10d447914051ecc84d6873932fdec840 nutrients_15_04109_v2.pdf 44bcf47b34db4321853065dad53aca4b62860b74 nutrients_15_04109_v2.pdf 6d70e8bcccc367eb24ae3b1c6e391aa06018dce956c3443f034d54844f53f232 nutrients_15_04109_v2.pdf Title: The Relationship between Depressive Symptoms, Quality of Life and miRNAs 8 Years after Bariatric Surgery Subject: (1) Background: There are conflicting results on whether weight loss after bariatric surgery (BS) might be associated with quality of life (QoL)/depressive symptomatology. We aim to determine whether BS outcomes are associated with QoL/depressive symptomatology in studied patients at the 8-year follow-up after BS, as well as their relationship with different serum proteins and miRNAs. (2) Methods: A total of 53 patients with class III obesity who underwent BS, and then classified into “good responders” and “non-responders” depending on the percentage of excess weight lost (%EWL) 8 years after BS (%EWL 50% and %EWL < 50%, respectively), were included. Basal serum miRNAs and different proteins were analysed, and patients completed tests to evaluate QoL/depressive symptomatology at 8 years after BS. (3) Results: The good responders group showed higher scores on SF-36 scales of physical functioning, role functioning—physical, role functioning—emotional, body pain and global general health compared with the non-responders. The expression of hsa-miR-101-3p, hsa-miR-15a-5p, hsa-miR-29c-3p, hsa-miR-144-3p and hsa-miR-19b-3p were lower in non-responders. Hsa-miR-19b-3p was the variable associated with the response to BS in a logistic regression model. (4) Conclusions: The mental health of patients after BS is limited by the success of the intervention. In addition, the expression of basal serum miRNAs related to depression/anxiety could predict the success of BS. Keywords: bariatric surgery; class III obesity; quality of life; depressive symptoms; miRNAs Author: Virginia Mela, Zaida Agüera, Maria D. Alvarez-Bermudez, Flores Martín-Reyes, Roser Granero, Ana Sánchez-García, Wilfredo Oliva-Olivera, Monica Tomé, Francisco J. Moreno-Ruiz, Rocío Soler-Humanes, Jose L. Fernández-Serrano, Pilar Sánchez-Gallegos, Jose M. Martínez-Moreno, Raquel Sancho-Marín, Fernando Fernández-Aranda, Eduardo García-Fuentes, Francisco J. Tinahones and Lourdes Garrido-Sánchez Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Sep 25 10:03:41 2023 CEST ModDate: Mon Sep 25 10:23:20 2023 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 17 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2002037 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- IOJCNK+VnURWPalladioL-Bold Type 1 Custom yes yes no 10 0 YFNERV+VnURWPalladioL Type 1 Custom yes yes no 15 0 AGMJTZ+URWPalladioL-Bold Type 1 Custom yes yes no 19 0 GDFKRZ+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 HNGHXP+URWPalladioL-Ital Type 1 Custom yes yes no 28 0 UWJUYN+CMSY10 Type 1 Builtin yes yes no 32 0 HGMNRX+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 50 0 LHCXDL+EURM10 Type 1 Builtin yes yes no 72 0 IQDYOR+URWPalladioL-BoldItal Type 1 Custom yes yes no 85 0 FDFNHL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 105 0 FDFNHM+PalatinoLinotype CID TrueType Identity-H yes yes yes 108 0 FDFNIN+PalatinoLinotype TrueType WinAnsi yes yes no 114 0 FDFNIP+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 117 0 FDFOEM+PalatinoLinotype TrueType MacRoman yes yes no 120 0 FDFNHL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 135 0 FDFNHM+PalatinoLinotype CID TrueType Identity-H yes yes yes 138 0 FDFNIN+PalatinoLinotype TrueType WinAnsi yes yes no 144 0 FDFNIP+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 147 0 FDFOEM+PalatinoLinotype TrueType MacRoman yes yes no 150 0 FDFNHL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 165 0 FDFNHM+PalatinoLinotype CID TrueType Identity-H yes yes yes 168 0 FDFNIN+PalatinoLinotype TrueType WinAnsi yes yes no 174 0 FDFNIP+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 177 0 FDFOEM+PalatinoLinotype TrueType MacRoman yes yes no 180 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-10-11 02:22:38 CEST RepresentationInformation: nutrients_15_04109_v2.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-10-05 01:35:47 CEST Size: 2002037 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 462 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Material and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Participants Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Psychometric Instruments Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Biochemical Data Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: miRNAs Sequencing Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Statistical Analysis Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Children: Item: Title: Characteristics of Participants Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Quality of Life and Depression at 8-Year Follow-Up after BS Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Item: Title: Association between Serum Protein Levels before and after Surgery vs. Psychological Variables Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: Association between Serum Protein Levels before and after Surgery vs. Bariatric Surgery Outcome Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Item: Title: miRNA Levels as a Biomarker Predictor of Intervention Success in Patients with Class III Obesity Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@76a3e297 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@4d3167f4 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@ed9d034 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@6121c9d6 Info: Title: The Relationship between Depressive Symptoms, Quality of Life and miRNAs 8 Years after Bariatric Surgery Author: Virginia Mela, Zaida Agüera, Maria D. Alvarez-Bermudez, Flores Martín-Reyes, Roser Granero, Ana Sánchez-García, Wilfredo Oliva-Olivera, Monica Tomé, Francisco J. Moreno-Ruiz, Rocío Soler-Humanes, Jose L. Fernández-Serrano, Pilar Sánchez-Gallegos, Jose M. Martínez-Moreno, Raquel Sancho-Marín, Fernando Fernández-Aranda, Eduardo García-Fuentes, Francisco J. Tinahones and Lourdes Garrido-Sánchez Subject: (1) Background: There are conflicting results on whether weight loss after bariatric surgery (BS) might be associated with quality of life (QoL)/depressive symptomatology. We aim to determine whether BS outcomes are associated with QoL/depressive symptomatology in studied patients at the 8-year follow-up after BS, as well as their relationship with different serum proteins and miRNAs. (2) Methods: A total of 53 patients with class III obesity who underwent BS, and then classified into “good responders” and “non-responders” depending on the percentage of excess weight lost (%EWL) 8 years after BS (%EWL 50% and %EWL < 50%, respectively), were included. Basal serum miRNAs and different proteins were analysed, and patients completed tests to evaluate QoL/depressive symptomatology at 8 years after BS. (3) Results: The good responders group showed higher scores on SF-36 scales of physical functioning, role functioning physical, role functioning emotional, body pain and global general health compared with the non-responders. The expression of hsa-miR-101-3p, hsa-miR-15a-5p, hsa-miR-29c-3p, hsa-miR-144-3p and hsa-miR-19b-3p were lower in non-responders. Hsa-miR-19b-3p was the variable associated with the response to BS in a logistic regression model. (4) Conclusions: The mental health of patients after BS is limited by the success of the intervention. In addition, the expression of basal serum miRNAs related to depression/anxiety could predict the success of BS. Keywords: bariatric surgery; class III obesity; quality of life; depressive symptoms; miRNAs Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Mon Sep 25 10:03:41 CEST 2023 ModDate: Mon Sep 25 10:23:20 CEST 2023 ID: 0x86d4e45d0e30cdceef3fb1957797f00e, 0x86d4e45d0e30cdceef3fb1957797f00e Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: UWJUYN+CMSY10 FontSubset: true FirstChar: 0 LastChar: 21 FontDescriptor: FontName: UWJUYN+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: AGMJTZ+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 252 FontDescriptor: FontName: AGMJTZ+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: IQDYOR+URWPalladioL-BoldItal FontSubset: true FirstChar: 68 LastChar: 124 FontDescriptor: FontName: IQDYOR+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: GDFKRZ+URWPalladioL-Roma FontSubset: true FirstChar: 1 LastChar: 252 FontDescriptor: FontName: GDFKRZ+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: LHCXDL+EURM10 FontSubset: true FirstChar: 11 LastChar: 20 FontDescriptor: FontName: LHCXDL+EURM10 Flags: Symbolic FontBBox: -32, -243, 1060, 720 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: HNGHXP+URWPalladioL-Ital FontSubset: true FirstChar: 45 LastChar: 121 FontDescriptor: FontName: HNGHXP+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: YFNERV+VnURWPalladioL FontSubset: true FirstChar: 161 LastChar: 243 FontDescriptor: FontName: YFNERV+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 34, 281, 152, 290 Annotation: Subtype: Link Rect: 34, 271, 72, 278 Annotation: Subtype: Link Rect: 34, 164, 96, 186 Annotation: Subtype: Link Rect: 126, 90, 154, 99 Annotation: Subtype: Link Rect: 34, 78, 147, 87 Annotation: Subtype: Link Rect: 34, 756, 169, 792 Annotation: Subtype: Link Rect: 515, 756, 560, 792 Annotation: Subtype: Link Rect: 131, 661, 142, 674 Annotation: Subtype: Link Rect: 234, 661, 245, 674 Annotation: Subtype: Link Rect: 507, 661, 518, 674 Annotation: Subtype: Link Rect: 120, 649, 132, 662 Annotation: Subtype: Link Rect: 162, 623, 173, 637 Annotation: Subtype: Link Rect: 456, 623, 467, 637 Annotation: Subtype: Link Rect: 175, 611, 186, 624 Annotation: Subtype: Link Rect: 120, 17, 254, 28 Annotation: Subtype: Link Rect: 404, 17, 560, 28 Annotation: Subtype: Link Rect: 34, 414, 87, 433 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 494, 619, 501, 628 ActionDest: 194 Annotation: Subtype: Link Rect: 541, 594, 548, 603 ActionDest: 194 Annotation: Subtype: Link Rect: 549, 594, 556, 603 ActionDest: 194 Annotation: Subtype: Link Rect: 404, 556, 411, 565 ActionDest: 194 Annotation: Subtype: Link Rect: 411, 556, 418, 565 ActionDest: 194 Annotation: Subtype: Link Rect: 208, 518, 215, 528 ActionDest: 194 Annotation: Subtype: Link Rect: 448, 518, 455, 528 ActionDest: 194 Annotation: Subtype: Link Rect: 458, 518, 470, 528 ActionDest: 194 Annotation: Subtype: Link Rect: 225, 506, 237, 515 ActionDest: 194 Annotation: Subtype: Link Rect: 240, 506, 252, 515 ActionDest: 194 Annotation: Subtype: Link Rect: 544, 481, 556, 490 ActionDest: 194 Annotation: Subtype: Link Rect: 220, 443, 227, 452 ActionDest: 194 Annotation: Subtype: Link Rect: 339, 381, 351, 389 ActionDest: 194 Annotation: Subtype: Link Rect: 197, 355, 209, 364 ActionDest: 194 Annotation: Subtype: Link Rect: 393, 343, 405, 352 ActionDest: 194 Annotation: Subtype: Link Rect: 351, 330, 363, 339 ActionDest: 194 Annotation: Subtype: Link Rect: 363, 330, 375, 339 ActionDest: 197 Annotation: Subtype: Link Rect: 383, 318, 395, 327 ActionDest: 197 Annotation: Subtype: Link Rect: 231, 280, 243, 289 ActionDest: 197 Annotation: Subtype: Link Rect: 389, 268, 401, 276 ActionDest: 197 Annotation: Subtype: Link Rect: 292, 230, 304, 239 ActionDest: 194 Annotation: Subtype: Link Rect: 411, 179, 423, 189 ActionDest: 194 Annotation: Subtype: Link Rect: 521, 167, 528, 176 ActionDest: 194 Annotation: Subtype: Link Rect: 466, 155, 478, 163 ActionDest: 197 Annotation: Subtype: Link Rect: 262, 129, 274, 138 ActionDest: 197 Annotation: Subtype: Link Rect: 389, 92, 401, 101 ActionDest: 197 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 231, 735, 243, 744 ActionDest: 197 Annotation: Subtype: Link Rect: 318, 723, 330, 732 ActionDest: 197 Annotation: Subtype: Link Rect: 524, 723, 536, 732 ActionDest: 197 Annotation: Subtype: Link Rect: 349, 710, 361, 719 ActionDest: 197 Annotation: Subtype: Link Rect: 335, 685, 347, 694 ActionDest: 197 Annotation: Subtype: Link Rect: 206, 660, 218, 669 ActionDest: 197 Annotation: Subtype: Link Rect: 404, 635, 416, 644 ActionDest: 197 Annotation: Subtype: Link Rect: 408, 597, 420, 606 ActionDest: 197 Annotation: Subtype: Link Rect: 412, 535, 424, 544 ActionDest: 197 Annotation: Subtype: Link Rect: 424, 535, 436, 544 ActionDest: 197 Annotation: Subtype: Link Rect: 401, 509, 413, 519 ActionDest: 197 Annotation: Subtype: Link Rect: 413, 509, 425, 519 ActionDest: 197 Annotation: Subtype: Link Rect: 408, 484, 420, 493 ActionDest: 197 Annotation: Subtype: Link Rect: 309, 459, 321, 468 ActionDest: 197 Annotation: Subtype: Link Rect: 398, 169, 410, 178 ActionDest: 197 Annotation: Subtype: Link Rect: 544, 157, 556, 166 ActionDest: 197 Annotation: Subtype: Link Rect: 458, 69, 470, 78 ActionDest: 197 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 406, 619, 418, 628 ActionDest: 197 Annotation: Subtype: Link Rect: 345, 506, 357, 515 ActionDest: 197 Annotation: Subtype: Link Rect: 331, 66, 343, 75 ActionDest: 197 Annotation: Subtype: Link Rect: 343, 66, 355, 75 ActionDest: 197 Annotation: Subtype: Link Rect: 356, 66, 368, 75 ActionDest: 197 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 435, 735, 447, 744 ActionDest: 197 Annotation: Subtype: Link Rect: 447, 735, 459, 744 ActionDest: 197 Annotation: Subtype: Link Rect: 460, 736, 472, 744 ActionDest: 197 Annotation: Subtype: Link Rect: 430, 497, 442, 506 ActionDest: 197 Annotation: Subtype: Link Rect: 413, 380, 420, 392 ActionDest: 82 Annotation: Subtype: Link Rect: 526, 355, 533, 367 ActionDest: 82 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 212, 444, 220, 456 ActionDest: 89 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 346, 403, 353, 415 ActionDest: 92 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 479, 692, 486, 704 ActionDest: 95 Annotation: Subtype: Link Rect: 287, 667, 294, 679 ActionDest: 95 Annotation: Subtype: Link Rect: 339, 667, 346, 679 ActionDest: 95 Annotation: Subtype: Link Rect: 517, 174, 524, 186 ActionDest: 125 Annotation: Subtype: Link Rect: 461, 149, 468, 161 ActionDest: 125 Annotation: Subtype: Link Rect: 546, 124, 553, 136 ActionDest: 125 Annotation: Subtype: Link Rect: 328, 74, 335, 86 ActionDest: 125 Page: Sequence: 9 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 216, 707, 223, 719 ActionDest: 155 Annotation: Subtype: Link Rect: 374, 103, 381, 115 ActionDest: 155 Annotation: Subtype: Link Rect: 398, 90, 405, 102 ActionDest: 155 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 340, 657, 347, 669 ActionDest: 155 Annotation: Subtype: Link Rect: 281, 396, 293, 405 ActionDest: 194 Annotation: Subtype: Link Rect: 296, 396, 308, 405 ActionDest: 197 Annotation: Subtype: Link Rect: 309, 396, 321, 405 ActionDest: 200 Annotation: Subtype: Link Rect: 467, 271, 479, 280 ActionDest: 197 Annotation: Subtype: Link Rect: 544, 170, 556, 179 ActionDest: 200 Annotation: Subtype: Link Rect: 360, 145, 372, 154 ActionDest: 200 Annotation: Subtype: Link Rect: 283, 82, 295, 91 ActionDest: 200 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 260, 735, 272, 744 ActionDest: 200 Annotation: Subtype: Link Rect: 499, 698, 511, 707 ActionDest: 200 Annotation: Subtype: Link Rect: 301, 535, 313, 544 ActionDest: 200 Annotation: Subtype: Link Rect: 364, 522, 376, 531 ActionDest: 200 Annotation: Subtype: Link Rect: 469, 509, 481, 519 ActionDest: 200 Annotation: Subtype: Link Rect: 406, 447, 418, 456 ActionDest: 200 Annotation: Subtype: Link Rect: 468, 397, 479, 406 ActionDest: 197 Annotation: Subtype: Link Rect: 368, 384, 380, 393 ActionDest: 197 Annotation: Subtype: Link Rect: 425, 321, 437, 330 ActionDest: 200 Annotation: Subtype: Link Rect: 243, 309, 255, 318 ActionDest: 200 Annotation: Subtype: Link Rect: 430, 309, 442, 318 ActionDest: 200 Annotation: Subtype: Link Rect: 384, 283, 396, 293 ActionDest: 200 Annotation: Subtype: Link Rect: 439, 246, 450, 255 ActionDest: 200 Annotation: Subtype: Link Rect: 409, 233, 421, 242 ActionDest: 200 Annotation: Subtype: Link Rect: 544, 221, 556, 230 ActionDest: 200 Page: Sequence: 13 Annotations: Annotation: Subtype: Link Rect: 413, 673, 425, 682 ActionDest: 194 Annotation: Subtype: Link Rect: 403, 660, 415, 669 ActionDest: 200 Annotation: Subtype: Link Rect: 544, 647, 556, 657 ActionDest: 200 Annotation: Subtype: Link Rect: 470, 610, 482, 619 ActionDest: 200 Annotation: Subtype: Link Rect: 481, 585, 493, 594 ActionDest: 200 Annotation: Subtype: Link Rect: 481, 572, 493, 581 ActionDest: 200 Annotation: Subtype: Link Rect: 496, 572, 508, 581 ActionDest: 200 Annotation: Subtype: Link Rect: 219, 560, 231, 569 ActionDest: 200 Annotation: Subtype: Link Rect: 234, 560, 246, 569 ActionDest: 200 Annotation: Subtype: Link Rect: 313, 484, 325, 493 ActionDest: 203 Annotation: Subtype: Link Rect: 201, 434, 213, 443 ActionDest: 203 Annotation: Subtype: Link Rect: 214, 434, 226, 443 ActionDest: 203 Annotation: Subtype: Link Rect: 264, 422, 276, 431 ActionDest: 203 Annotation: Subtype: Link Rect: 471, 422, 483, 431 ActionDest: 203 Annotation: Subtype: Link Rect: 377, 397, 389, 406 ActionDest: 203 Annotation: Subtype: Link Rect: 526, 257, 560, 268 Annotation: Subtype: Link Rect: 165, 245, 359, 256 Page: Sequence: 14 Annotations: Annotation: Subtype: Link Rect: 336, 549, 560, 560 Annotation: Subtype: Link Rect: 56, 538, 154, 549 Annotation: Subtype: Link Rect: 280, 503, 318, 514 Annotation: Subtype: Link Rect: 324, 503, 360, 514 Annotation: Subtype: Link Rect: 219, 469, 257, 480 Annotation: Subtype: Link Rect: 263, 469, 299, 480 Annotation: Subtype: Link Rect: 418, 434, 455, 445 Annotation: Subtype: Link Rect: 462, 434, 498, 445 Annotation: Subtype: Link Rect: 277, 411, 315, 422 Annotation: Subtype: Link Rect: 321, 411, 357, 422 Annotation: Subtype: Link Rect: 478, 388, 515, 399 Annotation: Subtype: Link Rect: 521, 388, 557, 399 Annotation: Subtype: Link Rect: 59, 354, 96, 364 Annotation: Subtype: Link Rect: 102, 354, 138, 364 Annotation: Subtype: Link Rect: 131, 320, 168, 330 Annotation: Subtype: Link Rect: 175, 320, 211, 330 Annotation: Subtype: Link Rect: 519, 284, 557, 295 Annotation: Subtype: Link Rect: 392, 250, 429, 261 Annotation: Subtype: Link Rect: 260, 215, 298, 226 Annotation: Subtype: Link Rect: 108, 182, 146, 192 Annotation: Subtype: Link Rect: 152, 182, 188, 192 Annotation: Subtype: Link Rect: 271, 158, 309, 169 Annotation: Subtype: Link Rect: 315, 158, 351, 169 Annotation: Subtype: Link Rect: 399, 135, 436, 146 Annotation: Subtype: Link Rect: 442, 135, 478, 146 Annotation: Subtype: Link Rect: 361, 112, 399, 123 Annotation: Subtype: Link Rect: 405, 112, 441, 123 Annotation: Subtype: Link Rect: 469, 89, 506, 100 Annotation: Subtype: Link Rect: 513, 89, 549, 100 Annotation: Subtype: Link Rect: 147, 67, 184, 77 Annotation: Subtype: Link Rect: 190, 67, 226, 77 Page: Sequence: 15 Annotations: Annotation: Subtype: Link Rect: 118, 711, 155, 721 Annotation: Subtype: Link Rect: 161, 711, 197, 721 Annotation: Subtype: Link Rect: 420, 687, 458, 698 Annotation: Subtype: Link Rect: 404, 664, 442, 675 Annotation: Subtype: Link Rect: 309, 629, 347, 640 Annotation: Subtype: Link Rect: 59, 607, 96, 617 Annotation: Subtype: Link Rect: 520, 595, 557, 606 Annotation: Subtype: Link Rect: 59, 584, 95, 594 Annotation: Subtype: Link Rect: 293, 560, 330, 571 Annotation: Subtype: Link Rect: 336, 560, 372, 571 Annotation: Subtype: Link Rect: 160, 538, 198, 548 Annotation: Subtype: Link Rect: 204, 538, 240, 548 Annotation: Subtype: Link Rect: 99, 504, 137, 514 Annotation: Subtype: Link Rect: 346, 480, 384, 491 Annotation: Subtype: Link Rect: 390, 480, 426, 491 Annotation: Subtype: Link Rect: 328, 445, 365, 456 Annotation: Subtype: Link Rect: 199, 411, 237, 422 Annotation: Subtype: Link Rect: 482, 388, 520, 399 Annotation: Subtype: Link Rect: 297, 365, 335, 376 Annotation: Subtype: Link Rect: 108, 331, 146, 341 Annotation: Subtype: Link Rect: 152, 331, 188, 341 Annotation: Subtype: Link Rect: 131, 308, 168, 318 Annotation: Subtype: Link Rect: 175, 308, 211, 318 Annotation: Subtype: Link Rect: 118, 274, 155, 284 Annotation: Subtype: Link Rect: 161, 274, 197, 284 Annotation: Subtype: Link Rect: 285, 250, 323, 261 Annotation: Subtype: Link Rect: 329, 250, 365, 261 Annotation: Subtype: Link Rect: 217, 227, 254, 238 Annotation: Subtype: Link Rect: 108, 193, 146, 203 Annotation: Subtype: Link Rect: 152, 193, 188, 203 Annotation: Subtype: Link Rect: 171, 170, 209, 180 Annotation: Subtype: Link Rect: 215, 170, 251, 180 Annotation: Subtype: Link Rect: 185, 146, 222, 157 Annotation: Subtype: Link Rect: 59, 124, 96, 134 Annotation: Subtype: Link Rect: 121, 90, 159, 100 Annotation: Subtype: Link Rect: 59, 67, 96, 77 Annotation: Subtype: Link Rect: 102, 67, 138, 77 Page: Sequence: 16 Annotations: Annotation: Subtype: Link Rect: 140, 722, 177, 733 Annotation: Subtype: Link Rect: 184, 722, 220, 733 Annotation: Subtype: Link Rect: 235, 687, 272, 698 Annotation: Subtype: Link Rect: 278, 687, 314, 698 Annotation: Subtype: Link Rect: 109, 653, 147, 664 Annotation: Subtype: Link Rect: 153, 653, 189, 664 Annotation: Subtype: Link Rect: 223, 629, 260, 640 Annotation: Subtype: Link Rect: 266, 629, 302, 640 Annotation: Subtype: Link Rect: 215, 607, 253, 617 Annotation: Subtype: Link Rect: 259, 607, 295, 617 Annotation: Subtype: Link Rect: 252, 584, 289, 594 Annotation: Subtype: Link Rect: 295, 584, 331, 594 Annotation: Subtype: Link Rect: 509, 560, 547, 571 Annotation: Subtype: Link Rect: 224, 538, 261, 548 Annotation: Subtype: Link Rect: 256, 514, 293, 525 Annotation: Subtype: Link Rect: 370, 491, 407, 502 Annotation: Subtype: Link Rect: 414, 491, 450, 502 Annotation: Subtype: Link Rect: 519, 468, 557, 479 Annotation: Subtype: Link Rect: 59, 458, 95, 468 Annotation: Subtype: Link Rect: 460, 434, 497, 445 Annotation: Subtype: Link Rect: 503, 434, 539, 445 Annotation: Subtype: Link Rect: 113, 412, 151, 422 Annotation: Subtype: Link Rect: 501, 330, 538, 341 Annotation: Subtype: Link Rect: 484, 307, 522, 318 Annotation: Subtype: Link Rect: 406, 284, 443, 295 Annotation: Subtype: Link Rect: 321, 250, 359, 261 Annotation: Subtype: Link Rect: 298, 215, 336, 226 Annotation: Subtype: Link Rect: 342, 215, 378, 226 Annotation: Subtype: Link Rect: 251, 181, 289, 192 Annotation: Subtype: Link Rect: 295, 181, 331, 192 Annotation: Subtype: Link Rect: 461, 146, 499, 157 Annotation: Subtype: Link Rect: 505, 146, 541, 157 Annotation: Subtype: Link Rect: 383, 112, 421, 123 Annotation: Subtype: Link Rect: 427, 112, 463, 123 Annotation: Subtype: Link Rect: 390, 89, 427, 100 Annotation: Subtype: Link Rect: 434, 89, 470, 100 Annotation: Subtype: Link Rect: 312, 66, 350, 77 Annotation: Subtype: Link Rect: 356, 66, 392, 77 Page: Sequence: 17 Annotations: Annotation: Subtype: Link Rect: 247, 722, 284, 733 Annotation: Subtype: Link Rect: 238, 699, 275, 710 Annotation: Subtype: Link Rect: 252, 687, 290, 698 Annotation: Subtype: Link Rect: 113, 653, 151, 664 Annotation: Subtype: Link Rect: 59, 619, 96, 629 Checksum: 7f81b259 Type: CRC32 Checksum: 10d447914051ecc84d6873932fdec840 Type: MD5 Checksum: 44bcf47b34db4321853065dad53aca4b62860b74 Type: SHA-1