype: Link Rect: 253, 433, 265, 443 ActionDest: 184 Annotation: Subtype: Link Rect: 265, 433, 277, 443 ActionDest: 187 Annotation: Subtype: Link Rect: 458, 295, 470, 304 ActionDest: 187 Annotation: Subtype: Link Rect: 543, 283, 555, 292 ActionDest: 187 Annotation: Subtype: Link Rect: 334, 270, 346, 279 ActionDest: 187 Annotation: Subtype: Link Rect: 526, 270, 538, 279 ActionDest: 187 Annotation: Subtype: Link Rect: 470, 132, 482, 141 ActionDest: 184 Page: Sequence: 14 Annotations: Annotation: Subtype: Link Rect: 325, 722, 337, 731 ActionDest: 184 Page: Sequence: 15 Annotations: Annotation: Subtype: Link Rect: 359, 287, 560, 298 Annotation: Subtype: Link Rect: 56, 276, 385, 287 Annotation: Subtype: Link Rect: 357, 264, 560, 275 Annotation: Subtype: Link Rect: 56, 253, 154, 264 Annotation: Subtype: Link Rect: 59, 208, 97, 218 Annotation: Subtype: Link Rect: 465, 172, 503, 183 Annotation: Subtype: Link Rect: 395, 138, 433, 149 Annotation: Subtype: Link Rect: 199, 104, 237, 114 Annotation: Subtype: Link Rect: 519, 80, 557, 91 Annotation: Subtype: Link Rect: 59, 70, 95, 80 Page: Sequence: 16 Annotations: Annotation: Subtype: Link Rect: 265, 721, 303, 732 Annotation: Subtype: Link Rect: 309, 721, 345, 732 Annotation: Subtype: Link Rect: 419, 698, 457, 709 Annotation: Subtype: Link Rect: 463, 698, 499, 709 Annotation: Subtype: Link Rect: 415, 675, 452, 686 Annotation: Subtype: Link Rect: 189, 653, 227, 663 Annotation: Subtype: Link Rect: 233, 653, 269, 663 Annotation: Subtype: Link Rect: 292, 629, 329, 640 Annotation: Subtype: Link Rect: 59, 607, 97, 617 Annotation: Subtype: Link Rect: 302, 560, 339, 571 Annotation: Subtype: Link Rect: 346, 560, 382, 571 Annotation: Subtype: Link Rect: 449, 548, 486, 559 Annotation: Subtype: Link Rect: 519, 537, 557, 548 Annotation: Subtype: Link Rect: 519, 525, 557, 536 Annotation: Subtype: Link Rect: 59, 515, 95, 525 Annotation: Subtype: Link Rect: 146, 491, 184, 502 Annotation: Subtype: Link Rect: 162, 457, 199, 467 Annotation: Subtype: Link Rect: 172, 434, 209, 444 Annotation: Subtype: Link Rect: 215, 434, 251, 444 Annotation: Subtype: Link Rect: 59, 411, 97, 421 Annotation: Subtype: Link Rect: 140, 377, 178, 387 Annotation: Subtype: Link Rect: 281, 353, 319, 364 Annotation: Subtype: Link Rect: 453, 330, 490, 341 Annotation: Subtype: Link Rect: 258, 295, 296, 306 Annotation: Subtype: Link Rect: 519, 272, 557, 283 Annotation: Subtype: Link Rect: 59, 262, 95, 272 Annotation: Subtype: Link Rect: 324, 238, 361, 249 Annotation: Subtype: Link Rect: 491, 226, 529, 237 Annotation: Subtype: Link Rect: 77, 192, 115, 203 Annotation: Subtype: Link Rect: 121, 192, 157, 203 Annotation: Subtype: Link Rect: 227, 169, 264, 180 Annotation: Subtype: Link Rect: 270, 169, 306, 180 Annotation: Subtype: Link Rect: 480, 157, 517, 168 Annotation: Subtype: Link Rect: 259, 100, 296, 111 Annotation: Subtype: Link Rect: 477, 88, 514, 99 Annotation: Subtype: Link Rect: 521, 88, 557, 99 Annotation: Subtype: Link Rect: 95, 66, 133, 76 Annotation: Subtype: Link Rect: 139, 66, 175, 76 Page: Sequence: 17 Annotations: Annotation: Subtype: Link Rect: 399, 721, 437, 732 Annotation: Subtype: Link Rect: 170, 687, 207, 697 Annotation: Subtype: Link Rect: 143, 641, 181, 651 Annotation: Subtype: Link Rect: 279, 594, 316, 605 Annotation: Subtype: Link Rect: 322, 594, 358, 605 Annotation: Subtype: Link Rect: 466, 571, 504, 582 Annotation: Subtype: Link Rect: 510, 571, 546, 582 Annotation: Subtype: Link Rect: 203, 515, 240, 525 Annotation: Subtype: Link Rect: 247, 515, 283, 525 Annotation: Subtype: Link Rect: 448, 491, 485, 502 Annotation: Subtype: Link Rect: 491, 491, 527, 502 Annotation: Subtype: Link Rect: 170, 457, 207, 467 Annotation: Subtype: Link Rect: 209, 433, 247, 444 Annotation: Subtype: Link Rect: 140, 411, 178, 421 Annotation: Subtype: Link Rect: 236, 376, 273, 387 Annotation: Subtype: Link Rect: 237, 353, 274, 364 Annotation: Subtype: Link Rect: 471, 330, 508, 341 Annotation: Subtype: Link Rect: 515, 330, 551, 341 Annotation: Subtype: Link Rect: 371, 318, 408, 329 Annotation: Subtype: Link Rect: 361, 295, 399, 306 Annotation: Subtype: Link Rect: 302, 272, 339, 283 Annotation: Subtype: Link Rect: 162, 249, 200, 260 Annotation: Subtype: Link Rect: 405, 226, 443, 237 Annotation: Subtype: Link Rect: 322, 203, 360, 214 Annotation: Subtype: Link Rect: 336, 169, 373, 180 Annotation: Subtype: Link Rect: 111, 100, 148, 111 Annotation: Subtype: Link Rect: 56, 77, 202, 88 Page: Sequence: 18 Annotations: Annotation: Subtype: Link Rect: 161, 721, 268, 732 Annotation: Subtype: Link Rect: 175, 698, 213, 709 Annotation: Subtype: Link Rect: 313, 675, 351, 686 Annotation: Subtype: Link Rect: 435, 663, 472, 674 Annotation: Subtype: Link Rect: 478, 663, 514, 674 Annotation: Subtype: Link Rect: 339, 640, 376, 651 Annotation: Subtype: Link Rect: 383, 640, 419, 651 Checksum: c554add7 Type: CRC32 Checksum: 6057bcebe7b8e197280ac083506bca01 Type: MD5 Checksum: bec48ebbfec29b371d66d5e9e27e54929cd02d51 Type: SHA-1