0d5f39a9fd2e6cdc97a2191a66c8ce45  pmc_9629697.pdf
336518492e1deaa1bd414b9fe149ab7c5128dbaf  pmc_9629697.pdf
2f9a41aee111c14743e1d0b6549bc1872b9982a5b65c86d7389afc6d93023d8d  pmc_9629697.pdf

Title:          Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock
Subject:        DOI: 10.1093/ehjacc/zuac096; European Heart Journal: Acute Cardiovascular Care, 11, 10, 2022-8-11.; Abstract:  Aims: Soluble urokinase–type plasminogen activator receptor (suPAR) is a biomarker reflecting the level of immune activation. It has been shown to have prognostic value in acute coronary syndrome and heart failure as well as in critical illness. Considering the complex pathophysiology of cardiogenic shock (CS), we hypothesized suPAR might have prognostic properties in CS as well. The aim of this study was to assess the kinetics and prognostic utility of suPAR in CS. Methods and results: SuPAR levels were determined in serial plasma samples (0–96 h) from 161 CS patients in the prospective, observational, multicentre CardShock study. Kinetics of suPAR, its association with 90-day mortality, and additional value in risk-stratification were investigated. The median suPAR-level at baseline was 4.4 [interquartile range (IQR) 3.2–6.6)] ng/mL. SuPAR levels above median were associat
Keywords:       Cardiogenic shock; suPAR; Risk stratification; Biomarker
Author:         Mari Hongisto
Creator:        Servigistics Arbortext Advanced Print Publisher 11.1.4546/W-x64
Producer:       PDFlib+PDI 9.0.7p3 (C++/Win64)
CreationDate:   Mon Oct 31 04:56:00 2022 CET
ModDate:        Wed Nov  2 06:44:40 2022 CET
Tagged:         yes
UserProperties: no
Suspects:       no
Form:           AcroForm
JavaScript:     no
Pages:          8
Encrypted:      no
Page size:      595.276 x 793.701 pts
Page rot:       0
File size:      445927 bytes
Optimized:      yes
PDF version:    1.5


name                                 type              encoding         emb sub uni object ID
------------------------------------ ----------------- ---------------- --- --- --- ---------
VGQEKH+GillSansNova-Book             CID TrueType      Identity-H       yes yes yes    647  0
QCWBHA+GillSansNova-Bold             CID TrueType      Identity-H       yes yes yes    650  0
MNNNSG+GillSansNova-BookItalic       CID TrueType      Identity-H       yes yes yes    653  0
FEXOCV+GillSansNova-Heavy            CID TrueType      Identity-H       yes yes yes    656  0
HBQFSX+STIXGeneral-Regular           Type 1C           Custom           yes yes yes    659  0
OJHKEE+TimesNewRomanPSMT             CID TrueType      Identity-H       yes yes yes     76  0
LDOFJO+GillSansNova-BoldItalic       CID TrueType      Identity-H       yes yes yes     78  0
OIFVTI+STIXGeneral-Bold              Type 1C           Custom           yes yes yes     77  0


Jhove (Rel. 1.22.1, 2019-04-17)
 Date: 2023-01-10 02:31:37 CET
 RepresentationInformation: pmc_9629697.pdf
  ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17)
  LastModified: 2022-11-10 02:20:58 CET
  Size: 445927
  Format: PDF
  Version: 1.5
  Status: Well-Formed, but not valid
  SignatureMatches:
   PDF-hul
  ID: PDF-HUL-122
  ErrorMessage: edu.harvard.hul.ois.jhove.module.pdf.PdfInvalidException: Invalid indirect destination - referenced object 'bib' cannot be found
   Offset: 435036
  ID: PDF-HUL-122
  ErrorMessage: edu.harvard.hul.ois.jhove.module.pdf.PdfInvalidException: Invalid indirect destination - referenced object 'bib' cannot be found
   Offset: 435036
  MIMEtype: application/pdf
  Profile: Linearized PDF, Tagged PDF
  PDFMetadata: 
   Objects: 0
   FreeObjects: 1
   IncrementalUpdates: 0
   DocumentCatalog: 
    ViewerPreferences: 
     HideToolbar: false
     HideMenubar: false
     HideWindowUI: false
     FitWindow: false
     CenterWindow: false
     DisplayDocTitle: true
     NonFullScreenPageMode: UseNone
     Direction: L2R
     ViewArea: CropBox
     ViewClip: CropBox
     PrintArea: CropBox
     PageClip: CropBox
    PageLayout: OneColumn
    PageMode: UseOutlines
    Language: en
    Outlines: 
     Item: 
      Title: Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock
      Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@37374a5e
      Children: 
       Item: 
        Title: Introduction
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4671e53b
       Item: 
        Title: Methods
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@2db7a79b
        Children: 
         Item: 
          Title: Inclusion criteria and data collection
          Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@6950e31
         Item: 
          Title: Blood sampling and laboratory analyses
          Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@b7dd107
       Item: 
        Title: Statistical analyses
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@42eca56e
       Item: 
        Title: Results
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@52f759d7
        Children: 
         Item: 
          Title: SuPAR levels in CS
          Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7cbd213e
         Item: 
          Title: Correlation of suPAR with other biomarkers
          Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@192d3247
         Item: 
          Title: Outcome and serial sampling of suPAR
          Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3ecd23d9
         Item: 
          Title: SuPAR in risk prediction
          Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@569cfc36
       Item: 
        Title: Discussion
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@43bd930a
       Item: 
        Title: Limitations
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@33723e30
       Item: 
        Title: Conclusions
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@64f6106c
       Item: 
        Title: Supplementary material
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@553a3d88
       Item: 
        Title: Acknowledgements
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a30d1e6
       Item: 
        Title: Funding
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5891e32e
       Item: 
        Title: Data availability
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@cb0ed20
       Item: 
        Title: References
        Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@8e24743
   Filters: 
    FilterPipeline: FlateDecode
    FilterPipeline: DCTDecode
   Images: 
    Image: 
     NisoImageMetadata: 
      FormatName: image/jpg
      CompressionScheme: JPEG
      ImageWidth: 1000
      ImageHeight: 695
      ColorSpace: RGB
      BitsPerSample: 8
      BitsPerSampleUnit: integer
    Image: 
     NisoImageMetadata: 
      FormatName: image/jpg
      CompressionScheme: JPEG
      ImageWidth: 1000
      ImageHeight: 563
      BitsPerSample: 8
      BitsPerSampleUnit: integer
    Image: 
     NisoImageMetadata: 
      FormatName: image/jpg
      CompressionScheme: JPEG
      ImageWidth: 1000
      ImageHeight: 860
      BitsPerSample: 8
      BitsPerSampleUnit: integer
    Image: 
     NisoImageMetadata: 
      FormatName: image/jpg
      CompressionScheme: JPEG
      ImageWidth: 1000
      ImageHeight: 1143
      BitsPerSample: 8
      BitsPerSampleUnit: integer
   Fonts: 
    Type0: 
     Font: 
      BaseFont: FEXOCV+GillSansNova-Heavy
      Encoding: Identity-H
      ToUnicode: true
     Font: 
      BaseFont: VGQEKH+GillSansNova-Book
      Encoding: Identity-H
      ToUnicode: true
     Font: 
      BaseFont: QCWBHA+GillSansNova-Bold
      Encoding: Identity-H
      ToUnicode: true
     Font: 
      BaseFont: OJHKEE+TimesNewRomanPSMT
      Encoding: Identity-H
      ToUnicode: true
     Font: 
      BaseFont: MNNNSG+GillSansNova-BookItalic
      Encoding: Identity-H
      ToUnicode: true
     Font: 
      BaseFont: LDOFJO+GillSansNova-BoldItalic
      Encoding: Identity-H
      ToUnicode: true
    Type1: 
     Font: 
      BaseFont: HBQFSX+STIXGeneral-Regular
      FontSubset: true
      FirstChar: 1
      LastChar: 6
      FontDescriptor: 
       FontName: HBQFSX+STIXGeneral-Regular
       Flags: Nonsymbolic
       FontBBox: -995, -455, 2000, 1055
       FontFile3: true
      EncodingDictionary: 
       BaseEncoding: WinAnsiEncoding
       Differences: true
      ToUnicode: true
     Font: 
      BaseFont: OIFVTI+STIXGeneral-Bold
      FontSubset: true
      FirstChar: 1
      LastChar: 3
      FontDescriptor: 
       FontName: OIFVTI+STIXGeneral-Bold
       Flags: Nonsymbolic, ForceBold
       FontBBox: -1030, -455, 2000, 1055
       FontFile3: true
      EncodingDictionary: 
       BaseEncoding: WinAnsiEncoding
       Differences: true
      ToUnicode: true
    CIDFontType2: 
     Font: 
      BaseFont: LDOFJO+GillSansNova-BoldItalic
      CIDSystemInfo: 
       Registry: Adobe
       Registry: Identity
       Supplement: 0
      FontDescriptor: 
       FontName: LDOFJO+GillSansNova-BoldItalic
       Flags: Nonsymbolic, Italic, ForceBold
       FontBBox: -404, -250, 1219, 960
       FontFile2: true
     Font: 
      BaseFont: VGQEKH+GillSansNova-Book
      CIDSystemInfo: 
       Registry: Adobe
       Registry: Identity
       Supplement: 0
      FontDescriptor: 
       FontName: VGQEKH+GillSansNova-Book
       Flags: Nonsymbolic
       FontBBox: -420, -251, 1219, 950
       FontFile2: true
     Font: 
      BaseFont: QCWBHA+GillSansNova-Bold
      CIDSystemInfo: 
       Registry: Adobe
       Registry: Identity
       Supplement: 0
      FontDescriptor: 
       FontName: QCWBHA+GillSansNova-Bold
       Flags: Nonsymbolic, ForceBold
       FontBBox: -476, -276, 1276, 961
       FontFile2: true
     Font: 
      BaseFont: MNNNSG+GillSansNova-BookItalic
      CIDSystemInfo: 
       Registry: Adobe
       Registry: Identity
       Supplement: 0
      FontDescriptor: 
       FontName: MNNNSG+GillSansNova-BookItalic
       Flags: Nonsymbolic, Italic
       FontBBox: -316, -235, 1219, 950
       FontFile2: true
     Font: 
      BaseFont: FEXOCV+GillSansNova-Heavy
      CIDSystemInfo: 
       Registry: Adobe
       Registry: Identity
       Supplement: 0
      FontDescriptor: 
       FontName: FEXOCV+GillSansNova-Heavy
       Flags: Nonsymbolic, ForceBold
       FontBBox: -504, -287, 1375, 966
       FontFile2: true
     Font: 
      BaseFont: OJHKEE+TimesNewRomanPSMT
      CIDSystemInfo: 
       Registry: Adobe
       Registry: Identity
       Supplement: 0
      FontDescriptor: 
       FontName: OJHKEE+TimesNewRomanPSMT
       Flags: Nonsymbolic
       FontBBox: -568, -307, 2046, 1040
       FontFile2: true
   XMP: <x:xmpmeta xmlns:x="adobe:ns:meta/" x:xmptk="Adobe XMP Core 5.4-c006 80.159825, 2016/09/16-03:31:08        ">
   <rdf:RDF xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#">
      <rdf:Description rdf:about=""
            xmlns:xmpMM="http://ns.adobe.com/xap/1.0/mm/"
            xmlns:xmpRights="http://ns.adobe.com/xap/1.0/rights/"
            xmlns:pdf="http://ns.adobe.com/pdf/1.3/"
            xmlns:dc="http://purl.org/dc/elements/1.1/"
            xmlns:prism="http://prismstandard.org/namespaces/basic/2.0/"
            xmlns:xmp="http://ns.adobe.com/xap/1.0/"
            xmlns:pdfx="http://ns.adobe.com/pdfx/1.3/"
            xmlns:pdfuaid="http://www.aiim.org/pdfua/ns/id/"
            xmlns:pdfaExtension="http://www.aiim.org/pdfa/ns/extension/"
            xmlns:pdfaSchema="http://www.aiim.org/pdfa/ns/schema#"
            xmlns:pdfaProperty="http://www.aiim.org/pdfa/ns/property#">
         <xmpMM:InstanceID>uuid:0bbcf440-812d-4c72-9ac0-75199a74772d</xmpMM:InstanceID>
         <xmpMM:DocumentID>uuid:A547D508-128D-43B8-C055-4A1B4DA93975</xmpMM:DocumentID>
         <xmpRights:Marked>True</xmpRights:Marked>
         <pdf:Keywords>Cardiogenic shock; suPAR; Risk stratification; Biomarker</pdf:Keywords>
         <pdf:Producer>PDFlib+PDI 9.0.7p3 (C++/Win64)</pdf:Producer>
         <dc:format>application/pdf</dc:format>
         <dc:identifier>10.1093/ehjacc/zuac096</dc:identifier>
         <dc:lang>en</dc:lang>
         <dc:publisher>
            <rdf:Bag>
               <rdf:li>Oxford University Press</rdf:li>
            </rdf:Bag>
         </dc:publisher>
         <dc:title>
            <rdf:Alt>
               <rdf:li xml:lang="x-default">Soluble urokinase-type plasminogen activator receptor improves early risk stratification in cardiogenic shock</rdf:li>
            </rdf:Alt>
         </dc:title>
         <dc:creator>
            <rdf:Seq>
               <rdf:li>Mari Hongisto</rdf:li>
               <rdf:li>Johan Lassus</rdf:li>
               <rdf:li>Tuukka Tarvasmäki</rdf:li>
               <rdf:li>Jordi Sans-Roselló</rdf:li>
               <rdf:li>Heli Tolppanen</rdf:li>
               <rdf:li>Anu Kataja</rdf:li>
               <rdf:li>Toni Jäntti</rdf:li>
               <rdf:li>Tuija Sabell</rdf:li>
               <rdf:li>Marek Banaszewski</rdf:li>
               <rdf:li>Jose Silva-Cardoso</rdf:li>
               <rdf:li>John Parissis</rdf:li>
               <rdf:li>Raija Jurkko</rdf:li>
               <rdf:li>Jindrich Spinar</rdf:li>
               <rdf:li>Maaret Castrén</rdf:li>
               <rdf:li>Alexandre Mebazaa</rdf:li>
               <rdf:li>Josep Masip</rdf:li>
               <rdf:li>Veli-Pekka Harjola</rdf:li>
               <rdf:li>for the CardShock Study Investigators and the GREAT Network</rdf:li>
            </rdf:Seq>
         </dc:creator>
         <dc:description>
            <rdf:Alt>
               <rdf:li xml:lang="x-default">DOI: 10.1093/ehjacc/zuac096; European Heart Journal: Acute Cardiovascular Care, 11, 10, 2022-8-11.; Abstract:  Aims: Soluble urokinase–type plasminogen activator receptor (suPAR) is a biomarker reflecting the level of immune activation. It has been shown to have prognostic value in acute coronary syndrome and heart failure as well as in critical illness. Considering the complex pathophysiology of cardiogenic shock (CS), we hypothesized suPAR might have prognostic properties in CS as well. The aim of this study was to assess the kinetics and prognostic utility of suPAR in CS. Methods and results: SuPAR levels were determined in serial plasma samples (0–96 h) from 161 CS patients in the prospective, observational, multicentre CardShock study. Kinetics of suPAR, its association with 90-day mortality, and additional value in risk-stratification were investigated. The median suPAR-level at baseline was 4.4 [interquartile range (IQR) 3.2–6.6)] ng/mL. SuPAR levels above median were associat</rdf:li>
            </rdf:Alt>
         </dc:description>
         <dc:rights>
            <rdf:Alt>
               <rdf:li xml:lang="x-default">© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.</rdf:li>
            </rdf:Alt>
         </dc:rights>
         <dc:subject>
            <rdf:Bag>
               <rdf:li>Cardiogenic shock</rdf:li>
               <rdf:li>suPAR</rdf:li>
               <rdf:li>Risk stratification</rdf:li>
               <rdf:li>Biomarker</rdf:li>
            </rdf:Bag>
         </dc:subject>
         <prism:aggregationType>Journal</prism:aggregationType>
         <prism:publicationName>European Heart Journal: Acute Cardiovascular Care</prism:publicationName>
         <prism:copyright>© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology.</prism:copyright>
         <prism:issn>2048-8726</prism:issn>
         <prism:elssn>2048-8734</prism:elssn>
         <prism:volume>11</prism:volume>
         <prism:number>10</prism:number>
         <prism:issueName/>
         <prism:startingPage>731</prism:startingPage>
         <prism:endingPage>738</prism:endingPage>
         <prism:doi>10.1093/ehjacc/zuac096</prism:doi>
         <prism:url>https://doi.org/10.1093/ehjacc/zuac096</prism:url>
         <xmp:CreateDate>2022-10-31T09:26:00+05:30</xmp:CreateDate>
         <xmp:ModifyDate>2022-11-02T11:14:40+05:30</xmp:ModifyDate>
         <xmp:CreatorTool>Servigistics Arbortext Advanced Print Publisher 11.1.4546/W-x64</xmp:CreatorTool>
         <xmp:MetadataDate>2022-11-02T11:14:40+05:30</xmp:MetadataDate>
         <pdfx:EPSprocessor>PStill version 1.84.42</pdfx:EPSprocessor>
         <pdfuaid:part>1</pdfuaid:part>
         <pdfaExtension:schemas>
            <rdf:Bag>
               <rdf:li rdf:parseType="Resource">
                  <pdfaSchema:schema>PDF/UA Universal Accessibility Schema</pdfaSchema:schema>
                  <pdfaSchema:namespaceURI>http://www.aiim.org/pdfua/ns/id/</pdfaSchema:namespaceURI>
                  <pdfaSchema:prefix>pdfuaid</pdfaSchema:prefix>
                  <pdfaSchema:property>
                     <rdf:Seq>
                        <rdf:li rdf:parseType="Resource">
                           <pdfaProperty:name>part</pdfaProperty:name>
                           <pdfaProperty:valueType>Integer</pdfaProperty:valueType>
                           <pdfaProperty:category>internal</pdfaProperty:category>
                           <pdfaProperty:description>Indicates, which part of ISO 14289 standard is followed</pdfaProperty:description>
                        </rdf:li>
                     </rdf:Seq>
                  </pdfaSchema:property>
               </rdf:li>
            </rdf:Bag>
         </pdfaExtension:schemas>
      </rdf:Description>
   </rdf:RDF>
</x:xmpmeta>
   Pages: 
    Page: 
     Sequence: 1
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 133, 580, 143, 590
       Flags: Print
      Annotation: 
       Subtype: Link
       Rect: 385, 580, 395, 590
       Flags: Print
      Annotation: 
       Subtype: Link
       Rect: 142, 532, 152, 542
       Flags: Print
      Annotation: 
       Subtype: Link
       Rect: 266, 81, 324, 88
       Flags: Print
      Annotation: 
       Subtype: Link
       Rect: 383, 63, 514, 70
       Flags: Print
      Annotation: 
       Subtype: Link
       Rect: 138, 727, 267, 736
       Flags: Print
    Page: 
     Sequence: 2
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 206, 287, 209, 296
       Flags: Print
       Destination: 25
      Annotation: 
       Subtype: Link
       Rect: 91, 256, 94, 265
       Flags: Print
       Destination: 25
      Annotation: 
       Subtype: Link
       Rect: 95, 256, 99, 265
       Flags: Print
       Destination: 25
      Annotation: 
       Subtype: Link
       Rect: 57, 214, 60, 223
       Flags: Print
       Destination: null
      Annotation: 
       Subtype: Link
       Rect: 64, 214, 67, 223
       Flags: Print
       Destination: null
      Annotation: 
       Subtype: Link
       Rect: 258, 203, 261, 212
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 262, 203, 266, 212
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 267, 203, 274, 212
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 523, 333, 529, 342
       Flags: Print
       Destination: 28
    Page: 
     Sequence: 3
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 253, 654, 259, 662
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 284, 354, 291, 363
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 144, 144, 169, 153
       Flags: Print
       Destination: 10
      Annotation: 
       Subtype: Link
       Rect: 318, 725, 345, 734
       Flags: Print
       Destination: 10
      Annotation: 
       Subtype: Link
       Rect: 370, 652, 395, 661
       Flags: Print
       Destination: 10
      Annotation: 
       Subtype: Link
       Rect: 358, 458, 384, 467
       Flags: Print
       Destination: 10
      Annotation: 
       Subtype: Link
       Rect: 312, 416, 339, 425
       Flags: Print
       Destination: 17
      Annotation: 
       Subtype: Link
       Rect: 495, 343, 522, 352
       Flags: Print
       Destination: 17
      Annotation: 
       Subtype: Link
       Rect: 465, 127, 493, 136
       Flags: Print
       Destination: 17
      Annotation: 
       Subtype: Link
       Rect: 384, 106, 528, 115
       Flags: Print
      Annotation: 
       Subtype: Link
       Rect: 312, 53, 339, 62
       Flags: Print
       Destination: 21
    Page: 
     Sequence: 4
    Page: 
     Sequence: 5
    Page: 
     Sequence: 6
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 265, 90, 269, 99
       Flags: Print
       Destination: 25
      Annotation: 
       Subtype: Link
       Rect: 270, 90, 277, 99
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 278, 90, 285, 99
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 172, 58, 175, 67
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 177, 58, 184, 67
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 465, 152, 472, 161
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 389, 121, 396, 130
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 433, 100, 437, 109
       Flags: Print
       Destination: 25
    Page: 
     Sequence: 7
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 115, 698, 118, 707
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 120, 698, 127, 707
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 129, 687, 132, 696
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 143, 540, 150, 549
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 59, 488, 65, 497
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 456, 708, 463, 717
       Flags: Print
       Destination: 28
      Annotation: 
       Subtype: Link
       Rect: 309, 555, 395, 564
       Flags: Print
      Annotation: 
       Subtype: Link
       Rect: 313, 189, 316, 196
       Flags: Print
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 313, 162, 316, 169
       Flags: Print
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 313, 144, 316, 151
       Flags: Print
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 313, 126, 316, 133
       Flags: Print
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 313, 99, 316, 106
       Flags: Print
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 313, 72, 316, 79
       Flags: Print
       Destination: 1
    Page: 
     Sequence: 8
     Annotations: 
      Annotation: 
       Subtype: Link
       Rect: 40, 709, 43, 716
       Flags: Print
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 40, 682, 43, 689
       Flags: Print
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 40, 646, 43, 653
       Flags: Print
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 36, 610, 43, 617
       Flags: Print
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 36, 574, 43, 581
       Flags: Print
       Destination: 1
      Annotation: 
       Subtype: Link
       Rect: 36, 538, 43, 545
       Flags: Print
       Destination: 5
      Annotation: 
       Subtype: Link
       Rect: 36, 511, 43, 518
       Flags: Print
       Destination: 21
      Annotation: 
       Subtype: Link
       Rect: 303, 727, 310, 734
       Flags: Print
       Destination: 21
      Annotation: 
       Subtype: Link
       Rect: 303, 690, 310, 697
       Flags: Print
       Destination: 21
      Annotation: 
       Subtype: Link
       Rect: 303, 643, 310, 650
       Flags: Print
       Destination: 21
      Annotation: 
       Subtype: Link
       Rect: 303, 615, 310, 622
       Flags: Print
       Destination: 21
      Annotation: 
       Subtype: Link
       Rect: 303, 569, 310, 576
       Flags: Print
       Destination: 25
      Annotation: 
       Subtype: Link
       Rect: 303, 541, 310, 548
       Flags: Print
       Destination: 25
  Checksum: 801a6bba
   Type: CRC32
  Checksum: 0d5f39a9fd2e6cdc97a2191a66c8ce45
   Type: MD5
  Checksum: 336518492e1deaa1bd414b9fe149ab7c5128dbaf
   Type: SHA-1