70d6b719c6578b501054b3ad082844e9 134_2025_Article_7903.pdf 8f55bf1d8fba65dc0dbb7bec207b4a916df8a6da 134_2025_Article_7903.pdf 65c1a8389af3b8aa17f054bdc30fc74b65eedcf6c9f311583516196a37feda02 134_2025_Article_7903.pdf Title: How to approach a patient hospitalized for pneumonia who is not responding to treatment? Subject: Intensive Care Medicine, https://doi.org/10.1007/s00134-025-07903-3 Keywords: Pneumonia; Community-acquired pneumonia; Hospital-acquired pneumonia; Ventilator-associated pneumonia; Nonresponding pneumonia; Management Author: Pedro Povoa Creator: Springer Producer: Acrobat Distiller 10.1.8 (Windows) CreationDate: Thu Jul 10 10:19:41 2025 CEST ModDate: Thu Jul 10 10:23:12 2025 CEST Custom Metadata: yes Metadata Stream: yes Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 790.866 pts Page rot: 0 File size: 1980716 bytes Optimized: yes PDF version: 1.4 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- MyriadPro-It Type 1C WinAnsi yes no yes 856 0 MyriadPro-Regular Type 1C Custom yes no yes 857 0 MyriadPro-Bold Type 1C Custom yes no yes 858 0 MyriadPro-Light Type 1C Custom yes no yes 870 0 MyriadPro-LightIt Type 1C WinAnsi yes no yes 877 0 MyriadPro-Semibold Type 1C Custom yes no yes 878 0 WarnockPro-Regular Type 1C Custom yes no yes 366 0 WarnockPro-It Type 1C Custom yes no yes 426 0 MyriadPro-SemiboldIt Type 1C Custom yes no yes 465 0 PZHLFJ+STIX-Regular Type 1C WinAnsi yes yes yes 553 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-06-04 04:10:21 CEST RepresentationInformation: 134_2025_Article_7903.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-06-03 14:29:01 CEST Size: 1980716 Format: PDF Version: 1.4 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf Profile: Linearized PDF PDFMetadata: Objects: 971 FreeObjects: 1 IncrementalUpdates: 1 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: false CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseOutlines Language: EN Outlines: Item: Title: How to approach a patient hospitalized for pneumonia who is not responding to treatment? Children: Item: Title: Abstract Item: Title: Introduction Item: Title: How and when to define a non-responder? Item: Title: What is the frequency of non-responders? Item: Title: Which factors are important to determine non-response? Item: Title: Approach to the patient with unresponsive pneumonia – differential diagnosis Children: Item: Title: Expected recovery time Item: Title: Diagnostic approach Children: Item: Title: Re-evaluation of the initial diagnosis of pneumonia Item: Title: Septic complication Item: Title: Wrong diagnosis Item: Title: Diagnostic work-up of non-responding patient with pneumonia Children: Item: Title: Review of patient medical history Item: Title: Imaging modalities Item: Title: Laboratory studies Item: Title: What to do with antibiotic therapy? Item: Title: Conclusion Item: Title: References Info: Title: How to approach a patient hospitalized for pneumonia who is not responding to treatment? Author: Pedro Povoa Subject: Intensive Care Medicine, https://doi.org/10.1007/s00134-025-07903-3 Keywords: Pneumonia; Community-acquired pneumonia; Hospital-acquired pneumonia; Ventilator-associated pneumonia; Nonresponding pneumonia; Management Creator: Springer Producer: Acrobat Distiller 10.1.8 (Windows) CreationDate: Thu Jul 10 10:49:41 CEST 2025 ModDate: Thu Jul 10 10:53:12 CEST 2025 ID: 0xe2ca74d0edef4342b706a9c61592e71e, 0x514c06f525f68843bbca88a9ebbe6c09 Filters: FilterPipeline: FlateDecode Images: Image: NisoImageMetadata: FormatName: image/png ImageWidth: 1500 ImageHeight: 840 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Filter: FlateDecode Intent: RelativeColorimetric Name: X Image: NisoImageMetadata: FormatName: image/png ImageWidth: 1961 ImageHeight: 1247 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Filter: FlateDecode Intent: RelativeColorimetric Name: X Fonts: Type1: Font: BaseFont: MyriadPro-SemiboldIt FirstChar: 0 LastChar: 255 FontDescriptor: FontName: MyriadPro-SemiboldIt Flags: Nonsymbolic, Italic FontBBox: -193, -250, 1164, 972 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: MyriadPro-Light FirstChar: 0 LastChar: 255 FontDescriptor: FontName: MyriadPro-Light Flags: Nonsymbolic FontBBox: -49, -250, 1046, 883 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: MyriadPro-It FirstChar: 0 LastChar: 255 FontDescriptor: FontName: MyriadPro-It Flags: Nonsymbolic, Italic FontBBox: -185, -250, 1090, 953 FontFile3: true Encoding: WinAnsiEncoding ToUnicode: true Font: BaseFont: MyriadPro-Regular FirstChar: 0 LastChar: 255 FontDescriptor: FontName: MyriadPro-Regular Flags: Nonsymbolic FontBBox: -157, -250, 1126, 952 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: PZHLFJ+STIX-Regular FontSubset: true FirstChar: 32 LastChar: 177 FontDescriptor: FontName: PZHLFJ+STIX-Regular Flags: Serif, Nonsymbolic FontBBox: -970, -486, 2208, 1023 FontFile3: true Encoding: WinAnsiEncoding ToUnicode: true Font: BaseFont: MyriadPro-Bold FirstChar: 0 LastChar: 255 FontDescriptor: FontName: MyriadPro-Bold Flags: Nonsymbolic FontBBox: -163, -250, 1256, 989 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: WarnockPro-It FirstChar: 0 LastChar: 255 FontDescriptor: FontName: WarnockPro-It Flags: Serif, Nonsymbolic, Italic FontBBox: -221, -533, 1474, 950 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: MyriadPro-LightIt FirstChar: 0 LastChar: 255 FontDescriptor: FontName: MyriadPro-LightIt Flags: Nonsymbolic, Italic FontBBox: -121, -250, 1007, 863 FontFile3: true Encoding: WinAnsiEncoding ToUnicode: true Font: BaseFont: MyriadPro-Semibold FirstChar: 0 LastChar: 255 FontDescriptor: FontName: MyriadPro-Semibold Flags: Nonsymbolic FontBBox: -161, -250, 1198, 972 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true Font: BaseFont: WarnockPro-Regular FirstChar: 0 LastChar: 255 FontDescriptor: FontName: WarnockPro-Regular Flags: Serif, Nonsymbolic FontBBox: -177, -533, 1474, 950 FontFile3: true EncodingDictionary: BaseEncoding: WinAnsiEncoding Differences: true ToUnicode: true XMP: 2025-07-10T13:49:41+05:30 Springer 2025-07-10T13:53:12+05:30 2025-07-10T13:53:12+05:30 Acrobat Distiller 10.1.8 (Windows) Pneumonia; Community-acquired pneumonia; Hospital-acquired pneumonia; Ventilator-associated pneumonia; Nonresponding pneumonia; Management False application/pdf https://doi.org/10.1007/s00134-025-07903-3 Springer Berlin Heidelberg Intensive Care Medicine, https://doi.org/10.1007/s00134-025-07903-3 Pneumonia Community-acquired pneumonia Hospital-acquired pneumonia Ventilator-associated pneumonia Nonresponding pneumonia Management How to approach a patient hospitalized for pneumonia who is not responding to treatment? Pedro Povoa Luís Coelho Jordi Carratala Kelly Cawcutt Sara E. Cosgrove Ricard Ferrer Carlos A. Gomez Michael Klompas Thiago Lisboa Ignacio Martin-Loeches Saad Nseir Jorge I. F. Salluh Sias Scherger Daniel A. Sweeney Andre C. Kalil 10.1007/s00134-025-07903-3 2010-04-23 true springer.com springerlink.com https://doi.org/10.1007/s00134-025-07903-3 10.1007/s00134-025-07903-3 1432-1238 journal Intensive Care Medicine The Author(s) 2010-04-23 true 10.1007/s00134-025-07903-3 noindex springer.com springerlink.com CVoR uuid:b0b03ebd-44f3-4e4b-8b6e-79c74e4d572f uuid:a9f1bf12-1227-47b6-9113-6e473b3c0c7c default 1 converted uuid:b0b03ebd-44f3-4e4b-8b6e-79c74e4d572f converted to PDF/A-2b pdfToolbox 2025-07-10T13:52:30+05:30 converted uuid:370d84ef-3bb2-4b00-9e1e-e49a4cce5131 converted to PDF/A-2b pdfToolbox 2025-07-10T13:53:12+05:30 2 B Pedro Povoa http://orcid.org/0000-0002-7069-7304 Luís Coelho http://orcid.org/0000-0003-0701-3624 Jordi Carratala http://orcid.org/0000-0003-3209-2563 Kelly Cawcutt http://orcid.org/0000-0003-3586-0951 Sara E. Cosgrove http://orcid.org/0000-0001-9458-4331 Ricard Ferrer http://orcid.org/0000-0002-4859-4747 Carlos A. Gomez http://orcid.org/0000-0001-5486-5710 Michael Klompas http://orcid.org/0000-0001-8641-4498 Thiago Lisboa http://orcid.org/0000-0003-4306-2212 Ignacio Martin-Loeches http://orcid.org/0000-0002-5834-4063 Saad Nseir http://orcid.org/0000-0002-7618-0357 Jorge I. F. Salluh http://orcid.org/0000-0002-8164-1453 Sias Scherger http://orcid.org/0000-0003-3299-855X Daniel A. Sweeney http://orcid.org/0000-0002-5398-3528 Andre C. Kalil http://orcid.org/0000-0002-6489-6294 http://ns.adobe.com/pdfx/1.3/ pdfx Adobe Document Info PDF eXtension Schema external Mirrors crossmark:MajorVersionDate CrossmarkMajorVersionDate Text external Mirrors crossmark:CrossmarkDomainExclusive CrossmarkDomainExclusive Text internal Mirrors crossmark:DOI doi Text external Mirrors crossmark:CrosMarkDomains CrossMarkDomains seq Text internal A name object indicating whether the document has been modified to include trapping information robots Text internal ID of PDF/X standard GTS_PDFXVersion Text internal Conformance level of PDF/X standard GTS_PDFXConformance Text internal Company creating the PDF Company Text internal Date when document was last modified SourceModified Text http://crossref.org/crossmark/1.0/ crossmark Crossmark Schema internal Usual same as prism:doi DOI Text external The date when a publication was publishe. MajorVersionDate Text internal CrossmarkDomainExclusive CrossmarkDomainExclusive Text internal CrossMarkDomains CrossMarkDomains seq Text http://prismstandard.org/namespaces/basic/2.0/ prism Prism Schema external This element provides the url for an article or unit of content. The attribute platform is optionally allowed for situations in which multiple URLs must be specified. PRISM recommends that a subset of the PCV platform values, namely “mobile” and “web”, be used in conjunction with this element. NOTE: PRISM recommends against the use of the #other value allowed in the PRISM Platform controlled vocabulary. In lieu of using #other please reach out to the PRISM group at prism-wg@yahoogroups.com to request addition of your term to the Platform Controlled Vocabulary. url URI external The Digital Object Identifier for the article. The DOI may also be used as the dc:identifier. If used as a dc:identifier, the URI form should be captured, and the bare identifier should also be captured using prism:doi. If an alternate unique identifier is used as the required dc:identifier, then the DOI should be specified as a bare identifier within prism:doi only. If the URL associated with a DOI is to be specified, then prism:url may be used in conjunction with prism:doi in order to provide the service endpoint (i.e. the URL). doi Text external ISSN for an electronic version of the issue in which the resource occurs. Permits publishers to include a second ISSN, identifying an electronic version of the issue in which the resource occurs (therefore e(lectronic)Issn. If used, prism:eIssn MUST contain the ISSN of the electronic version. issn Text internal Volume number volume Text internal Issue number number Text internal Starting page startingPage Text internal Ending page endingPage Text external The aggregation type specifies the unit of aggregation for a content collection. Comment PRISM recommends that the PRISM Aggregation Type Controlled Vocabulary be used to provide values for this element. Note: PRISM recommends against the use of the #other value currently allowed in this controlled vocabulary. In lieu of using #other please reach out to the PRISM group at info@prismstandard.org to request addition of your term to the Aggregation Type Controlled Vocabulary. aggregationType Text external Title of the magazine, or other publication, in which a resource was/will be published. Typically this will be used to provide the name of the magazine an article appeared in as metadata for the article, along with information such as the article title, the publisher, volume, number, and cover date. Note: Publication name can be used to differentiate between a print magazine and the online version if the names are different such as “magazine” and “magazine.com.” publicationName Text external Copyright copyright Text http://ns.adobe.com/pdf/1.3/ pdf Adobe PDF Schema internal A name object indicating whether the document has been modified to include trapping information Trapped Text http://ns.adobe.com/xap/1.0/mm/ xmpMM XMP Media Management Schema internal UUID based identifier for specific incarnation of a document InstanceID URI internal The common identifier for all versions and renditions of a document. DocumentID URI internal The common identifier for all versions and renditions of a document. OriginalDocumentID URI internal A reference to the original document from which this one is derived. It is a minimal reference; missing components can be assumed to be unchanged. For example, a new version might only need to specify the instance ID and version number of the previous version, or a rendition might only need to specify the instance ID and rendition class of the original. DerivedFrom ResourceRef Identifies a portion of a document. This can be a position at which the document has been changed since the most recent event history (stEvt:changed). For a resource within an xmpMM:Ingredients list, the ResourceRef uses this type to identify both the portion of the containing document that refers to the resource, and the portion of the referenced resource that is referenced. http://ns.adobe.com/xap/1.0/sType/Part# stPart Part http://www.aiim.org/pdfa/ns/id/ pdfaid PDF/A ID Schema internal Part of PDF/A standard part Integer internal Amendment of PDF/A standard amd Text internal Conformance level of PDF/A standard conformance Text Springer Nature ORCID Schema http://springernature.com/ns/xmpExtensions/2.0/ sn authorInfo Bag AuthorInformation external Author information: contains the name of each author and his/her ORCiD (ORCiD: Open Researcher and Contributor ID). An ORCiD is a persistent identifier (a non-proprietary alphanumeric code) to uniquely identify scientific and other academic authors. AuthorInformation http://springernature.com/ns/xmpExtensions/2.0/authorInfo/ author Specifies the types of author information: name and ORCID of an author. name Text Gives the name of an author. orcid URI Gives the ORCID of an author. http://ns.adobe.com/xap/1.0/t/pg/ xmpTPg XMP Paged-Text internal XMP08 Spec: An ordered array of plate names that are needed to print the document (including any in contained documents). PlateNames Seq Text http://www.niso.org/schemas/jav/1.0/ jav NISO external Values for Journal Article Version are one of the following: AO = Author’s Original SMUR = Submitted Manuscript Under Review AM = Accepted Manuscript P = Proof VoR = Version of Record CVoR = Corrected Version of Record EVoR = Enhanced Version of Record journal_article_version Closed Choice of Text Pages: Page: Label: 893 Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 507, 683, 540, 650 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 126, 586, 139, 574 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 199, 586, 211, 574 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 293, 586, 306, 574 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 370, 586, 382, 574 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 462, 586, 474, 574 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 125, 572, 138, 560 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 218, 572, 230, 560 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 322, 572, 334, 560 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 412, 572, 424, 560 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 165, 558, 177, 546 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 240, 558, 252, 546 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 334, 558, 346, 546 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 412, 558, 424, 546 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 514, 558, 526, 546 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 139, 544, 151, 532 Flags: Print AppearanceDictionary: true Thumb: true Page: Label: 894 Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 125, 643, 130, 631 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 106, 607, 111, 595 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 280, 559, 285, 547 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 79, 511, 84, 499 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 90, 511, 95, 499 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 206, 487, 216, 475 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 163, 463, 173, 451 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 178, 463, 188, 451 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 182, 415, 187, 403 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 192, 415, 202, 403 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 251, 355, 256, 343 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 341, 434, 346, 422 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 374, 434, 379, 422 Flags: Print AppearanceDictionary: true Destination: 1 Annotation: Subtype: Link Rect: 388, 398, 393, 386 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 398, 398, 403, 386 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 409, 398, 413, 386 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 531, 350, 536, 338 Flags: Print AppearanceDictionary: true Destination: 145 Thumb: true Page: Label: 895 Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 56, 704, 61, 692 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 67, 704, 72, 692 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 78, 704, 88, 692 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 253, 644, 258, 632 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 262, 644, 272, 632 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 277, 644, 287, 632 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 84, 632, 89, 620 Flags: Print AppearanceDictionary: true Destination: 24 Annotation: Subtype: Link Rect: 204, 584, 209, 572 Flags: Print AppearanceDictionary: true Destination: 1 Annotation: Subtype: Link Rect: 107, 548, 117, 536 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 123, 548, 133, 536 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 167, 548, 172, 536 Flags: Print AppearanceDictionary: true Destination: 24 Annotation: Subtype: Link Rect: 181, 488, 191, 476 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 198, 488, 208, 476 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 252, 392, 262, 380 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 189, 272, 199, 260 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 469, 680, 479, 668 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 487, 680, 497, 668 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 393, 656, 403, 644 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 408, 656, 418, 644 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 395, 428, 405, 416 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 328, 392, 338, 380 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 353, 344, 358, 332 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 363, 344, 373, 332 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 418, 272, 423, 260 Flags: Print AppearanceDictionary: true Destination: 53 Thumb: true Page: Label: 896 Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 143, 282, 153, 270 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 159, 282, 169, 270 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 230, 162, 240, 150 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 100, 102, 110, 90 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 477, 282, 487, 270 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 332, 234, 342, 222 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 372, 174, 382, 162 Flags: Print AppearanceDictionary: true Destination: 219 Thumb: true Page: Label: 897 Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 140, 609, 150, 596 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 236, 573, 241, 560 Flags: Print AppearanceDictionary: true Destination: 24 Annotation: Subtype: Link Rect: 249, 573, 259, 560 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 242, 441, 252, 428 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 59, 393, 69, 380 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 74, 393, 84, 380 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 131, 316, 136, 304 Flags: Print AppearanceDictionary: true Destination: 53 Annotation: Subtype: Link Rect: 262, 244, 267, 232 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 199, 84, 209, 72 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 431, 633, 436, 620 Flags: Print AppearanceDictionary: true Destination: 24 Annotation: Subtype: Link Rect: 473, 633, 478, 620 Flags: Print AppearanceDictionary: true Destination: 53 Annotation: Subtype: Link Rect: 530, 510, 535, 498 Flags: Print AppearanceDictionary: true Destination: 53 Annotation: Subtype: Link Rect: 307, 498, 317, 486 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 323, 498, 333, 486 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 355, 366, 365, 354 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 485, 330, 490, 318 Flags: Print AppearanceDictionary: true Destination: 53 Annotation: Subtype: Link Rect: 510, 270, 520, 258 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 424, 172, 434, 160 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 448, 88, 453, 76 Flags: Print AppearanceDictionary: true Destination: 145 Thumb: true Page: Label: 898 Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 245, 669, 255, 657 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 280, 597, 285, 585 Flags: Print AppearanceDictionary: true Destination: 53 Annotation: Subtype: Link Rect: 228, 549, 237, 537 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 270, 391, 274, 379 Flags: Print AppearanceDictionary: true Destination: 53 Annotation: Subtype: Link Rect: 197, 222, 207, 210 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 205, 186, 216, 174 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 181, 138, 186, 126 Flags: Print AppearanceDictionary: true Destination: 53 Annotation: Subtype: Link Rect: 401, 681, 411, 668 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 417, 681, 427, 668 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 402, 621, 412, 608 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 336, 489, 347, 476 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 353, 489, 363, 476 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 308, 453, 318, 440 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 492, 405, 497, 392 Flags: Print AppearanceDictionary: true Destination: 53 Annotation: Subtype: Link Rect: 343, 296, 348, 284 Flags: Print AppearanceDictionary: true Destination: 53 Annotation: Subtype: Link Rect: 327, 272, 337, 260 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 342, 272, 352, 260 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 357, 272, 367, 260 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 372, 272, 382, 260 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 423, 224, 433, 212 Flags: Print AppearanceDictionary: true Destination: 219 Thumb: true Page: Label: 899 Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 143, 489, 153, 476 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 158, 489, 168, 476 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 191, 453, 201, 440 Flags: Print AppearanceDictionary: true Destination: 145 Annotation: Subtype: Link Rect: 206, 393, 216, 380 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 217, 285, 227, 272 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 93, 201, 103, 188 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 275, 177, 285, 164 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 341, 597, 350, 584 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 523, 573, 533, 560 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 353, 441, 363, 428 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 367, 441, 377, 428 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 383, 417, 393, 404 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 397, 417, 407, 404 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 412, 417, 422, 404 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 421, 177, 426, 164 Flags: Print AppearanceDictionary: true Destination: 53 Thumb: true Page: Label: 900 Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 185, 585, 195, 572 Flags: Print AppearanceDictionary: true Destination: 219 Annotation: Subtype: Link Rect: 200, 585, 210, 572 Flags: Print AppearanceDictionary: true Destination: 312 Annotation: Subtype: Link Rect: 256, 513, 265, 500 Flags: Print AppearanceDictionary: true Destination: 312 Annotation: Subtype: Link Rect: 85, 465, 94, 452 Flags: Print AppearanceDictionary: true Destination: 312 Annotation: Subtype: Link Rect: 100, 465, 110, 452 Flags: Print AppearanceDictionary: true Destination: 312 Annotation: Subtype: Link Rect: 144, 105, 154, 92 Flags: Print AppearanceDictionary: true Destination: 312 Thumb: true Page: Label: 901 Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 181, 442, 282, 434 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 56, 433, 99, 425 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 300, 189, 292 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 123, 273, 254, 265 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 198, 246, 285, 238 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 237, 107, 229 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 264, 210, 286, 202 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 201, 185, 193 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 228, 174, 283, 166 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 165, 142, 157 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 171, 138, 290, 130 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 160, 111, 281, 103 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 171, 84, 290, 76 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 676, 452, 668 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 408, 658, 537, 650 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 484, 622, 530, 614 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 613, 378, 605 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 498, 577, 531, 569 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 568, 420, 560 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 453, 541, 525, 533 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 532, 380, 524 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 441, 505, 530, 497 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 496, 344, 488 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 469, 440, 461 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 476, 451, 530, 443 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 442, 397, 434 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 357, 406, 517, 398 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 399, 379, 533, 371 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 370, 346, 362 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 357, 343, 497, 335 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 458, 316, 532, 308 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 307, 366, 299 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 357, 280, 489, 272 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 484, 253, 530, 245 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 244, 395, 236 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 208, 455, 200 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 384, 181, 503, 173 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 154, 448, 146 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 452, 136, 524, 128 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 127, 365, 119 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 461, 100, 532, 92 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 91, 380, 83 Flags: Print AppearanceDictionary: true Thumb: true Page: Label: 902 Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 191, 676, 265, 668 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 667, 134, 659 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 239, 595, 287, 587 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 586, 160, 578 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 550, 218, 542 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 110, 505, 237, 497 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 110, 469, 277, 461 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 442, 208, 434 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 257, 406, 280, 398 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 397, 175, 389 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 199, 370, 276, 362 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 361, 126, 353 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 181, 343, 276, 335 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 334, 123, 326 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 166, 298, 284, 290 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 289, 82, 281 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 156, 235, 285, 227 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 226, 94, 218 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 199, 286, 191 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 190, 269, 182 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 181, 267, 173 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 172, 201, 164 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 152, 154, 271, 146 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 86, 118, 208, 110 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 221, 91, 277, 83 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 82, 165, 74 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 676, 465, 668 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 658, 432, 650 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 503, 640, 537, 632 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 631, 410, 623 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 408, 604, 534, 596 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 595, 342, 587 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 362, 559, 502, 551 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 481, 532, 537, 524 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 523, 390, 515 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 470, 496, 527, 488 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 487, 400, 479 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 389, 460, 525, 452 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 451, 335, 443 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 415, 424, 528, 416 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 415, 330, 407 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 458, 388, 532, 380 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 379, 386, 371 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 443, 352, 533, 344 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 343, 356, 335 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 445, 316, 532, 308 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 307, 343, 299 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 262, 431, 254 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 373, 235, 524, 227 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 467, 199, 524, 191 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 190, 400, 182 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 497, 163, 531, 155 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 154, 407, 146 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 395, 118, 528, 110 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 109, 354, 101 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 365, 73, 502, 65 Flags: Print AppearanceDictionary: true Thumb: true Page: Label: 903 Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 71, 676, 210, 668 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 210, 640, 285, 632 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 71, 631, 137, 623 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 514, 703, 536, 695 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 694, 402, 686 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 319, 667, 467, 659 Flags: Print AppearanceDictionary: true Annotation: Subtype: Link Rect: 357, 640, 479, 632 Flags: Print AppearanceDictionary: true Thumb: true Checksum: 69267617 Type: CRC32 Checksum: 70d6b719c6578b501054b3ad082844e9 Type: MD5 Checksum: 8f55bf1d8fba65dc0dbb7bec207b4a916df8a6da Type: SHA-1 Checksum: 65c1a8389af3b8aa17f054bdc30fc74b65eedcf6c9f311583516196a37feda02 Type: SHA-256