16cff5d8868857651d93334ff3b1f010 nutrients-18-01370.pdf ad3d563713b1f7f5a0dfc0203732d68b1a849e3a nutrients-18-01370.pdf 046e244939adc965d1ea53dd37a00e351834abb3febd009c168b23bb05cd59a5 nutrients-18-01370.pdf Title: Uncertainty Meets Disordered Eating and Body Image:A Transdiagnostic Network Study Across Depressive, Anxiety and Anorexia Nervosa Symptoms Including a Control Group Subject: Background and objectives: Intolerance of uncertainty (IU) is a well-established transdiagnostic process in anxiety (ANX) and major depressive disorder (MDD), and has been increasingly implicated in anorexia nervosa (AN). However, most previous research including patients with AN has relied on total or subscale scores from eating disorder measures, which obscures how specific eating attitudes and body dissatisfaction symptoms relate to distinct facets of IU. The primary objective of the present study was to characterize item-level networks linking eating attitudes, body dissatisfaction, and IU in a pooled clinical mental health sample, alongside a control group (CG). Methods: Data were drawn from a sample including individuals with symptoms related to AN (N = 105), MDD (N = 97), and ANX (N = 240), a comorbid group (N = 84) with symptoms of two or more of these conditions, and a CG (N = 842). Separate item-level networks were estimated for clinical and control groups, and network structure and centrality indices were compared. Results: Network analyses revealed distinct organizational patterns between the clinical and control subsamples. Although both networks showed identical diameters, the clinical network exhibited a shorter average path length and higher clustering, indicating stronger local connectivity, whereas the control network showed higher modularity. In the clinical subsample, nodes related to binge eating, post-eating guilt, and IU emerged as the most central and acted as key connectors between clusters. In contrast, the control network displayed a more distributed centrality pattern, suggesting a more integrated and homogeneous network organization. Conclusions: This study provides new evidence to refine our understanding of how IU relates to eating attitudes and body dissatisfaction across diagnostic mental health boundaries. Identifying highly influential psychopathological symptoms across eating, mood, and anxiety disorders, as well as bridge nodes linking these mental health domains, is important for understanding transdiagnostic symptom dynamics. These insights may inform the development of more sensitive screening and diagnostic tools, as well as targeted intervention points to support more personalized and mechanism-focused treatments. Keywords: uncertainty; anorexia nervosa; anxiety; major depression; network analysis Author: Roser Granero, Isabel Krug and Litza Kiropoulos Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Mon Apr 27 11:08:56 2026 CEST ModDate: Mon Apr 27 11:12:21 2026 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 23 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 3926168 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- VYPWWJ+URWPalladioL-Bold Type 1 Custom yes yes yes 110 0 VRAVOJ+URWPalladioL-Roma Type 1 Custom yes yes yes 111 0 MIKRSI+VnURWPalladioL Type 1 Custom yes yes yes 112 0 MAOMOE+URWPalladioL-Ital Type 1 Custom yes yes yes 113 0 NKZTII+URWPalladioL-BoldItal Type 1 Custom yes yes yes 286 0 CKBPVA+EURM10 Type 1 Builtin yes yes yes 301 0 FXXUVH+CMSY10 Type 1 Builtin yes yes yes 325 0 IEJOGD+PalatinoLinotype TrueType WinAnsi yes yes no 319 0 BCDEEE+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 353 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 354 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 355 0 BCDNEE+ArialNarrow CID TrueType Identity-H yes yes yes 381 0 BCDMEE+Arial-BoldMT CID TrueType Identity-H yes yes yes 382 0 IEKAKL+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 361 0 IEJOGD+PalatinoLinotype TrueType WinAnsi yes yes no 362 0 IEKAKL+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 407 0 IEJOGD+PalatinoLinotype TrueType WinAnsi yes yes no 408 0 BCDLEE+PalatinoLinotype-BoldItalic TrueType WinAnsi yes yes no 428 0 BCDFEE+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 429 0 BCDGEE+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 430 0 BCDNEE+ArialNarrow CID TrueType Identity-H yes yes yes 467 0 BCDMEE+Arial-BoldMT CID TrueType Identity-H yes yes yes 468 0 IEKAKL+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 447 0 IEJOGD+PalatinoLinotype TrueType WinAnsi yes yes no 448 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2026-05-09 03:09:45 CEST RepresentationInformation: nutrients-18-01370.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2026-05-08 05:38:40 CEST Size: 3926168 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 791 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Materials and Methods Children: Item: Title: Participants and Procedure Item: Title: Measures Item: Title: Statistical Analysis Item: Title: Results Children: Item: Title: Results for the Clinical Subsample Item: Title: Results for the Control Subsample Item: Title: Comparison Between the Networks Item: Title: Discussion Children: Item: Title: Network in the Clinical Subsample Item: Title: Network in the Control Subsample Item: Title: Limitations and Strengths Item: Title: Implications Item: Title: References Info: Title: Uncertainty Meets Disordered Eating and Body Image:A Transdiagnostic Network Study Across Depressive, Anxiety and Anorexia Nervosa Symptoms Including a Control Group Author: Roser Granero, Isabel Krug and Litza Kiropoulos Subject: Background and objectives: Intolerance of uncertainty (IU) is a well-established transdiagnostic process in anxiety (ANX) and major depressive disorder (MDD), and has been increasingly implicated in anorexia nervosa (AN). However, most previous research including patients with AN has relied on total or subscale scores from eating disorder measures, which obscures how specific eating attitudes and body dissatisfaction symptoms relate to distinct facets of IU. The primary objective of the present study was to characterize item-level networks linking eating attitudes, body dissatisfaction, and IU in a pooled clinical mental health sample, alongside a control group (CG). Methods: Data were drawn from a sample including individuals with symptoms related to AN (N = 105), MDD (N = 97), and ANX (N = 240), a comorbid group (N = 84) with symptoms of two or more of these conditions, and a CG (N = 842). Separate item-level networks were estimated for clinical and control groups, and network structure and centrality indices were compared. Results: Network analyses revealed distinct organizational patterns between the clinical and control subsamples. Although both networks showed identical diameters, the clinical network exhibited a shorter average path length and higher clustering, indicating stronger local connectivity, whereas the control network showed higher modularity. In the clinical subsample, nodes related to binge eating, post-eating guilt, and IU emerged as the most central and acted as key connectors between clusters. In contrast, the control network displayed a more distributed centrality pattern, suggesting a more integrated and homogeneous network organization. Conclusions: This study provides new evidence to refine our understanding of how IU relates to eating attitudes and body dissatisfaction across diagnostic mental health boundaries. Identifying highly influential psychopathological symptoms across eating, mood, and anxiety disorders, as well as bridge nodes linking these mental health domains, is important for understanding transdiagnostic symptom dynamics. These insights may inform the development of more sensitive screening and diagnostic tools, as well as targeted intervention points to support more personalized and mechanism-focused treatments. Keywords: uncertainty; anorexia nervosa; anxiety; major depression; network analysis Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Mon Apr 27 11:08:56 CEST 2026 ModDate: Mon Apr 27 11:12:21 CEST 2026 ID: 0x1d4d118ebea7fa6bdb7dfca59f651ded, 0x93b27c6f7f9ce87755ba10f2f1ba6ae1 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: MIKRSI+VnURWPalladioL FontSubset: true FirstChar: 225 LastChar: 225 FontDescriptor: FontName: MIKRSI+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: MAOMOE+URWPalladioL-Ital FontSubset: true FirstChar: 2 LastChar: 237 FontDescriptor: FontName: MAOMOE+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: FXXUVH+CMSY10 FontSubset: true FirstChar: 0 LastChar: 0 FontDescriptor: FontName: FXXUVH+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true ToUnicode: true Font: BaseFont: CKBPVA+EURM10 FontSubset: true FirstChar: 11 LastChar: 11 FontDescriptor: FontName: CKBPVA+EURM10 Flags: Symbolic FontBBox: -32, -243, 1060, 720 FontFile: true ToUnicode: true Font: BaseFont: VYPWWJ+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 134 FontDescriptor: FontName: VYPWWJ+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: NKZTII+URWPalladioL-BoldItal FontSubset: true FirstChar: 78 LastChar: 110 FontDescriptor: FontName: NKZTII+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: VRAVOJ+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: VRAVOJ+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true ToUnicode: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 34, 204, 124, 223 Annotation: Subtype: Link Rect: 88, 77, 152, 84 Annotation: Subtype: Link Rect: 34, 64, 119, 72 Annotation: Subtype: Link Rect: 34, 773, 141, 809 Annotation: Subtype: Link Rect: 515, 773, 560, 809 Annotation: Subtype: Link Rect: 127, 643, 138, 656 Annotation: Subtype: Link Rect: 208, 643, 219, 656 Annotation: Subtype: Link Rect: 330, 643, 341, 656 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 335, 714, 342, 723 ActionDest: 74 Annotation: Subtype: Link Rect: 223, 658, 230, 667 ActionDest: 74 Annotation: Subtype: Link Rect: 307, 630, 314, 639 ActionDest: 74 Annotation: Subtype: Link Rect: 296, 574, 303, 583 ActionDest: 74 Annotation: Subtype: Link Rect: 306, 574, 313, 583 ActionDest: 74 Annotation: Subtype: Link Rect: 436, 561, 443, 569 ActionDest: 74 Annotation: Subtype: Link Rect: 446, 560, 453, 569 ActionDest: 74 Annotation: Subtype: Link Rect: 357, 519, 369, 528 ActionDest: 74 Annotation: Subtype: Link Rect: 372, 519, 384, 528 ActionDest: 74 Annotation: Subtype: Link Rect: 430, 449, 442, 458 ActionDest: 74 Annotation: Subtype: Link Rect: 442, 449, 454, 458 ActionDest: 181 Annotation: Subtype: Link Rect: 420, 435, 432, 444 ActionDest: 181 Annotation: Subtype: Link Rect: 435, 435, 447, 444 ActionDest: 181 Annotation: Subtype: Link Rect: 357, 407, 369, 416 ActionDest: 181 Annotation: Subtype: Link Rect: 372, 407, 384, 416 ActionDest: 181 Annotation: Subtype: Link Rect: 461, 379, 473, 388 ActionDest: 181 Annotation: Subtype: Link Rect: 473, 379, 485, 388 ActionDest: 181 Annotation: Subtype: Link Rect: 191, 310, 203, 319 ActionDest: 181 Annotation: Subtype: Link Rect: 206, 310, 218, 319 ActionDest: 181 Annotation: Subtype: Link Rect: 392, 310, 404, 319 ActionDest: 181 Annotation: Subtype: Link Rect: 238, 282, 250, 291 ActionDest: 181 Annotation: Subtype: Link Rect: 251, 282, 263, 291 ActionDest: 181 Annotation: Subtype: Link Rect: 531, 282, 543, 291 ActionDest: 181 Annotation: Subtype: Link Rect: 544, 282, 556, 291 ActionDest: 181 Annotation: Subtype: Link Rect: 238, 198, 250, 207 ActionDest: 181 Annotation: Subtype: Link Rect: 531, 171, 543, 180 ActionDest: 181 Annotation: Subtype: Link Rect: 544, 170, 556, 180 ActionDest: 181 Annotation: Subtype: Link Rect: 427, 129, 439, 138 ActionDest: 181 Annotation: Subtype: Link Rect: 439, 129, 451, 138 ActionDest: 181 Annotation: Subtype: Link Rect: 452, 129, 464, 138 ActionDest: 181 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 284, 717, 296, 726 ActionDest: 181 Annotation: Subtype: Link Rect: 544, 703, 556, 712 ActionDest: 181 Annotation: Subtype: Link Rect: 288, 675, 300, 684 ActionDest: 181 Annotation: Subtype: Link Rect: 298, 619, 310, 628 ActionDest: 181 Annotation: Subtype: Link Rect: 310, 619, 322, 628 ActionDest: 245 Annotation: Subtype: Link Rect: 292, 591, 304, 600 ActionDest: 245 Annotation: Subtype: Link Rect: 236, 564, 248, 572 ActionDest: 245 Annotation: Subtype: Link Rect: 249, 564, 260, 572 ActionDest: 245 Annotation: Subtype: Link Rect: 277, 508, 289, 517 ActionDest: 245 Annotation: Subtype: Link Rect: 289, 508, 301, 517 ActionDest: 245 Annotation: Subtype: Link Rect: 331, 480, 342, 489 ActionDest: 245 Annotation: Subtype: Link Rect: 343, 480, 355, 489 ActionDest: 245 Annotation: Subtype: Link Rect: 481, 424, 493, 433 ActionDest: 245 Annotation: Subtype: Link Rect: 493, 424, 505, 433 ActionDest: 245 Annotation: Subtype: Link Rect: 496, 410, 508, 419 ActionDest: 245 Annotation: Subtype: Link Rect: 214, 341, 226, 350 ActionDest: 245 Annotation: Subtype: Link Rect: 421, 313, 433, 322 ActionDest: 245 Annotation: Subtype: Link Rect: 185, 257, 197, 266 ActionDest: 245 Annotation: Subtype: Link Rect: 197, 257, 209, 266 ActionDest: 245 Annotation: Subtype: Link Rect: 447, 229, 459, 238 ActionDest: 245 Annotation: Subtype: Link Rect: 259, 201, 271, 210 ActionDest: 245 Annotation: Subtype: Link Rect: 274, 201, 286, 210 ActionDest: 245 Annotation: Subtype: Link Rect: 378, 173, 389, 182 ActionDest: 245 Annotation: Subtype: Link Rect: 390, 173, 402, 182 ActionDest: 245 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 209, 744, 221, 754 ActionDest: 245 Annotation: Subtype: Link Rect: 224, 744, 236, 754 ActionDest: 245 Annotation: Subtype: Link Rect: 346, 703, 358, 712 ActionDest: 272 Annotation: Subtype: Link Rect: 358, 703, 370, 712 ActionDest: 272 Annotation: Subtype: Link Rect: 243, 647, 255, 656 ActionDest: 272 Annotation: Subtype: Link Rect: 255, 647, 267, 656 ActionDest: 272 Annotation: Subtype: Link Rect: 208, 619, 220, 628 ActionDest: 272 Annotation: Subtype: Link Rect: 264, 591, 276, 600 ActionDest: 272 Annotation: Subtype: Link Rect: 277, 591, 289, 600 ActionDest: 272 Annotation: Subtype: Link Rect: 289, 591, 301, 600 ActionDest: 272 Annotation: Subtype: Link Rect: 203, 549, 215, 559 ActionDest: 272 Annotation: Subtype: Link Rect: 216, 550, 228, 559 ActionDest: 272 Annotation: Subtype: Link Rect: 471, 466, 483, 475 ActionDest: 272 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 219, 548, 233, 559 ActionDest: 24 Annotation: Subtype: Link Rect: 421, 533, 428, 545 ActionDest: 131 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 328, 700, 340, 709 ActionDest: 272 Annotation: Subtype: Link Rect: 345, 630, 357, 639 ActionDest: 272 Annotation: Subtype: Link Rect: 379, 546, 391, 556 ActionDest: 272 Annotation: Subtype: Link Rect: 417, 367, 429, 376 ActionDest: 272 Annotation: Subtype: Link Rect: 386, 228, 398, 237 ActionDest: 272 Annotation: Subtype: Link Rect: 295, 74, 307, 83 ActionDest: 272 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 217, 418, 224, 430 ActionDest: 42 Annotation: Subtype: Link Rect: 217, 307, 224, 319 ActionDest: 332 Annotation: Subtype: Link Rect: 549, 223, 556, 235 ActionDest: 333 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 553, 154, 560, 166 ActionDest: 46 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 432, 756, 439, 768 ActionDest: 334 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 549, 323, 555, 335 ActionDest: 424 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 13 Annotations: Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 14 Annotations: Annotation: Subtype: Link Rect: 482, 146, 494, 155 ActionDest: 272 Annotation: Subtype: Link Rect: 272, 104, 284, 113 ActionDest: 272 Annotation: Subtype: Link Rect: 544, 76, 556, 85 ActionDest: 272 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 15 Annotations: Annotation: Subtype: Link Rect: 543, 745, 555, 754 ActionDest: 181 Annotation: Subtype: Link Rect: 211, 717, 223, 726 ActionDest: 272 Annotation: Subtype: Link Rect: 223, 717, 235, 726 ActionDest: 272 Annotation: Subtype: Link Rect: 447, 703, 459, 712 ActionDest: 272 Annotation: Subtype: Link Rect: 192, 675, 199, 684 ActionDest: 74 Annotation: Subtype: Link Rect: 544, 647, 556, 656 ActionDest: 272 Annotation: Subtype: Link Rect: 347, 577, 359, 586 ActionDest: 272 Annotation: Subtype: Link Rect: 263, 522, 275, 531 ActionDest: 272 Annotation: Subtype: Link Rect: 531, 452, 543, 461 ActionDest: 272 Annotation: Subtype: Link Rect: 544, 452, 556, 461 ActionDest: 272 Annotation: Subtype: Link Rect: 429, 396, 441, 405 ActionDest: 272 Annotation: Subtype: Link Rect: 491, 216, 503, 226 ActionDest: 272 Annotation: Subtype: Link Rect: 226, 161, 238, 170 ActionDest: 540 Annotation: Subtype: Link Rect: 203, 133, 215, 142 ActionDest: 540 Annotation: Subtype: Link Rect: 241, 119, 253, 128 ActionDest: 540 Annotation: Subtype: Link Rect: 269, 91, 281, 100 ActionDest: 540 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 16 Annotations: Annotation: Subtype: Link Rect: 531, 661, 543, 670 ActionDest: 540 Annotation: Subtype: Link Rect: 544, 661, 556, 670 ActionDest: 540 Annotation: Subtype: Link Rect: 543, 619, 555, 628 ActionDest: 540 Annotation: Subtype: Link Rect: 280, 591, 292, 600 ActionDest: 540 Annotation: Subtype: Link Rect: 293, 591, 305, 600 ActionDest: 540 Annotation: Subtype: Link Rect: 284, 536, 296, 545 ActionDest: 540 Annotation: Subtype: Link Rect: 549, 480, 556, 489 ActionDest: 74 Annotation: Subtype: Link Rect: 496, 438, 508, 447 ActionDest: 181 Annotation: Subtype: Link Rect: 248, 382, 260, 391 ActionDest: 181 Annotation: Subtype: Link Rect: 376, 76, 388, 85 ActionDest: 272 Annotation: Subtype: Link Rect: 388, 76, 400, 85 ActionDest: 272 Annotation: Subtype: Link Rect: 401, 76, 413, 85 ActionDest: 272 Annotation: Subtype: Link Rect: 413, 76, 425, 85 ActionDest: 540 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 17 Annotations: Annotation: Subtype: Link Rect: 539, 744, 556, 754 ActionDest: 540 Annotation: Subtype: Link Rect: 417, 703, 428, 712 ActionDest: 272 Annotation: Subtype: Link Rect: 429, 703, 446, 712 ActionDest: 540 Annotation: Subtype: Link Rect: 446, 703, 463, 712 ActionDest: 540 Annotation: Subtype: Link Rect: 526, 661, 538, 670 ActionDest: 272 Annotation: Subtype: Link Rect: 539, 661, 556, 670 ActionDest: 540 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 18 Annotations: Annotation: Subtype: Link Rect: 526, 185, 560, 196 Annotation: Subtype: Link Rect: 165, 171, 358, 182 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 19 Annotations: Annotation: Subtype: Link Rect: 252, 425, 290, 436 Annotation: Subtype: Link Rect: 296, 425, 332, 436 Annotation: Subtype: Link Rect: 238, 399, 275, 410 Annotation: Subtype: Link Rect: 206, 374, 244, 385 Annotation: Subtype: Link Rect: 192, 348, 229, 359 Annotation: Subtype: Link Rect: 185, 323, 223, 334 Annotation: Subtype: Link Rect: 361, 297, 398, 308 Annotation: Subtype: Link Rect: 519, 284, 557, 295 Annotation: Subtype: Link Rect: 519, 259, 557, 270 Annotation: Subtype: Link Rect: 59, 247, 95, 257 Annotation: Subtype: Link Rect: 274, 220, 311, 231 Annotation: Subtype: Link Rect: 235, 195, 272, 206 Annotation: Subtype: Link Rect: 278, 195, 314, 206 Annotation: Subtype: Link Rect: 104, 158, 142, 168 Annotation: Subtype: Link Rect: 148, 158, 184, 168 Annotation: Subtype: Link Rect: 436, 131, 474, 142 Annotation: Subtype: Link Rect: 235, 106, 272, 117 Annotation: Subtype: Link Rect: 279, 106, 315, 117 Annotation: Subtype: Link Rect: 59, 68, 96, 78 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 20 Annotations: Annotation: Subtype: Link Rect: 59, 731, 96, 742 Annotation: Subtype: Link Rect: 368, 705, 406, 716 Annotation: Subtype: Link Rect: 300, 679, 338, 690 Annotation: Subtype: Link Rect: 394, 654, 431, 665 Annotation: Subtype: Link Rect: 221, 616, 258, 627 Annotation: Subtype: Link Rect: 264, 616, 300, 627 Annotation: Subtype: Link Rect: 95, 578, 133, 588 Annotation: Subtype: Link Rect: 139, 578, 175, 588 Annotation: Subtype: Link Rect: 464, 552, 501, 563 Annotation: Subtype: Link Rect: 333, 526, 371, 537 Annotation: Subtype: Link Rect: 377, 526, 413, 537 Annotation: Subtype: Link Rect: 444, 501, 481, 512 Annotation: Subtype: Link Rect: 170, 463, 208, 473 Annotation: Subtype: Link Rect: 374, 437, 412, 448 Annotation: Subtype: Link Rect: 178, 411, 215, 422 Annotation: Subtype: Link Rect: 453, 386, 491, 397 Annotation: Subtype: Link Rect: 303, 360, 341, 371 Annotation: Subtype: Link Rect: 347, 360, 383, 371 Annotation: Subtype: Link Rect: 59, 323, 96, 333 Annotation: Subtype: Link Rect: 310, 284, 347, 295 Annotation: Subtype: Link Rect: 354, 284, 390, 295 Annotation: Subtype: Link Rect: 364, 258, 402, 269 Annotation: Subtype: Link Rect: 408, 258, 444, 269 Annotation: Subtype: Link Rect: 156, 221, 193, 231 Annotation: Subtype: Link Rect: 414, 194, 452, 205 Annotation: Subtype: Link Rect: 318, 170, 355, 180 Annotation: Subtype: Link Rect: 362, 170, 398, 180 Annotation: Subtype: Link Rect: 519, 156, 557, 167 Annotation: Subtype: Link Rect: 59, 144, 95, 154 Annotation: Subtype: Link Rect: 470, 118, 508, 129 Annotation: Subtype: Link Rect: 514, 118, 550, 129 Annotation: Subtype: Link Rect: 386, 92, 423, 103 Annotation: Subtype: Link Rect: 192, 67, 230, 78 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 21 Annotations: Annotation: Subtype: Link Rect: 397, 743, 435, 754 Annotation: Subtype: Link Rect: 441, 743, 477, 754 Annotation: Subtype: Link Rect: 86, 719, 124, 729 Annotation: Subtype: Link Rect: 130, 719, 166, 729 Annotation: Subtype: Link Rect: 488, 679, 525, 690 Annotation: Subtype: Link Rect: 425, 654, 462, 665 Annotation: Subtype: Link Rect: 489, 628, 527, 639 Annotation: Subtype: Link Rect: 104, 578, 141, 588 Annotation: Subtype: Link Rect: 147, 578, 183, 588 Annotation: Subtype: Link Rect: 292, 552, 330, 563 Annotation: Subtype: Link Rect: 336, 552, 372, 563 Annotation: Subtype: Link Rect: 181, 514, 219, 524 Annotation: Subtype: Link Rect: 417, 488, 455, 499 Annotation: Subtype: Link Rect: 452, 462, 490, 473 Annotation: Subtype: Link Rect: 86, 425, 124, 435 Annotation: Subtype: Link Rect: 520, 399, 557, 410 Annotation: Subtype: Link Rect: 489, 373, 526, 384 Annotation: Subtype: Link Rect: 415, 347, 453, 358 Annotation: Subtype: Link Rect: 472, 322, 509, 333 Annotation: Subtype: Link Rect: 459, 296, 496, 307 Annotation: Subtype: Link Rect: 181, 259, 218, 269 Annotation: Subtype: Link Rect: 224, 259, 260, 269 Annotation: Subtype: Link Rect: 139, 221, 176, 231 Annotation: Subtype: Link Rect: 183, 221, 219, 231 Annotation: Subtype: Link Rect: 357, 182, 394, 193 Annotation: Subtype: Link Rect: 400, 182, 436, 193 Annotation: Subtype: Link Rect: 432, 156, 469, 167 Annotation: Subtype: Link Rect: 59, 119, 96, 129 Annotation: Subtype: Link Rect: 514, 92, 551, 103 Annotation: Subtype: Link Rect: 346, 67, 384, 78 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 22 Annotations: Annotation: Subtype: Link Rect: 311, 743, 349, 754 Annotation: Subtype: Link Rect: 395, 731, 433, 742 Annotation: Subtype: Link Rect: 406, 705, 443, 716 Annotation: Subtype: Link Rect: 449, 705, 485, 716 Annotation: Subtype: Link Rect: 465, 680, 503, 690 Annotation: Subtype: Link Rect: 509, 680, 545, 690 Annotation: Subtype: Link Rect: 496, 654, 534, 665 Annotation: Subtype: Link Rect: 220, 628, 257, 639 Annotation: Subtype: Link Rect: 410, 603, 447, 614 Annotation: Subtype: Link Rect: 59, 578, 96, 588 Annotation: Subtype: Link Rect: 286, 552, 324, 563 Annotation: Subtype: Link Rect: 330, 552, 366, 563 Annotation: Subtype: Link Rect: 240, 526, 278, 537 Annotation: Subtype: Link Rect: 185, 501, 223, 512 Annotation: Subtype: Link Rect: 229, 501, 265, 512 Annotation: Subtype: Link Rect: 351, 475, 389, 486 Annotation: Subtype: Link Rect: 395, 475, 431, 486 Annotation: Subtype: Link Rect: 108, 450, 146, 461 Annotation: Subtype: Link Rect: 152, 450, 188, 461 Annotation: Subtype: Link Rect: 59, 412, 96, 422 Annotation: Subtype: Link Rect: 421, 399, 459, 410 Annotation: Subtype: Link Rect: 156, 373, 193, 384 Annotation: Subtype: Link Rect: 393, 347, 430, 358 Annotation: Subtype: Link Rect: 100, 323, 137, 333 Annotation: Subtype: Link Rect: 489, 296, 527, 307 Annotation: Subtype: Link Rect: 417, 271, 454, 282 Annotation: Subtype: Link Rect: 293, 245, 331, 256 Annotation: Subtype: Link Rect: 183, 220, 221, 231 Annotation: Subtype: Link Rect: 182, 182, 220, 193 Annotation: Subtype: Link Rect: 113, 157, 150, 167 Annotation: Subtype: Link Rect: 350, 130, 388, 141 Annotation: Subtype: Link Rect: 131, 106, 168, 116 Annotation: Subtype: Link Rect: 294, 79, 331, 90 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Page: Sequence: 23 Annotations: Annotation: Subtype: Link Rect: 174, 731, 211, 742 Annotation: Subtype: Link Rect: 218, 731, 254, 742 Annotation: Subtype: Link Rect: 280, 692, 318, 703 Annotation: Subtype: Link Rect: 324, 692, 360, 703 Annotation: Subtype: Link Rect: 226, 654, 264, 665 Annotation: Subtype: Link Rect: 59, 616, 96, 627 Annotation: Subtype: Link Rect: 102, 616, 138, 627 Annotation: Subtype: Link Rect: 519, 590, 557, 601 Annotation: Subtype: Link Rect: 59, 578, 95, 588 Annotation: Subtype: Link Rect: 519, 552, 557, 563 Annotation: Subtype: Link Rect: 347, 526, 383, 537 Annotation: Subtype: Link Rect: 517, 501, 554, 512 Annotation: Subtype: Link Rect: 448, 475, 485, 486 Annotation: Subtype: Link Rect: 492, 475, 528, 486 Annotation: Subtype: Link Rect: 59, 450, 96, 461 Annotation: Subtype: Link Rect: 90, 425, 128, 435 Annotation: Subtype: Link Rect: 250, 399, 288, 410 Annotation: Subtype: Link Rect: 256, 373, 293, 384 Annotation: Subtype: Link Rect: 267, 347, 304, 358 Annotation: Subtype: Link Rect: 426, 27, 560, 37 Checksum: 45f665fc Type: CRC32 Checksum: 16cff5d8868857651d93334ff3b1f010 Type: MD5 Checksum: ad3d563713b1f7f5a0dfc0203732d68b1a849e3a Type: SHA-1 Checksum: 046e244939adc965d1ea53dd37a00e351834abb3febd009c168b23bb05cd59a5 Type: SHA-256