ࡱ> 'uwNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrst` TbjbjDR`"4|`|år5$Y-h,åPPC***"PZ*** nw܎ @6\ 0}|&Y0}% %% mpݹ *  mmmdmmmqPPPPPP  Review  SEQ CHAPTER \h \r 1Complications in Adult Cardiac Surgery - A General Overview A. Thomas Pezzella, MD Founder/Director International Childrens Heart Fund Director Special Projects, World Heart Foundation __________ Contact: A. Thomas Pezzella, M.D. 17 Shamrock Street Worcester, MA 01605 508-791-1951 (office)  HYPERLINK "mailto:tpezzella@hotmail.com" tpezzella@hotmail.com Abstract Cardiac Surgery has made significant advances over the past fifty years. Over 700,000 adult cardiac operations are performed annually in the USA and more than 700,000 worldwide. Despite increasing age, complexity, and comorbidity, the results have continued to improve. This is due, in large measure, to the specific areas of improvement and experience in preoperative selection and preparation; operative advances, especially in monitoring, anesthesia, surgical skill, techniques and technology, cardiopulmonary bypass; and postoperative care, particularly in the intensive care environment. This review will focus on the general advances in the understanding of complications, risk assessment, quality assurance, and the emergence of evidence based medicine as a powerful tool to apply objective data to best practice medicine and prevention of mistakes, errors, near misses and complications. Key Words: Adult Cardiac Surgery; Complications; Mistakes; Errors; Quality Assurance; Risk Assessment; Evidence Based Medicine Outline Introduction Complications/Mortality Strategic/Organizational Initiatives Tactical/Managerial Initiatives Pre-operative phase Risk Assessment/Severity Scores Operative phase Postoperative phase Long Term Results Cost Evidence based medicine Quality Assurance/Quality Improvement I keep six honest serving-men (They taught me all I knew); Their names are What and Why and When and How and Where and Who Rudyard Kipling INTRODUCTION Cardiac surgery had its formal beginning in the early 20th century. Ludwig Rehn was the first to successfully suture a penetrating wound of the heart in 1896, although Ansel Cappelen first closed a bleeding ventricular wound in 1894 with the postoperative death probably related to coronary injury and hemorrhagic shock.(1) Interestingly, it is not uncommon for unsuccessful firsts not to be accorded the usual accolades befitting their accomplishments.(( Subsequently, closed cardiac procedures evolved in the first half of the century, notably closure of patent ductus arterious, Blalock Taussig shunt, repair of coarctation, and closed approaches to the mitral and pulmonic valve.(2) Cardiac surgery utilizing cardiopulmonary bypass (CPB) dominated the second half of the 20th century, following a brief period of remarkable clinical series utilizing systemic hypothermia,(3) or cross circulation approaches.(4) Since the first successful closure of an atrial septal defect (ASD) utilizing cardiopulmonary bypass (CBP) by John Gibbon at Jefferson University in Philadelphia, in 1953,(5) the number of adult operations utilizing CPB has grown to a present annual rate of over 700,000 cases in the USA with the majority being coronary artery bypass grafting (CABG)(6) (figure one). Worldwide the total number of procedures utilizing CPB including both adult and pediatric populations is estimated at 1.2-1.4 million patients per year. Another 3,000 or more cardiac surgeons in another 1,000 centers complete the global picture. Kirklin in 1990,(7) summarized the previous 25 years in cardiac surgery to include technical and scientific advances in support systems, hospital environment, surgical procedures, myocardial management or protection, and the developing systems of comparison and prediction. This has burgeoned to include cost analysis, given the escalating costs (figure 1), risk stratification and management, outcomes and quality assurance. It is this latter concern that has dominated the literature in recent years. Relman stressed this in his concept of the three recent revolutions in medical care: 1950-1970 as the era of expansion; 1971-1985 as the revolt of payers; and 1986 to the present as the outcome movement.(8) This outcome movement has generated a whole new vocabulary ranging from risk to quality assurance, to outcome evaluation and analysis, and ultimately quality of life issues. Unfortunately the language of advertising, marketing, providers, clients, product lines, networking and consortiums have also brought into healthcare the whole aspect of medicine and health care delivery as a major business enterprise with costs and profits/losses on a par with quality of care and medical outcomes. Public awareness and a perceived need for accountability has burgeoned into a major catalyst and driving force. The emergence of internet access and web based groups has spawned a large scale overseeing of health care activity with subsequent unregulated reporting of outcomes and results. Despite this scrutiny, increased knowledge, experience, maturity, judgment, technical advances, and improved skills have made open-heart surgery safer, efficient, cost effective, and more readily available, with subsequent decreases in overall mortality. At the national level, the Society of Thoracic Surgery (STS) National Cardiac Database reports a raw operative mortality for cardiac surgery in the USA of less than 5% with isolated CABG mortality under 3%.(9) (www.ctsnet.org/doc/2988) This has been corroborated at the regional, state, Veterans Administration (VA) and institutional levels. Representative institutional experiences are summarized in (figure 2 a, b). Morbidity, however, is noted in 25-40% of patients undergoing cardiac surgery with individual incidences of specific complications in the 0-5% range (figure 3 a, b). This has gradually increased with changing demographics (age, sex, body surface area, body mass index), complex cardiac pathology with decreased left ventricular (LV) function, and increasing associated comorbidy. This has led to subsequent increased lengths of stay (LOS), organ failure, transfers to chronic health facilities, and increasing readmission rates. (Table 1) In short, higher risk patients are surviving with attendant increases in morbidity, yet ultimate increase in survival, albeit with long term quality of life issues and challenges. Preoperative selection and preparation, diagnostic sophistication, improved and advanced operative approaches and technique, and advances in the intensive care unit (ICU) have contributed to this continued effort. Better knowledge of the pathophysiology of the disease process, advanced monitoring, and improved and more effective medications, especially anesthetic agents, have dramatically stabilized and improved the perioperative care of patients. Improved diagnostic support, especially at the bedside, along with increasing electronic interface, bedside computerized nursing, and more reliable point of care testing are becoming valuable components of the standardized critical pathways.(( The application of risk analysis, best practice or evidence based medicine (EBM), along with emerging guidelines and algorithms will continue to help cardiac surgeons give better care to their patients and help avoid or decrease ontoward results, ie. complications, in this increasing group of challenging patients. Complications Against this background of advances in cardiac surgery with higher risk groups is the increased focus on quality assurance, outcomes and costs, along with the stress and agony of poor results or complications. Traditionally it is the cardiac surgeon who, as the head of the team, is perceived as the most culpable or responsible for ontoward results. Surgeons have been most mindful of this accountability and responsibility. It has been the careful analysis of complications with emphasis on prediction, avoidance, recognition and treatment through the medium of the traditional morbidity/mortality conferences (M&M) that has advanced the quality of surgery in the USA and worldwide through the years. The report of the Institute of Medicine, To Error is Human, focused national attention on the potentially harmful effects of human error in medicine, noting 44,000 to 98,000 deaths occurring annually due to medical errors.(14) The incidence of iatrogenic deaths and society cost from all causes may be even higher (Table 2). The public and press, especially with the burgeoning internet access have demanded increased knowledge and information re. outcomes and results (Table 3, 4). The bottom line is the perception, or, in fact, the reality that safety and quality are of major concern to the general public. A detailed analysis of complications is thus warranted to help us better predict, prevent, recognize, and treat complications. Three aspects of ontoward results or complications need to be examined: human factors, errors and complications. Carthey et al(15) have summarized nicely the aspects of the human factor in cardiac surgery. They utilized the concepts of institutional and individual differences in surgical performance. This is based on the organizational accident causation theories of Reason.(16) These theories distinguish between active failures and latent conditions. Active failures are made at the scene, e.g. during surgery, whereas latent conditions are poor or inaccurate decisions made at higher levels, e.g., the manufacturers of product. In a detailed study of human factors in a multicenter study of 243 arterial switch operations for transposition of the great vessels, de Leval et al(17) highlighted the role of human factors in native surgical outcomes. The negative outcome is accentuated by the patients risk factors. Human compensation, i.e. recovery or rescue methods, are utilized to address both the error and risk factor. Human errors are normal in the sense that they occur. These errors result from inadequate, flawed, or illogical knowledge or behavior patterns. Reason(16) subsequently distinguishes variable and constant errors (Figure 4). Clearly target B is constant and more easily corrected with a change in the rifle sight. This has dramatic application in the clinical setting where correcting an individuals performance is much easier than analysis and correction of a systems failure. Reason (16) nicely defines errors, mistakes, slips, and lapses. Error will be taken as a generic term to encompass all those occasions in which a planned sequence of mental or physical activities fails to achieve its intended outcome, and when these failures cannot be attributed to the intervention of some chance agency. Mistakes may be defined as deficiencies or failures in the judgmental and/or inferential processes involved in the selection of an objective or in the specifications of the means to achieve it, irrespective of whether or not the actions directed by this decision-scheme run according to plan. Slip is failure in execution of an intended action sequence. (18) Lapse is failure in the storage or memory phase of an action sequence. (18) Complications are thus the result of one of more of the four. Slips and lapses are active errors, whereas, mistakes are latent errors. A complication is thus a deviation or departure from the expected or anticipated outcome of a surgical procedure. Morbidity is a diseased condition or state that results from complications. This is a more generic term that includes the entire panorama or complications associated with cardiac surgery. Complications can be anticipated/unanticipated, expected/unexpected, predicted/unpredicted, avoidable/unavoidable, or recognized/unrecognized. They can be temporally classified as preoperative, operative, or postoperative complications. Post-operative complications are further divided into early (<30 days) or late (>30 days) with chronic complications, residua, or deciduas being temporary (eg. phrenic nerve paraparesis) or fixed (eg. CVA). Mortality is defined by The Society of Thoracic Surgery and The American Association for Thoracic Surgery as: Thirty-day mortality (sometimes termed operative mortality) is death within 30 days of operation... ... ... Hospital mortality is death within any time interval after operation if the patient is not discharged from the hospital. Hospital to hospital transfer is not considered discharge; transfer to a nursing home or rehabilitation unit is considered hospital discharge unless the patient subsequently dies of complications of the operation(19) Strategic/Organizational Initiatives Historically, postoperative complications have been well addressed by the surgical community. In the early 1900's Ernest A. Codman classified complications as errors due to lack of technical knowledge or skill, surgical judgment, care, equipment or diagnostic skill.(20) It was also Codman who first championed the need for outcomes assessment.(21) Even earlier, Florence Nightingale, a devoted English nurse, noted disparity in outcomes in many London hospitals of the mid 1800s. She highlighted the concept of severity of disease and risk adjustment. (21) She emphasized the concept that the hospital should do the sick no harm (primum non nocere). The cornerstone of the approach to complications or adverse outcomes has been with the development of the American surgical training programs. The time honored surgical morbidity and mortality conferences (M&Ms) are the origin and mainstay of present day peer review and outcomes analysis. This all evolved with the departure of the American Halstedian surgical training programs from the European model of total proctored training. This American model of surgical resident included planning the operation, performing it, and providing the postoperative care, all in a structured, supervised way, with graduating degrees of supervision and autonomy.(22) Analysis of problems or complications was an integral component of this processed learning. This program became the model for subsequent specialty programs (American Board of Specialties), and the ultimate establishment of the American Board of Thoracic Surgery in 1948.(23) This Halstedian tradition has been maintained with the structured system of progressive training, phased transfer or delegation of responsibility, and evaluation of surgical results and outcomes. Frank Spencer, a disciple of the Halsted/Blalock School, stated that 75% of the important events in an operation are related to making decisions, and 25% to dexterity (Figures 5a, b).(24) Here again, the emphasis was placed on the individual surgeon, and not the system. Both Frank Spencer and John Kirklin focused on the operating room environment. The atmosphere in the OR was serious, professional, calm, organized, and methodical. There was no wasted moves/motions or conversations (idle palaver). Concentration on the task at hand was the order of the day. Recent technology has added objective to subjective validation of these concepts. Tried and true aphorisms from our mentors still hold true - Cut well, tie well, get well; Modify, simplify, apply; Keep it simple - Denton A Cooley. Unfortunately, the morbidity/mortality conference, as traditionally described, primarily addresses factual data, and offers limited insight into all aspects of complications. The discussion oftentimes failed to balance punitive with constructive criticism. (Figure 6) At a higher level discussion of trends and sentinel efforts affords deeper insight into team function, product lines, critical care pathways, and systems analysis. Again the theories of Reason, (16) as promulgated by de Leval and others,(17) continue to stress the human failures or active errors and system or latent failure concepts. The broader concept of surgical failure also includes the notions of omission and commission. This implies things done or not done. Not to do an operation (omission), when indicated, can create a complication that is avoidable. In contrast, an operation done without absolute or relative indications (commission), can also cause complications that are unavoidable. de Laval continues to drive home the message of the Bristol affair. In his address Beyond Flatland he describes Flatland, a race of two dimensional people who are unable to appreciate the full reality of the Spaceland, or three dimensional universe(25). Now we are in Complexland, a new wave of thinking resulting from the 1944 discovery of nonequilibrium thermodynamics. This implies self organization, whereby space and time patterns emerge at random without external influence. Again he is striving to emphasize methods to analyze complex problems. A note of caution here is not to add complex solutions to complex problems. Seek simplicity, then distrust, may be an appropriate approach. de Leval(17), in a simplified organized fashion analyzes medical outcomes resulting from the interaction of three sets of complex variables: patients, treatment, and care providers. It is the care providers that constitute the human factor. Emphasis on error prevention, detection, and recovery are the logical areas of concentration in the detection and analysis of errors, or near misses. Error recovery is a crucial area, since it requires fairness and tolerance. Errors will occur and many are unpreventable. The ability to recover a serious unavoidable error or complication is the hallmark of a successful strategy for patient safety. Four isolated or combined factors will cause an airplane crash weather, mechanical failure, human error, or a violent human action i.e. terrorism. All of these factors have been addressed in the airline industry, thus achieving the 2nd safest form of travel, after escalators. The Law of Parsimony may apply here, as fashioned from William of Occams Razor theory, which is to look for simple solutions within a complex mileu. Humans are parismony machines: they select the shortest, and thus most efficient path to the production of true theorems, given a set of facts (obervations) and theories ( HYPERLINK "http://www.knowledge-finder.com/philosophy/parsimony-fourth-substance.html" www.knowledge-finder.com/philosophy/parsimony-fourth-substance.html). Blackstone(26) carries this further by nicely offering his statistical expertise to help us better utilize statistical data mechanisms in this analysis and assessment of outcomes. Employing a Newtonian concept, one should abandon traditional methods of logic, deduction, expert opinion (ie. in my experience), consensus, and let actual data speak for themselves. This type of approach is called inductive logic, where analysis of the data infers information regarding the problem, or question, or hypothesis being considered. Blackstone(27) in a well reasoned editorial again emphasizes the Reason methodology in commenting on a series of articles devoted to monitoring of clinical performance(28) (29) (30). The common cause variation in outcome analysis focuses on the blunt end ie. systems failure, whereas special cause variation is sharp end variation i.e. extrinsic influence (eg surgical skill or judgment) Sundt, et al(31) has beautifully built on the Reason, deLeval and Blackstone approach. He utilizes the tools and methods described herein to focus on patient safety, ie. avoidance of problems through the understanding of the systems involved. This is adequately summarized in (Figure 7). The concept of systems is an important one. Systems analysis is a common practice in the non-medical world. Systems analysis or improvement is synonomous with continuous quality improvement (CQI) or total quality management (TQM). W. Edwards Deming and J. M. Juran are the architects of this movement. (32) Following World War a! they dramatically helped re-establish and re-form Japan s manufacturing base. Deming established 14 points of management (Figure 8) within a system of profound knowledge: Knowledge of a system Knowledge of variation Knowledge of psychology Theory of knowledge Noland(33) combined this Deming improvement knowledge and professional health care knowledge into a PDSA (Plan-Do-Study-Act) cycle (Figure 9) A practical example of system analysis is the failure made effect analysis (FMEA) process developed by the military. The objective of FMEA is to identify failures or improvements in a product or process, as well as individual operator mistakes or errors. An example of its application is the evaluation of extracorporeal perfusion circuits. (34) A rating scale was developed to evaluate the degree of failure, the occurrence or incidence of failure, and the means of detection of failure. This highlights the concept that once recognized, failure of process or device can be corrected, improved, or replaced, thus avoiding adverse results. There are very few classification systems available for recording or documenting complications. Most texts and reviews list the major and minor complications associated with various procedures and operations. A generic classification system has been adapted from Rutherford (35) and Clavien (36). (Figure 10) Tactical/Managerial/Initiatives Given this broad based background of complications that attempts to give structure to the surgical process, let us now focus on specific efforts and initiatives to both understand and improve the process. Interestingly, cardiac surgeons perform operations and care for patients. Yet, all of this revolves around problem solving (Figure 11). The subjective and objective elements involve a life-long career of study and reflection beyond the formative training years. This is the role for the continuing medical education (CME) process. This includes conferences, meetings, seminars, workshops, symposia and personal interaction with colleagues. The internet has become a powerful tool in this endeavor (www.ctsnet.org). A word of caution regarding experience. When tested and challenged with thoughtful study and reflection and appropriate changes and modications experience is a most powerful tool. However, when not used properly and effectively, it can be extremely harmful. To quote Oscar Wilde Experience is the name everyone gives to their mistakes. An experience with 100 operations could be one operation done wrong or improperly 100 times. The establishment of standard guidelines, algorithms, local practice and clinical care pathways, are extremely useful and informative. Examples include practice guidelines developed by the Society of Thoracic Surgery (37) (Figure 12) as well as the American Heart Association/American College of Cardiology (AHA/ACC) recommendations or guidelines, series (www.acc.org/clinical/statements.htm). However, they do not replace the time honored individualized approach to patient care. The paradigm shift to focus on the total patient in a holistic fashion as the basis of care has dominated the current scene.(38) The Cardiothoracic surgeon may delegate responsibility of care of his patient to appropriate consultants or services (eg Intensivists) but he/she remains totally involved in the short and long term care. Familiarity with proper diagnosis and coding are extremely important. It is these codes that form the basis for data retrieval and billing. Improper documentation can become the source of inaccurate database information and billing submissions, especially in an unaudited atmosphere. The International Classification of Disease, Ninth Revision, and Clinical Modification (ICD-9-CM) classifies morbidity and mortality information for statistical purposes, as well as indexing of hospital records by disease and operations (39). It is important to distinguish complications of care from pre existing comorbidities. The coding is also limited by the inability to document the temporal relationships of preoperative and postoperative conditions or complication. The Current Procedural Terminology (CPT) is a listing of descriptive terms and identifying codes for medical services and procedures performed by physicians.(40) Most of the data utilized by overseaing groups, like Leapfrog, and Medicare eminate from these sources. The Society of Thoracic Surgery and the American Association of Thoracic Surgery have been very proactive in educational aspects of CPT and ICD-9-CM coding. ( HYPERLINK "http://www.ctsnet.org/doc/319" http://www.ctsnet.org/doc/319) The residency training period has undergone recent modification both in length, operative requirements, and quality. The American Cardiothoracic Residency program is evolving into a six year program with 3 years basic surgery, and 3 years specialty training. Competence has become a focal point for all graduate medical education programs. The Accreditation Council for Graduate Medical Education (ACGME) has endorsed six areas of general competencies to be incorporated into the GME programs. Ultimately, the successful surgeon must have 3 attributes: Competence (figure 13) (41) Personality Character This translates into the 3 As: Ability (competence) Availability (character) Affability (personality) Kwasnik(42) has added a fourth A-Accountability (figure 14). This also includes accepting responsibility. This incorporates the other As since it requires autonomy or ability to do the job; assumption or willingness to do the job; and assignment or ability to work with others and delegate responsibility. Beyond this structural education and training period, resulting in state licensure and board certification, the remainder of the cardiac surgeons career revolves around state license renewal, renewing hospital privileges and credentialing, board re-certification (every 10 years for CT Surgery), and continuing medical education (CME). The initial hospital privilege credentialing process may also involve a fixed period of proctoring and/or temporary privileges prior to full unrestricted privileges. Beyond this, mandated surgical morbidity/mortality conferences, peer review and mandatory reporting in many states of sentinel adverse events or outcomes have become the mainstay of both voluntary and involuntary reporting and tracking of complications, as well as evaluating obvious cases of professional incompetence. This proctoring process is required by many medical staffs.(43) The goal is to assess a physicians technical skill prior to granting full medical staff privileges. This peer review system has become the cornerstone of ensuring quality medical care.(44) The Health Care Quality Improvement Act (HCQIA) of 1986 created the National Practitioners Data Bank (NPDA). This outlines the whole process of peer review, in terms of how reviews are conducted and physicians protected. Implemented in 1995 the NPDA authorized the Secretary of Health and Human Services (HHS) to establish a registry that restricts the ability of unethical or incompetent doctors to move within the states without documentation of previous damaging or incompetent performance. (45) Basic to this whole concept of complications and accountability is the development of an attitude of maturity and sensibility. This requires both personal and group professionalism and collegiality. Professionalism carries with it three elements. (1) (46) Knowledge implies acquisition of a predetermined period of training and education, and a life-time of continuing application of this knowledge with constant relearning and acquisition of new and evolving information and shills. (2) Altruism is the commitment to patients and society and adherence to a code of ethics (Hippocratic Oath). (3) Self-regulation revolves around accepted standards and regulations for education, training, performance, and competency. This all translates into the expectancy that physicians act with integrity and skill in their relationships with peers, staff, patients and families. Patient confidentialty enters the equation at this point. Discussions at the bedside, as well as discussions of other health care professionals regarding physicians, care, recommendations, and opinions must be tempered with professionalism and caution. Loose lips do sink ships. Human behavior in this area is hard to modify and temper. The Health Insurance Portability and accountability act of 1996 (HIPAA) (http://www.hhs.gov/ocr/hipaa/privacy.html) has created standards for the privacy of individually identifiable health information. This law also protects the patients rights to health coverage during certain situations. (http://cms.hhs.gov/hipaa/online/default.asp) Medical malpractice is the legal process through which the patient or family seeks financial retribution for alleged negligence or incompetence resulting in an adverse outcome. There is a crisis in medicine today related to the increasing malpractice suits, large settlements and increasing malpractice premium costs. Tort reform at the state and federal level has become a major priority given the increasing direct and indirect financial impact on the overall healthcare system. Once again it is important to stress that the largest contributor to errors or complications is system failure.(47) Surprisingly, there has been a decrease in overall medical adverse events from 1972 to 1992. The current rate is below 3%. It is also noted that cardiothoracic surgery accounts for about 3% of malpractice claims noted in the Physicians Insurers Association of America (PIAA) database.(48) The components of a malpractice lawsuit are illustrated in (Figure 15)(49). One area not noted is settlements. The important point to stress regarding a settlement is that it is reported as a lost malpractice suit, which is subsequently recorded in the National Data Bank.(49) Prevention of malpractice is nicely summarized in (Figure 16).(48) Clearly, trusting and caring physicians who are honest, sincere and have performed everything in the best interest of the patient, will avoid the majority of lawsuits. Yet we cannot ignore the medical malpractice crisis in the USA (especially in 19 states). (50) This translates into decreased access for patients because of an inflated cost of medical liability premiums. The adage of crisis precipitates change is long overdue. A recent survey of 4 Florida countries revealed 94% of CT surgeons have been sued with an average of 3.62 lawsuits each thus far in their surgical careers. (50) Combining the elements of practice guidelines and malpractice prevention into a useful checklist for the operating surgeon is summarized in (Figure17). Pre-operative counselling is a crucial phase. It is there that the risks and benefits are discussed. Risks include complications. Whether these complications should be broadly discussed or detailed, including written information is a matter of debate. In any event, complications related to the patients problem, related comorbidity, and the extent of surgery should be openly presented and discussed. The disclosure of complications perioperatively is also a debated issue. Certainly disclosure to patient, family, and discussion at morbidity/mortality conference, or peer review is the usual procedure. A useful phrase for consideration is to admit your mistakes, errors, or shortcomings, but dont advertize. The evaluation and discussions that follow commission, e.g. performance of operations or procedures, again do not include omission, e.g. operations/procedures turned down or rejected. How dramatic was the change in mortality noted in New York state when high risk cases were turned down, and referred out of state! However, when death, complications, or other adverse outcomes occur a useful mnemonic is helpful to follow (Figure 18). Pre-operative Phase RISK ASSESSMENT/SEVERITY SCORES Let us now look at complications in a temporal setting. As mentioned, open-heart surgery has become increasingly important in terms of access, cost, and results, particularly in the setting of a sophisticated public awareness which desires more information regarding both surgeon specific and institutional outcomes. This information is now readily available on the internet (Table 2, 3, 4). A number of scoring systems utilizing univariate and multivariate regression modes have emerged to help the cardiologist and cardiac surgeon better counsel the patient and family regarding surgical risk(51) (Table 5). They are essential tools for risk assessment, cost analysis and overall assessment of patient benefit. The major determinants of perioperative morbidity and mortality remain age, sex, body surface area, acuity of the operation (elective, urgent, emergency), associated co-morbidities (especially smoking, diabetes, obesity, renal dysfunction, hypertension, stroke, chronic obstructive pulmonary disease, and peripheral vascular disease); and the degree of cardiac dysfunction. Univariate analysis is used to correlate a particular risk factor with a specific outcome, which is the methodology utilized in the Society of Thoracic Surgeons (STS) database (Figure 19). This calculation is difficult to assess when multiple factors are involved. In multivariate regression analysis, only those variables found significant in univariate analysis are used to assess the independent association of these variables with specific outcome or results. Several multivariate risk modes allow for bedside calculation of operative risk, including the Parsonnet scoring system which is one of the earliest.(65) The Cleveland Clinic (CCF in Table 3) severity scoring system is practical in that the score is directly correlated with predicted mortality (Figure 20a,b).(59) The Northern New England risk calculator includes CABG and valve surgery risk (Figure 21) (66). The Euro Score is an additional risk source which is available for on-line calculation. ( HYPERLINK "http://www.euroscore.org/" www.euroscore.org/)( Specifically, the risk of advanced age has become important and relevant in terms of access to care, cost and outcome. At present, three percent of Americans are octogenarians, and by 2010 there is projected to be an increase to 4.3%, representing 12 million people.(67) Between 1987 and 1990 there was a 67% increase in cardiac surgery in this age group.(68) Mortality and quality of life are the prime indicators of success in this age group. Operative mortalities between 7.9% and 13.5% have been reported in octogenarians, with one study reporting a 5-year median survival of 55%, compared to 69% in age group 70-79 years, and 81% for age group 60-69 years.(68) Utilizing Standard Form 36 Health questionnaire (SF-36 form) and the Seattle Angina Questionnaire, 83.7% of the octogenarian surgical patients were living at home with 74.8% enjoying good or excellent health(69) (Figure 22). Females remain at higher risk for myocardial revascularization. Two basic studies show a two-to-three fold increase in mortality for women versus men.(70,71) Waiting lists for emergency, urgent, or elective cardiac surgery has ceased to be a problem in the United States, with the exception of heart, and heart-lung transplantation. Unfortunately, cost effectiveness and efficiency can be problematic in some cases where preoperative counselling, and more complete evaluation of the disease process or comorbidity are not approached. In other countries waiting lists pose a problem or challenge. Rexius et al(72) from Sweden noted a median waiting time for CABG of 55 days. There was a 1.3% mortality in the 5,864 patients waiting for elective surgery. Cesena et al(73) from Brazil noted a median waiting time of 126 days. There was a 2.5% mortality in a group of 516 patients. Impaired LV function was a major risk factor for death in both groups. Interestingly none of the risk scores for myocardial revascularization include either hospital or surgeon specific volumes as specific risks for mortality or adverse outcome. At least nine large studies have addressed the notion that hospitals performing small numbers of CABG operations have higher operative mortality.(74-82) Six of these nine studies found increased operative mortality in low volume providers.(74-79) In three other studies there was no correlation.(77-79) The Institute of Medicine summarized the relationship between higher-volume and better outcome ( HYPERLINK "(http://www.nap.edu/catalog/1005.html)" http://www.nap.edu/catalog/1005.html) and concluded that procedure or patient volume is an imprecise indicator of quality even though a majority of the studies reviewed showed some association of higher volume and better outcome.(83) The observations on operator volume and outcome have prompted some to suggest regionalization i.e. to refer nonemergent CABG patients to large volume centers.(79,84) The role for selective regionalization was advocated by Nallamothu et al,(82) when they found that low risk patients did equally well in high volume or low volume hospitals. They suggested regional referral for elective high risk patients to high volume institutions. Crawford et al(85) pointed out that a policy of regionalized referrals for CABG may have adverse effects on healthcare, including increased cost, decreased patient satisfaction, and reduced availability of surgical services in remote or rural locations. Birkmeyer et al(86) again point out the emphasis on hospital volume by both the Institute of Medicine and the Leapfrog group. Again using Medicare Claims data and the Nationwide Inpatient sample they examined 6 cardiovascular procedures between 1994 and 1999 and noted a 2-5% change in adjusted mortality for valve surgery, and <2% change in adjusted mortality for CABG Surgery. Clearly this debate will continue. (87) A sensitive area of discussion revolves around modalities to adjust risks and outcomes. Referral of high risks patients to high volume centers or out of state shifts the risk, decreases the cost for the referring facility, and lets the surgeon off the hook. Whether the motive is patient driven, facility driven, or surgeon driven is a matter of speculation. Shahian et al(88) have openly discussed gaming. This includes upcoding of comorbidities, change of operative class, transfer of postoperative patients to extended care facilities, and avoidance of high risk patients. Innapropriate or excessive coding of risk factors increases the expected mortality rate. Adding mitral valve repair to CABG changes the class from isolated CABG. Finally transfer of patients from acute to chronic care facilities changes the database of deaths occurring where the operation was performed. Carey et al(89) studied the California statewide discharge database ever a 3 year period. When corrected for transfer to chronic facilities the aggregated 3 year in-hospital mortality rose for CABG (2.98% to 3.45%); CABG plus (9.25% to 10.67%); and valve only (4.85% to 5.45%). Once again, as painted out earlier the STS definition of hospital mortality includes patients transferred to chronic health facilities, whose death was attributable to the operation. (19) Operative Phase A difficult area to gather objective data and document ontoward events is the data dense environment of the operating room or theater. Notable attention has been given to preoperative and postoperative aspects in the literature, but there is a dirth of objective information re. intraoperative events. We assume the infrastructure and design of the operating room is safe and functional. Basic knowledge of OR design and function should be familiar to the cardiac surgeon and the operating team room team. A knowledge of the basic equipment, monitors, and supplies necessary for specific operations is fundamental. Anesthesia controls IV access, airway, anesthesia, monitoring, and overall patient support during the operation. Recent attention has been given to general and specific anesthesia related complications. Anesthesia complications are not discussed. Nursing issues in the OR include chart control, patient identification, positioning, prepping, and draping. The OR documentation paperwork is maintained by nursing. Instruments and supplies are usually prepared from physician and procedure specific pereference lists. The recently implemented time out routine insures that the right patient is receiving the right operation on the right anatomical part of the body. Positioning is important insofar as pressure necrosis and peripheral nerve injury are concerned events. Cautery burns are documented. A summary of operating room data and events is maintained in the operative nursing record. The attending primary cardiac surgeon must have a mental checklist to assure that the appropriate instruments, suture, and product needed for a specific operation is available, ready, and operational (eg the surgical sternal saw must be checked and functional prior to use). It is wise and prudent to review and rehearse the sequence of the operation with the operating room team prior to the incision. Any specifics or deviation from the routine are better received and discussed prior to the skin incision. Notification of the family or relatives of the progress of the operation at various times during the procedure is considered routine in most programs. Certainly, notification of an intraoperative complication or catastrophe is appropriate. A designated spokes person or protocol is standard in most centers. Surgeon specific data or the human factor is difficult to quantitute and document. The three fundamental requirements for the surgeon include character, personality, and competence. Attempts at objective measurement of the surgical personality offer some insight into character as well. Mc Greevy et al (90) used the US Air force NEO PI-R psychological testing to measure personality traits in surgical residents. Data on the five major personality traits (Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness) were analyzed. The Conscientiousness facet analysis was the most revealing. The traits of conscientiousness include competence, order, dutifulness, achievement-striving, self-discipline, and deliberation. All residents, both male and female scored higher in this facet than the general population. The NEO PI-R is a stable testing modality across the adult life span, and consistent in retesting. Technical proficiency is a basic required surgical trait. Validation of this proficiency historically has been the qualitive assessment by mentor observation. This modality will remain the basis of apprentice-based teaching or transfer of skills. These In-Training Evaluation Reports (ITERs) are composed of global rating scales of technical proficiency evaluated, assessed, and completed at various phases of the surgical residency training period. True validity and reliability remain a major concern. (91) Objective testing and evaluation of technical proficiency and dexterity is gaining more attention. Guerlain et al (92) have employed a multitrack, synchronized, digital audio-visual recording system (RATE tool) to monitor intraoperative performance. This RATE tool allows analysis of technical judgment, technique, team performance, and communication patterns. Hance et al(93) have adopted an objective system to evaluate technical proficiency and dexterity. It consists of a bench model skills assessment for cardiac surgery. The goal is to establish construct validity, which is a means to differentiate varying skill levels. Four skills are assessed - aortic root cannulation, femoral triangle dissection, aorta to vein graft anastomosis, and vein graft to Left Anterior Descending Artery anastomosis. Cadaveric porcine models were utilized. Assessment was performed by senior surgeons utilizing a standard validated evaluation system. This type of assessment protocal will gradually be integrated into many training programs. The perfusionist is a critical component of the operative team. Complications related to cardiopulmonary bypass are beyond the scope of this review. However, all programs are encouraged and often required to formulate perfusion protocols that include routine cases, special cases, and recognition and correction of operative complications i.e. trouble-shooting. The cardiac surgeon must maintain a basic knowledge of cardiopulmonary bypass physiology and techniques. A coordinated communicative network between Anesthesia, Surgeon, Perfusionist, and Nursing is crucial to operative success and avoidance of preventable complications. Probably, the most valuable component of the operative phase, is a regularly scheduled meeting of the operating room team, including the ICU staff, to discuss routine protocols, problems, concerns, suggestions, and other items that all contribute to a smooth running service. This is a notable example of the Hawthorne effect.( Post-operative Phase RISKS AFTER ARRIVAL IN THE INTENSIVE CARE UNIT (ICU) In general, risk is stratified for the overall cardiac surgery experience, including early outcomes for the operative procedure based on preoperative risk factors. The APACHE III score (Acute Physiologic And Chronic Health Evaluation), however, is used only for non-cardiac surgery risk based on clinical presentation upon arrival in the ICU.(94) Since application of the APACHE III to cardiac surgery is difficult (with many variables changing rapidly due to the manipulation that occurs early), a refined APACHE III was developed for patients undergoing CABG(94). Independent predictors of survival were acute physiology score, age, emergency operation, reoperation, number of grafts performed and gender. Higgins et al(95), from the Cleveland Clinic, developed an ICU admission score for predicting morbidity and mortality (Figure 23). This allowed sequential assessment of prognosis, and improved stratification because of a continuously updated data. For example, the use of intra-aortic balloon counter pulsation (IABP) signified a worsening prognosis likely due to a significant intracardiac event related to degree of pathology, myocardial protection, technical events or extended cardiopulmonary bypass times. Knaus(96) gives a nice historical review of APACHE, noting that over 2000 peer review articles utilize APACHE as a key component for the methods and results section. Assessments have been made for risks after the first ICU day. Kuhn et al(97), utilizing APACHE a!, noted a mortality of 50% for patients with APACHE a! score g" 28 after the first ICU day. Another consideration is readmission to the ICU. This is a significant event. Bardel et al(98) noted a 3.6% readmission rate with pre-operative renal failure and initial mechanical ventilation for >24following CABG as risk factors for readmission. Again, prolonged ICU-LOS is an independent variable for complications and poor outcomes. Williams et al(99) noted that in a group of 49 patients (3.8% of total over a one year period) remaining in ICU >14 days had a 28.5% in hospital mortality; compared with 5.3% of those in ICU <14 days. At 2 years there were 22 of 35 discharged patients alive (81% survival); or 45% of the original 49 patients. The older Ontario score system (Figure 24) is still useful in correlating overall mortality, ICU-LOS, and Postop-LOS. (13) The ICU is a complex environment. Nast et al (100) report a contemporary experience in an ICU setting. The goal was to evaluate voluntary patient safety events. Physicians, nurses, and allied health personal participated. Of 157 events reported 85.54% caused no harm, 48% were human factor related, and 34% organizational or system related. The data highlights the value of voluntary, confidential, non-punitive approaches, used in a constructive manner to identify errors, near misses, and other causative factors. LONG TERM RESULTS Outcomes after hospitalization have become increasingly important in terms of quality of life. Basically, quality of life (QOL) indicators are objective and subjective. Objective health status and function can be assessed directly with patient contact by health care professionals. Subjective assessment is the patients perception of how they feel or are doing. QOL can be generic (eg SF-36; Seattle Questionnaire; Nottingham Health Profile), functional status, disease specific, or symptom severity. As mentioned, SF-36 form is a short questionnaire with eight multi-item variables (Figure 22).(101) Falcoz et al(102) found the SF-36 more suitable for cardiac surgery compared to the Nottingham Health Profile (Figure 22); especially with regards to the assessment of angina and dyspnea. Lindsay et al(103) reported 214 patients undergoing CABG in whom the SF-36 form was used before and after operation. At a mean of 16.4 months postoperatively, the SF-36 score showed that high levels of social support were associated with improved health status and quality of life. Simchen et al(104) in a study from Israel, reported on 1270 patient one year following CABG. One-third reported their quality of life as not good, particularly females and those of lower socioeconomic status. Rehabilitation programs were targeted as the reason for improvement. QOL measures are becoming increasingly utilized as predictors of health related quality of life (HRQL) outcomes. Preoperative SF 36 studies were performed before, and at 6 mos, and 1 year post-operatively. A VA study(105) evaluated 1,973 patients undergoing coronary artery bypass (CABG) surgery before and six months postoperatively. Multivariable analysis targeted current smoking and psychiatric disease as targets for improvement. A French study(106) evaluated CABG and valve patients pre-operatively and one year postoperatively. Functional status was better for valve patients with NYHA functional class b! or c! and angina class b! or c! as predictors of impairment at one year. These quality of life measures following CABG will undoubtedly become more important as the population ages. More importantly, six month and twelve month outcomes in terms of mortality may be better indicators for quality assurance than the traditional 30 day or hospital mortality reporting. COST The number of Medicare patients has risen to over 40 million, with the number of uninsured rising to an almost equal number. Access to care and rising costs continue to challenge healthcare providers. The Health Care Financing Administration [HCFA: now called Centers for Medical and Medicaid Services (CMS)] budget has risen from 21.5 billion in 1977 to 214.6 billion in 1997,(107) with treatment for coronary artery disease accounting for more than 80 billion of that cost, and CAD continuing to be the leading cause of death and morbidity in the USA. The total cost of cardiovascular disease and stroke in the USA in 2005 is estimated at $393.5 billion. (Figure 1) This includes the direct costs of $241.9 billion and the indirect costs of $151.6 billion (lost productivity morbidity and mortality). This all translates into approximately 16% of GNP spent on healthcare. At the same time, expensive medical technology continues to grow and develop. With the escalating costs of cardiac surgery, attempts have been made to find effective ways to reduce these costs while maintaining good outcomes. Beginning in the last decade, individual cardiac surgeon and institutional results in New York State were made available to the media and public, causing outcries both within the medical establishment and the general public.(108) CMS has mandated progressively lowering reimbursements, utilizing DRGs for cardiac surgical procedures, in a further attempt to control the continuing growth of operations and cost. Initiated in 1983, Diagnosis-related-groups or DRDs are reimbursed fixed fees for each patient admission, regardless of the providers actual incurred costs. These prospective payments shifted financial risk from payers to hospitals. Apopted by other third party payers, variations of payment have evolved, including capitation or lump sum payment for all in patient care. The reimbursement for cardiac surgery from Medicare decreased 9.3% from 1991 to 1997.(102) With a rising population at risk and the influx of the baby boomers into this patient mix, financial issues will become even more critical and relevant. The specific cost of CABG has been studied extensively, with particular attention given to preoperative risk factors and complications, both of which increase length of stay (LOS). Taylor(109) prospectively studied 500 patients undergoing CABG, and found a charge of $11,900 + 12,700. No preoperative clinical features were significant predictors of cost, whereas postoperative sternal wound infection, respiratory failure and LV failure were. Ferraris et al(110) studied hospital charges in 938 patients undergoing CABG. They found that risk factors for postoperative morbidity are different than those for postoperative mortality. Their findings suggested that older patients with preoperative anemia and low blood volume who also have other co-morbidities (CHF, stroke, COPD or hypertension) are at increased risk for postoperative complications and increased hospital costs. The most costly outcome in their study was perioperative death. Cohen(111) et al, analyzed hospital cost, (not charges) for 89 elective CABG patients with an average postoperative LOS of 9.3 days and found the total costs were from $17,420, $19,153 and $21,828 for the 25th, 50th and 75th percentiles, respectively. Williams(112) et al, found increased cost to be correlated with high average risk (utilizing the Parsonnet equation) and increased LOS in 2,589 CABG patients. Shahian(113) et al, however showed no correlation between hospital size, volume of surgery and cost. Strategies to decrease cost include operating on lower risk patients, more expedient surgery (i.e. on the same admission as diagnostic catheterization, same day admissions, decreasing ICU and restrictive hospital stay, improved home care, and greater use of chronic care facilities and rehabilitation centers). Shorter LOS in the acute care hospital, however, has led to increased readmission rates, and more frequent discharges to chronic facilities, along with increasing utilization of home health services. Lazar et al(114), demonstrated a distinct change from 1990 to 1998, with discharge-to-home-with-services increasing from 14.75% to 46.5%, and transfer to rehabilitation units increasing from 2.9% to 13.7%. Readmission rates following cardiac surgery range from 5.3% to 20.9%(114-118). Preoperative risk factors associated with increased readmission rates include female sex, diabetes, chronic lung disease and preoperative atrial fibrillation.(117-118) The most common readmission diagnoses have included atrial fibrillation, angina, congestive heart failure, ventricular tachycardia, wound problems, pneumonia and gastrointestinal complaints.(115) EVIDENCE-BASED MEDICINE (EBM) EBM provides a basis for the evaluation of treatment and application to a specific clinical problem or situation. Meakins(119) nicely summarizes the five steps in EBM: define the question or problem; search for the evidence; critically evaluate the literature; apply the results; and audit the outcome. A number of resources have emerged as a source EBM information i.e. ( HYPERLINK "http://www.clinicalevidence.org" www.clinicalevidence.org) ( HYPERLINK "http://www.ebmny.org)," www.ebmny.org) ( HYPERLINK "http://www.cochrane.org)." www.cochrane.org). Familiarity with the precepts and principals of EBM will help facilitate the organization of a large amount of information and enable the practitioner to answer clinical questions at the point of care in real time. It is important to note the historical contribution of Archie Cochrane to the EBM concept.(21,120,121) A quote summarized his rationale: I had considerable freedom of clinical choice of therapy: my trouble was that I did not know which to use and when. I would gladly have sacrificed my freedom for a little knowledge.(21) Thirty years later we are a lot closer to that knowledge. Simply put evidence is the link between what we know and what we do in medicine. EBM is designed to achieve optimal management of clinical problems or challenges. From this, practice management guidelines, paradigms and algorithms can be developed. The ultimate focus of risk stratification and outcome assessment is to account for differences in patient risk factors so that patient outcomes can be used as an indicator of quality of care. A major problem arises in attaining this goal because uniform definitions of quality of care are not available. A grading or standardized classifications system has emerged that recognizes the difficulties in defining best practices for a given illness or problem. Professional organizations have opted to promote practice guidelines or suggested therapy for given disease(122,123) (Figure 25, 26). These guidelines or recommendations represent a compilation of available published evidence, including randomized trials and risk adjusted observational studies, as well as consensus among panel of experts proficient at treating the given disease.(115) For example, the practice guideline for coronary artery bypass grafting is available on the internet ( HYPERLINK "http://www.acc.org/clinical/guidelines/bypass/ExecIndex.htm)" http://www.acc.org/clinical/guidelines/bypass/ExecIndex.htm) for both practitioners and the lay public. Figure 27 illustrates the 1999 AHA/ACC Guidelines for coronary artery bypass grafting inpatients with acute (Q-wave) myocardial infarction. These guidelines were developed using a summation of available randomized controlled trials, risk adjusted observational studies, and expert consensus. They are meant to provide clinicians with accepted standards of care that most would agree upon, with an ultimate goal of limiting deviations from accepted standards. Guideline development continues to represent a work in progress. The methodology for developing guidelines for disease treatment is evolving. Many published guidelines do not adhere to accepted standards for developing guidelines.(124) The area where greatest improvement is needed is in the identification, evaluation and synthesis of the scientific evidence. An implicit part of assessing outcome is the development of a best standard of care for a given illness or disease process. Once the most efficacious treatment is known then comparisons with, or deviations from, the standard can be assessed - a process called benchmarking. As mentioned above, the best standard is not always known. Meta-analysis is a quantitative approach for systemically assessing the results of multiple previous studies to determine the best outcome. The overall goal of meta-analysis is to combine the results of previous students to arrive at a consensus conclusion about the bet outcome. Stated in a different way, meta-analysis is a tool used to summarize efficacy studies (usually RCTs) of an intervention in a defined population with disease in order to determine which intervention is likely to be effective in a large population with similar disorder. Meta-analysis is a tool that can relate efficacy studies to effectiveness of an intervention by summarizing available medical evidence. To date EBM recommendations are slowly evolving regarding the perioperative care of the cardiac surgery patient. In addition to EBM indications for coronary acting bypass grafting, similar guidelines are available for valve surgery ( HYPERLINK "http://www.acc.org/clinical/guidelines/valvular/dirindex.htm" http://www.acc.org/clinical/guidelines/valvular/dirindex.htm). Teaching and incorporationg EBM into Clinical training programs has developed(125). The American College of Surgeons has established the Office of Evidence-Based Surgery (OEBS) (126). They have utilized the four steps as developed by Sackett et al(127): (1) Formulate a question based on a clinical situation encourtered in daily practice. (2) Do a focused search of the relevant literature. (3) Critically appraise the literature obtained to find the best evidence. (4) Integrate the information and act in accordance with the best available evidence. So who is involved in these 4 steps? The individual surgeon can accomplish (step 1 and 4). A librarian or independent Pub Med search can identify the available literature (step 2). Critical appraisal is the difficult area. Interpretation of the literature and stastical knowledge can be a formidable challenge (step 3). Research coordinators and unbiased committees within the concerned societies are in the best position to generate overall recommendations. Yet the individual surgeon must have a basic understanding of statistics. Critical analysis of the literature is crucial to the process of understanding and making any necessary changes or adjustments in ones clinical practice. (128) Since approximately 30% of journal articles may contain errors a basic knowledge of statistics and research design is useful. (128) Formulating the question (step 1) is basic to the EBM process. The clinical question is formulated as PICO: (129) P - Patient/problem I - Intervention C - Comparison O - Outcome(s) of interest A clinical example is given: What is the value of laser transmyocardial myocardial revascularyation (TMR) with no option angina. P - Patient with unotable angina or bypassable lesions I - TMR C - No TMR O - Early, mid, or long term results Dunning et al(129) have nicely organized a best evidence series in cardiac surgery. A structured protocal has been constructed to answer the patient problem (p): Introduction; Clinical scenario; 3 Part question (eg - No option angina; TMR; angina relief or survival); search strategy; search outcome. (130,131) Outcome analysis has become the ultimate test of all of our efforts. This has been clearly echoed by Donabedian: Outcomes are much more easily used only as cues that prompt and motivate the assessment of process and structure in a search for causes that can be remedied. (132,133) Further, Donabedian views quality as the ultimate goal. It depends on 2 interdependent variables: technical and interpersonal. Technical is basically our craft or what we do; interpersonal is interaction with our patients, balancing their needs and wants. Quality Assurance/Quality Improvement The ultimate goal is to make the surgical operation safer and minimize on toward results or complications. The search for the Holy Grail of perfection will continue, or, in economic terms, for high quality providers or value-based purchasing. The experts agree that humans cannot perform flawlessly and the expectation of perfection is unattainable. Reason(17) and Sundt(31) have emphasized structure or systems with human components as a part. This structure or system starts or continues a process or function. Finally the outcomes or results are analyzed, evaluated, recorded, and subsequently reported. Birkmeyer et al (134) has beautifully outlined the structure, process, outcome process (Figure 28). Surgical competence and proficiency remains a key component of the structure, process, outcome (SPD) cascade. Satava et al (135) have summarized the ACGME six components of competence (Figure 13) and add proficiency as the level of performance in each area of competence. To maintain proficiency requires evidence of professional standing, lifelong learning and quality improvement, cognitive expertise, and practice performance. Unless the surgeon and surgical community engage in maintaining competence/proficiency, as well as buying in or investing in the total SPO effort, the entire effort will be compromised. A useful and practical device that bridges the statistical and tactical aspects is the critical paths or pathways. Utilizing clinical guidelines as a basis these pathways are designed to reduce variation in care, decrease resource utilization, costs and, hopefully, improve quality (136). One potential weakness in this approach is application to the complicated or less ideal patient. Outcome analysis has received the most attention in this quality assurance effort. Certain lessons have been learned: Crude mortality is not enough; differences related to chance and casemix do make a difference; disclosure of results to the general public can encourage potentially harmful consequences; and data collection requires organized and experienced individuals and teams. On a practical note, the available database record should be initiated early in the process, usually at the time of surgery. Computer entry following the operation by an unbiased, designated database person is recommended, and crucial to the process. Subsequent perioperative events are recorded at the time of discharge. Partiality re. what events took place or what constitutes complication remain a sensitive and controversial area. Again, the discharge coding (ICD-9) is crucial to subsequent chart reviews. (39) The computer tools and systems utilized to collate, analyze, and validate the data and make subsequent conclusions and recommendations continue to evolve. There are 3 risk-adjustment database systems presently being used by many centers and groups: National Surgical Quality Improvement Program (NSQIP); DXCG; and Charlson Comorbidity Index (CCI). (137) The NSQIP utilizes medical record abstraction, whereas the other 2 use secondary data produced by hospitals for accounting/billing purposes. These last two utilize ICD-9 Codes. Blackstone, Rogers, Spiegelhalter, and Treasure have nicely summarized the outcome analysis process and debate, with particular attention to CUSUM or cumulative sum charts (27-30). This charting system is designed to identify deviation from a performance standard. Its forte is that it provides early warning signs for subtle changes or problems in a system. Whereas the CUSUM methods examine overall surgical outcomes, it does not compensate for variable case mix. VLAD charts (Variable Life Adjusted Display) address this situation. (138) That probably sums up the whole purpose of report cards recognize problems early and offer solutions, rather then afixing blame. Herein lies the strength of the Northern New England study group. (www.nnecdsg.org/) A focused regional group of centers have combined in a proactive way to share data, analyze it in a constructive way, and offer suggestions and recommendations for change or improvement. There is a word of caution re. mandatory databases. Shahian et al(139) have nicely documented the evolution and initiation of a mandatory reporting system in Massachusetts. The major progressive element in this program is the statewide adoption of the Society of Thoracic Surgeons (STS) National Cardiac Database (NCD). Grunkemeier, et al(140) in commenting on the Massachusetts argue that the model entails both continuous quality improvement (CQI) which is proactive and progressive, and cardiac report cards which can be negative, and at times punitive. They applaud the well received Northern New England Cardiovascular Disease Study group model which is voluntary, and the participants controlling the data. (141) In summary, quality assurance is shifting from quality improvement to performance or value improvement. This becomes a pro-active movement that is less punitive and accusatory and more constructive. The joint commission on the accreditation of Healthcare Organizations (JCAHO), as well as the American College of Surgeons in collaboration with the National Surgical Quality Improvement Program have been notable examples of this improvement effort. It is interesting to compare a macro approach, i.e. JCAHO, and the micro approach, i.e. a clinical cardiathoracic surgery working in the trenches (Figure 29). The strategic/tactical top/down and the strategic bottom/up approaches are surprisingly similar. (142) (143) The strategic and tactical goals have thus been set. The basic tools are now available, and continue to evolve and improve. Application is the ongoing process, with the ultimate goal of making surgery and surgical decisions safe and beneficial for the patients we treat and serve. Figure 1 Annual Caseload Open Heart Cardiac Surgery, USA* Coronary Artery Bypass Graft (CABG) (2002) 515,000 Valve Replacement or Repair (2002) 93,000 Heart Transplantation (2003) 2,057 Congenital Heart (2000) (<20yrs of age) 25,000 Other (1999) (6) 90,000 Total 725,057 _______________________________________________________________ Estimated Direct and Indirect Costs of Heart Diseases Estimated Direct and Indirect Costs (in Billions of Dollars of Heart Diseases) United States: 2005Heart DiseasesDirect CostsHospital$77.7Nursing Home19.1Physicians/Other Professionals18.5Drugs/OtherMedical Durables19.4Home Health Care4.8Total Expenditures$139.5Indirect CostsLost Productivity/Morbidity21.4Lost Productivity/Mortality93.9Grand Totals$254.8 *Heart Disease and Stroke Statistics --2005 Update, American Heart Association ( HYPERLINK "http://www.americanheart.org" http://www.americanheart.org) Figure 2 (a) Toronto General Hospital Experience * Operations performed from 1993-1997 Number Meaning age Timing mortality (mean +/-S.D.) Urgent Emergent rate Coronary 7,371 62 ( 10 44% 3% 2.3% Artery bypass Aortic valve surgery 1,070 63 ( 15 32% 2% 2.5% Mitral valve surgery 704 59 ( 14 27 % 6% 4.3% Double/triple 381 57 ( 16 23% 3% 9.0% valve surgery Ascending aorta ( arch 475 57 ( 16 26% 16% 6.6% ( aortic valve surgery Congenital heart 473 42 ( 15 11% 1% 3.2% surgery in adults Miscellaneous 638 57 ( 14 33% 23% 10.2% ___________________________________________________________________________________________________________ *Left ventricular aneurysms (254), heart transplantation (99), myectomy (94), mapping +ablation (44), post infarction rupture of the septum (37), atrial myxoma (29), others (82). * Adapted from Cheng DC, David TE. Perioperative care in cardiac anesthesia and surgery. Landes Bioscience Georgetown, TX 1999, p2 Figure 2 (b) * Cleveland Clinic 2002 Mortality CABG 1.2% Aortic Valve Surgery <1% Mitral Valve Surgery 0.3% (repair) (0% replacement) Great Vessel Surgery 3.5% _______ *Cleveland Clinic Department of Thoracic and Cardiovascular Surgery, 2002 Department Review ( HYPERLINK "http://clevelandclinic.org/heartcenter" http://clevelandclinic.org/heartcenter) Figure 3 (a)(9) STS NATIONAL CARDIAC DATABASE (STS-NCO)*+ 1997 CABG (161,018 patients) Complications(%) Mortality(%) Re-operation for bleeding 2.32 13 Perioperative myocardial infarction 1.08 19 Infection sternum superficial 0.73 -- Infection sternum deep 0.63 11 Infection Leg 1.26 -- Infection UTI 1.52 -- Septicemia 0.9 38.6 Neurologic CVA permanent 1.65 28 CVA transient 0.74 -- Delirium 2.62 -- Pulmonary mechanical ventilation > 5 days 5.46 21 Pulmonary embolism 0.33 -- Pulmonary edema 2.12 -- ARDS 0.87 -- Pneumonia 2.45 -- Renal failure (creatinine>2.0) 3.14 30.6 With dialysis 0.87 47.6 Cardiac Heart block requiring pacemaker 0.81 -- Tamponade 0.39 25 Atrial fibrillation 19.37 -- Cardiac arrest 1.46 64.1 GI complication 2.45 17 Multisystem Failure 0.6 74.4 *http://www.ctsnet.org/doc/2988 (current specific complication rates after 1997 unavailable) + Through 1997, 450 centers contribute patients to the STS-NCD 2.4 million patients through 1997 enrolled in STS-NCD Data fields include 217 core fields and 255 extended fields Data analysis and warehouse center after 1998 at Duke clinical Research Institute + (Shahian, D.M, Blackstone, E.H., Edreards, FH, et al Cardiac Surgery Risk Models: A position article Ann Thorac Surg 2004; 78:1868-1877) 944 of 4, 856 acute care hospitals in USA perform open heart surgery (Hospital statistics - 2002 Health Forum LLL, p159) Figure 3 (b) Toronto General Hospital Experience * Complications rates from 1993-1997 CABG Valves AA/A CHD Miscellaneous Re-exploration for bleeding 1.5% 4.0% 6.5% 4.2% 4.2% Perioperative stroke 1.4% 2.5% 6.6% 0.0% 2.2% Perioperative myocardial 2.4% 1.3% 1.7% 0.6% 1.6% Infarction Deep sternal infection 0.8% 0.7% 1.1% 0.6% 0.2% Superficial wound infection 1.7% 0.8% 1.7% 1.9% 1.4% Sternal dehiscence 0.3% 0.1% 0.6% 0.0% 0.2% Renal failure 0.3% 0.3% 0.6% 0.0% 1.6% Mean ICU stay (days) 1.9 2.5 3.3 2.4 3.4 Abbreviations CABG = coronary artery bypass graft; AA/A = ascending aorta + / - arch; CHD = congenital heart disease * Adapted from Cheng DC, David TE. Perioperative care in cardiac anesthesia and surgery. Landes Bioscience Georgetown, TX 1999, p2 Figure 4  Target patterns of ten shots fired by two riflemen. A's pattern exhibits no constant error, but rather large variable errors. B's pattern shows a large constant error, but small variable errors.(17) Figure Five (a) (24) Characteristics of surgical decisions 1. Decisions are a combination of planning, observation, and deduction. 2. Two components A. A precise plan B. Modify the plan with unexpected events 3. Emotional considerations A. Decisions under stress, within limited time Balancing probabilities (Dunphy) B. Few things in an operating room are neutral: either help or harm the operation C. A calm, serious atmosphere with intense concentration (a conductor and a symphony orchestra)  Figure Five (b) (24) Four basic concepts about dexterity 1. Teaching is badly neglected a. Importance minimized p!.  Teach a monkey to operate q!.  Will automatically learn b. Don t know how c. Time consuming 2. A significant percentage of surgical complications are error in technique 3. Residents vary widely in natural ability, often those with little dexterity are taught least. 4. Learning how to operate is a process that should continue for decades. The residency should teach one how to learn on his own. Figure 6 Problems with Morbidity/Mortality Conference Presentation of chronological difficult cases, complications, deaths without tracking trends. Anecdotal without national statistical norms Narrow focus; ignores systems analysis Required by hospital or program; Hesitancy to be judgmental or punitive Figure 7  In Reason's [17] "Swiss cheese" model of accident causation, adverse events occur when active failures at the operational level align with gaps or weaknesses in the systems, or latent failures at the organizational level permitting an error or accident sequence to go untrapped and uncompensated. Efforts must be made to reduce the gaps as well as reduce the errors. The defense systems can fail either because of or organizational failure or because of performance failures of the operators. (Adapted from Carthley J, et al. The human factor in cardiac surgery: errors and near misses in a high technology medical domain. Ann Thorac Surg 2001; 72:300-5.)(16) Figure 8 Demings 14 Points for Management* 1. Create constancy of purpose for improvement of product and service. 2. Adopt the new philosophy. 3. Cease dependence on mass inspection. 4. End the practice of awarding business on the basis of price tag alone. 5. Improve constantly and forever the system of production and service. 6. Institute training. 7. Adopt and institute leadership. 8. Drive out fear. 9. Break down barriers among staff areas. 10. Eliminate slogans, exhortations, and targets for the work force. 11. Eliminate numerical quotas for the work force and numerical goals for people in management. 12. Remove barriers that rob people of pride of workmanship. 13. Encourage education and self-improvement for everyone. 14. Take action to accomplish the transformation. *(32) Adapted from Scherkenbach WW: The Deming Route to Quality and Productivity. Milwaukee, ASQC Quality Press, 1986 Figure 9     The PDSA cycle for learning and improvement.(33) Figure 10 Surgical Complications Classification Schemes Type of Complication Anticipated/Unanticipated Expected/Unexpected Predicted/Unpredicted Avoidable/Unavoidable Recognized/Unrecognized Preventable/UnpreventableFatal/Nonfatal (mortality/morbidity) Early/Late (<30 days/>30 days)b Major/Minor Permanent/Temporary Disabling/Nondisabling (mild/moderate/severe) Specific/Nonspecific Single/Multiple Systemic/Local Cardiac/Noncardiac Category Comorbidity factors  patient related Systems failure Directly attributable to operation (commission) Human Factor Directly attributable to delayed or premature operation or management, omission of operation, or failure to recognize error/complication Unrelated to operation/procedure Sequela* Outcome Complete recovery/resolution from complication Partial recovery No recovery Fatal *Sequela (ae) accepted negative consequence of an operation or procedure eg surgical scar, decreased pulmonary function following lung resection, or decreased mobility following lower leg amputation. (35) Rutherford, R.B. Suggested Standards for reporting complications in Vascular Surgery p1-10. Complications in Vascular Surgery Bernhard, VM, Towne, JB ed Quality Med. Pub, St. Louis, 1991 (36) Clavien, PA, Sanabria, JR, Strasberg, SM. Proposed classification of complications of surgery with examples of utility in cholecystectomy Surgery 1992; 111:518-526. bEarly - One-time events - occuring within 30 days of surgery or before hospital discharge, whichever is sooner. Late - time-related events - after 30 days. bGrunkemeier, G, Jin, R. Ch7-Surgical Treatment of Outcome Data p225-231. In Cohn, L.H., Edmunds, L.H., ed. Cardiac Surgery in the Adult 2nd edition, MC Graw Hill, New York, 2003. Figure 10 (cont) Grading Grade `! - Minor - resolved spontaneously without care, or patient care, or minimal medical care Grade a! - Potentially - life threatening requiring intervention Grade b! - Residual or lasting disability Grade c! - Death directly related to complication Figure 11 Problem solving equation OBJECTIVE Knowledge Skill Technique Problem (Challenge) Solution (Management/Resolution)  SUBJECTIVE Judgment Maturity Experience Doing Right Things Right  Accepted Indications Proper Time of Operation Relative/Absolute Suitable operation for patient Accepted Contraindications Technically correct Figure 12 Example of Surgical Practice Guidelines ISCHEMIC HEART DISEASE: III (37) Diagnosis: 414.10 Left ventricular aneurysm Procedure: 33542 Resection or application of left ventricular aneurysm Indication: 1. Congestive heart failure 2. Systemic emboli 3. Angina pectoris 4. Ventricular arrhythmias Confirmation of Indication: Cardiac imaging study with contrast, echocardiography, or radionuclide technique showing dyskinesia Relative Contraindications: Asymptomatic true aneurysm Actions Prior to Procedure: 1. Coronary arteriography 2. Left ventriculography often indicated Actions During Procedure: 1. Remove mural thrombus 2. In presence of ventricular tachycardia, map endocardium and ablate sites of early repolarization Actions Following Procedure: 1. Cardiorespiratory support 2. Treat arrhythmias Outcome: 1. Mortality of 3% to 30% determined by patient age, general status, associated disease, and extent of myocardium involved. 2. Discharge in 7 to 21 days depending on preoperative status 3. Diminution or relief of symptoms References: Komeda M, David TE, Malik A, Invanov J, Sun Z. Operative Risk and Long-Term Results of Operation for Left Ventricular Aneurysm. Ann Thorac Surg 1992; 53:22-29. Mills NL, Everson CT, Hockmuth DR. Technical Advances in the Treatment of Left Ventricular Aneurysm. Ann Thorac Surg 1993; 55:792-800. Baciewicz PA, Weintraub WS, Jones EL, et al. Late Follow-up after Repair of Left Ventricular Aneurysm and (usually) associated Coronary Bypass Grafting. Am J Cardiol 1991:68:193-200. Figure 13 ACGME General Competencies CategoryACGME CompetencyPatient careResidents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and promotion of health.Medical knowledgeResidents must demonstrate knowledge about established and evolving biomedical, clinical, and cognate (eg, epidemiological and socio-behavioral) sciences and the application of this knowledge to patient care.Practice-based learning and improvementResidents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices.Interpersonal and communication skillsResidents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, patients families, and professional associates.ProfessionalismResidents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.Systems-based practiceResidents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to call on system resources to provide care that is of optimal value. Figure 14   Figure 15 Anatomy of a Suit(49) Plaintiffs complaint Summons-complaint and venue Verification (Bill of Particulars) Defendants answera Discoverya Interrogatories Requests for production Documents Name of witnesses Depositions Plaintiff Defendant(s) Motionsa Trial (judge or jury) Appeals (not always) a These steps do not always occur in this order. Figure 16(48) 1. Listen patiently. 2. Respect the patients dignity and privacy. 3. Return phone calls promptly. 4. Be polite. 5. Be on time. 6. Have the patient join in decision-making. Allow time for reflection. 7. Keep patients expectations in line with reality (prepare them for all eventualities). 8. Be honest about a misadventure (never cover up or try to blame others). 9. Avoid high-risk situations such as cases you are not fully equipped to handle or cases in which there is a personality clash with a patient or family. 10. Treat the patient as you would like to be treated. Figure 17 Surgical consideration (commission) Preoperative Counselling: Patient; family; relative; appropriate others; referring primary and specialist HIPAA Compliance Operative: Indications: relative/absolute Contraindications: relative/absolute Timing: when/where to operate (level of facility capability) Techniques available: Various methods; aggressive; conservative; palliative; curative Technique employed: knowledge, familiarity Complications: (major/minor) Preoperative risks; comorbidity Operative predicted; unpredicted Early postoperative < 30 days Late postoperative > 30 days Chronic/residua Post-operative: Disclosure too much; too little information re. complications/outcome* *Mavroudis, C., Mavroudis C.D., Naunheim, K.S., Sade, R.M. Ethics in Cardiothoracic Surgery-Should Surgical Errors Always be disclosed to the patient? Ann. Thorac. Surg 2005; 80:399-408 - A debate regarding a surgical error that allowed the operating surgeon the opportunity to hide or conceal the information from family members following the patients death. Figure 18 The ABCDE Mnemonic for Breaking Bad News* Advance preparation Arrange for adequate time, privacy and no interruption (turn pager off or to silent mode). Review relevant clinical information. Mentally rehearse, identify words or phrases to use and avoid. Prepare yourself emotionally. Build a therapeutic environment/relationship Determine what and how much the patient wants to know. Have family or support persons present. Introduce yourself to everyone. Warn the patient that bad news is coming. Use touch when appropriate. Schedule follow-up appointments. Communicate well Ask what the patient or family already knows. Be frank but compassionate; avoid euphemisms and medical jargon. Allow for silence and tears; proceed at the patients pace. Have the patient describe his or her understanding of the news; repeat this information at subsequent visits. Allow time to answer questions; write things down and provide written information. Conclude each visit with a summary and follow-up plan. Deal with patient and family reactions Assess and respond to the patient and the familys emotional reaction; repeat at each visit. Be empathetic. Do not argue with or criticize colleagues. Encourage and validate emotions Explore what the news means to the patient. Offer realistic hope according to the patients goals. Use interdisciplinary resources. Take care of our own needs; be attuned to the needs of involved house staff and office or hospital personnel. *Adapted from Rabow MW, McPhee SJ. Beyond breaking bad news: How to help patients that suffer. West J Med 1999; 171:261. Figure 19 Essential Data Entered in the Society of Thoracic Surgeons (STS) Database*b Demographics Age, Gender Acuity/Priority Elective/urgent/emergent Comorbidities Smoking Diabetes Morbid obesity Renal failure Hypertension Stroke COPD Peripheral vascular disease Cerebrovascular disease Cardiac disease Recent MI Type of angina Cardiogenic shock Preoperative arrhythmias Preoperative meds (diuretics, inotropes, antiarrhythmics, NTG) * Current Core STS data elements and definitions available at  HYPERLINK "http://www.sts.org/doc/4502" http://www.sts.org/doc/4502 b Bojar RM. Manual of Perioperative Care in Cardiac Surgery. Third Edition Malden, MA, Blackwell Science, 1999, p80 Figure 20 (a) Cleveland Clinic Clinical Preoperative Severity Scoring System * (59) Preoperative Factor Factor Emergency case 6 Creatinine > 1.6-1.8 1 Creatinine > 1.9 4 Severe LV dysfunction 3 Reoperation 3 Mitral regurgitation 3 Age 65-74 1 Age > 75 2 Prior vascular surgery 2 COPD 2 Hematocrit < 34% 2 Aortic stenosis 1 Weight < 65kg 1 Diabetes 1 Cerebrovascular disease 1 Maximum Score 31 Relevant range 0-13+_______________ COPD - chronic obstructive pulmonary disease LV - left ventricular Figure 20 (b)  * The correlation of the clinical severity scoring system with mortality at the Cleveland Clinic. (Source: Higgins TL, Estafanous FG, Loop FD, et al. Stratification of morbidity and mortality outcome by preoperative risk factors in coronary artery bypass patients. JAMA 1992; 265:234-238.)(59) Figure 21(66) Risk Algorithm Northern New EnglandPreoperative estimation of risk of CABG, mitral or aortic valve mortalityPatient or disease characteristicCABG mortality scoreAortic valve mortality scoreMitral valve mortality scoreAge 60-69 Age 70-79 Age e"80 Female sex EF <40% NYHA b! NYHA c! LVEDP e"20 Urgent surgery Emergency surgery Prior CVA Prior CABG PVD CHF Atrial fibrillation CAD Diabetes Dialysis or creatinine e"2 COPD BSA <1.70 BSA 1.70-1.99 Mitral replacement Concomitant CABG Total score 2.5 4.0 11.0 2.0 1.5 2.0 9.0 3.0 1.5 1.5 2.5 2.0 1.5 2.0 3.0 1.0 1.5 1.5 5.5 1.5 2.0 1.5 1.5 1.5 1.0 1.5 1.5 3.0 3.0 1.5 1.0 2.0 1.5 2.0 6.0 1.5 1.5 1.4 1.5 1.5 1.5 2.0 Preoperative Risk Total scoreMortality (%)Aortic (%)Mitral (%)<3<0.4<1.8<0.630.41.80.640.62.20.950.83.11.161.23.61.571.55.12.082.16.62.792.88.54.0103.711.94.8114.615.17.1126.617.29.2135.223.711.6149.931.417.0157.336.919.6169.643.026.61712.0>43.034.01815.841.21921.648.020e"31.7>60.0 Figure 22 (69) (101) (102) Generic Quality of Life Instruments Short Form 36 (SF 36)Seattle angina questionnaireNottingham Health ProfilePhysical functioningExertional capacityMobilitySocial functioningAngina stabilityPainRole limitations Physical EmotionalTreatment frequencyEnergyTreatment satisfactionSleepDisease perceptionEmotional reactionMental healthSocial IsolationEnergy/VitalityPainGeneral health perceptions Figure 23 Intensive Care Unit Risk Stratification Score (95) Variable Value Preoperative factors Small body size (BSA < 1.72m2) 1 Prior hear operation One 1 Two or more 2 History of operation or angioplasty 3 for peripheral vascular disease Age > 70 years 3 Preoperative creatinine > 1.9mg/dL 4 Preoperative albumin < 3.5mg/dL 5 Intraoperative factors CPB time > 160 minutes 3 Use of IABP after CPB 7 ICU admission physiology A-a O2 gradient > 250mmHg 2 Heart rate > 100 beats/min 3 Cardiac index < 2.1 L. min-1.m-2 3 CVP > 17mmHg 4 Arterial bicarbonate < 21 mmol/L 4 A-a = Alveolar-arterial; BSA = body surface area; CPB = Cardiopulmonary bypass; CVP = central venous pressure; IABP = intraaortic balloon pump; ICU = intensive care unit   Sequential analysis of mortality risk in cardiac surgical patients. Use of preoperative and intensive care unit (ICU) risk stratification scores for sequential analysis of mortality risk. A preoperative score of 7 was used as the cut point between a low and high risk. An ICU admission score of 14 was used as the cut point to determine the level of risk. Figure 24 Ontario Score Risk Index for Mortality, ICU LOS and PostOp LOS (13) Risk Factor Risk Score Age, y < 65 0 65 74 2 > 75 3 Sex Male 0 Female 1 Left ventricular function Grade 1 0 Grade 2 1 Grade 3 2 Grade 4 3 Type of Surgery CABG only 0 Single valve 2 Complex 3 Urgency of surgery Elective 0 Urgent 1 Emergency 4 Repeat operation No 0 Yes 2 Range of scores Observed Mortality Rates, ICU, LOS and PostOp LOS by Risk Score In-Hospital Risk Patients, Mortality Mean ICU Mean PostOp Score % Rate, % LOS,d LOS,d 0 11.81 0.25 2.27 8.04 1 14.73 0.79 2.39 8.43 2 17.84 1.30 2.81 9.25 3 17.07 2.89 2.89 10.35 4 14.23 4.59 3.16 10.97 5 10.72 5.69 3.31 11.44 6 6.43 8.13 3.68 12.80 7 3.88 11.61 4.33 13.14 > 8 3.30 13.22 5.87 14.51 Figure 25 Grading of Recommendations and Levels of Evidence * GRADE A Level 1a Evidence from large randomized clinical trials (RCTs) or systematic reviews (including meta-analyses) of multiple randomized trials which collectively has at least as much data as one single well-defined trial. Level 1b Evidence from at least on All or None high quality cohort study; in which ALL patients died/failed with conventional therapy and some survived/succeeded with the new therapy (e.g. chemotherapy for tuberculosis, meningitis, or defibrillation for ventricular fibrillation); or in which many died/failed with conventional therapy (e.g. penicillin for pneumococcal infections). Level 1c Evidence from at least one moderate sized RCT or a meta-analysis of small trials which collectively only has a moderate number of patients. Level 1d Evidence from at least one RCT. GRADE B Level 2 Evidence from at least one high quality study of non-randomized cohorts who did and did not receive the new therapy. Level 3 Evidence from at least one high quality case control study. Level 4 Evidence from at least one high quality case series. GRADE C Level 5 Opinions from experts without reference or access to any of the foregoing (e.g. argument from physiology, bench research or first principles). * Adapted from (122) Yusuf S, Cairns JA, Camm AJ, Fallen EL, Gersh BJ. Evidence based Cardiology. 1998 BMJ Books, London p2 Figure 26 ACC/AHA Classification for Guidelines Series(123) The ACC/AHA classifications I, II and III are used to summarize indications as follows: Class I: Conditions for which there is evidence and/or general agreement that a given procedure or treatment is useful and effective. Class II: Conditions for which there is conflicting evidence and/or a divergence of opinion about the usefulness/or efficacy of a procedure. Class IIa: Weight of evidence/opinion is in favor of usefulness/efficacy. Class IIb: Usefulness/efficacy is less well established by evidence/opinion. Class III: Conditions for which there is evidence and/or general agreement that the procedure/treatment is not useful/effective and in some cases may be harmful. Figure 27 1999 AHA/ACC Guidelines for CABG in ST-segment elevation (Q-wave) MI(123) Indication and clinical condition Definition of level of evidence  Class I Class I: Conditions for which None there is evidence and/or general agreement that a given procedure or treatment is useful and effective.  Class IIa Class II: Conditions for which there 1. On going is conflicting evidence and/or a ischemia/infarction not divergence of opinion about the responsive to maximal usefulness or efficacy of a therapy. Procedure. Class IIb Class IIa: Weight of evidence/ 1. Progressive LV pump opinion is in favor of usefulness/ failure with coronary efficacy. stenosis compromising viable myocardium outside Class IIb: Usefulness/efficacy the initial infarct area. is less well established by evidence/opinion. 2. Primary reperfusion in the early hours (<6 to 12 hours) of an evolving ST-segment elevation MI.  Class III Class III: Conditions for which there 1. Primary reperfusion late is evidence and/or general (>12 hours) in evolving agreement that the procedure/ ST-segment elevation MI treatment is not useful/effective without ongoing ischemia and in some cases may be harmful. Figure 28 Summation SPO* Structure Process Outcome  Surgeon - Character/Personality/Competence - Human Factor Staff - Support - Team - Product Line - Clinical Care Pathways Hospital - infrastructure/volume/resources - Systems Patient - Risk assessment  Effective - EBM (evidence-based-medicine) Safe - Surgeon/System related Timely - waits/delays Efficient - Cost control/Personal waste Patient centered - Individual Focus Equitable Quality to all served  Surgeon participation Evaluation/Database Methods of analysis Results/Critiques/Report Card PDSA cycle (Plan/Do/Study/Act) (see Figure 9) __________ * Modified from (134) Birkmeyer, JD, Dimick, JB. Birkmeyer, NJ Measuring the quality of medical care; Structure, Process, or Outcomes? J Am Coll Surg 2004;198:626-632 Figure 29 Components of Quality Assurance/Performance JCAHO (142)V. A. Gaudiani (143)Accessibility of CarePatient SatisfactionAppropriateness of CareInstitutional processContinuity of CareOutcomesEffectiveness of CareAppropriateness of careEfficacy of CareEfficiency of resource managementEfficiency of CarePatient Perspective IssuesSafety of Care EnvironmentTimeliness of Care Table One Risk Factors Associated with Either Increased Length of Stay (L) or Increased Incidence of Organ failure Morbidity (M) or Both (L/M) Following coronary Revascularization. Risk factor Boston Albany VA Canada (10) (11) (12) (13) DemographicsAdvanced ageLMLIncreased ratio of age/red blood cell volumeL/MFemale genderLDisease specific diagnosesCHF or cardiomegalyLL/MMConcomitant valve diseaseMLReoperationMLLV dysfunction (ejection fraction)LSurgical priorityMLIABP pre-opLActive endocarditisMComorbid conditionsObesityLRenal dysfunctionLLMPeripheral vascular diseaseLMChronic obstructive lung diseaseLCerebrovascular diseaseL/MHypertensionL/M Abbreviations: CHF= congestive heart failure; LV = left ventricular; IABP = intraaortic balloon counterpulsation Table Two Iatrogenic Deaths in the United States* Iatrogenic Deaths in The United States (Deaths induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures)ConditionDeathsCostAdverse Drug Reactions106,000$12 billionMedical error98,000$2 billionBedsores115,000$55 billionInfection88,000$5 billionMalnutrition108,800-------Outpatients199,000$77 billionUnnecessary Procedures37,136$122 billionSurgery-Related32,000$9 billionTOTAL783,936$282 billion * (http://www.ourciviliztion.com/medicine/usamed/deaths.htm) Table Three Partial listing of publicly available information sources related to Thoracic Surgery SourceTargeted audienceCommunication mediaInformation availableAmerican college of Cardiology/ American Heart AssociationPatients needing CABG (nationwide)Internet ( HYPERLINK "http://www.acc.org/clinical/guidelines/bypass/bypass7.htm" http://www.acc.org/clinical/guidelines/bypass/bypass7.htm) Literature-based indications for CABGAgency for Health Care Research & QualityBroad base of health care consumers and providersInternet ( HYPERLINK "http://www.ahcpr.gov/" http://www.ahcpr.gov/)Large knowledge base focusing on empowering consumers to judge health care quality.California Office of Statewide Health Planning and DevelopmentPatients who purchase healthcare insurance in CaliforniaInternet ( HYPERLINK "http://www.oshpd.cahnet.gov/hpp/ccmrp/ccmrp summary.pdf" http://www.oshpd.cahnet.gov/hpp/ccmrp/ccmrp summary.pdf)In-hospital CABG mortality data from 1998Canadian Health Care SystemProvide consumers with hospital outcomes for various procedures that might indicate quality at a given hospitalInternet ( HYPERLINK "http://www.hcsc.gc.ca/ohihbsi/available/conference/presentations/guerriere" http://www.hcsc.gc.ca/ohihbsi/available/conference/presentations/guerriere e.pdf)Risk-adjusted hospital mortality rates for Canadian hospitals.Cochrane Collaboration All interested consumersInternet ( HYPERLINK "http://www.cochraneconsumer.com/" http://www.cochraneconsumer.com/)Summarizes available published evidence about a wide variety of healthcare interventions including cardiac surgery.Dartmouth University Use large healthcare databases to inform the public of nationwide trends in health care deliveryInternet ( HYPERLINK "http://www.dartmouthatlas.org/99US/chap" http://www.dartmouthatlas.org/99US/chap 5 sec 12.php)CABG mortality rates across the U.S. based primarily on claims databasesHealth Care ChoicesNew York not-for-profit corporation dedicated to educating the public about the nations health care systemInternet ( HYPERLINK "http://www.healthcarechoices.org/cardiacsurgery.htm" http://www.healthcarechoices.org/cardiacsurgery.htm ) Select state CABG mortality rates, Primitive attempt to collate all publicly available data about physicians. Not nearly complete enough but evolving Table Three (cont) HealthFinderNIH Government sponsored information web site about a wide variety of medical problems.Internet ( HYPERLINK "http://www.healthfinder.gov/healthcare/" http://www.healthfinder.gov/healthcare/) General information in fairly specific detail about cardiac procedures (with drawings and diagrams).Healthoutcomes.comPatients requiring operation or catheter-based intervention nationwideInternet  HYPERLINK "http://www.healthoutcomes.com" www.healthoutcomes.com In-hospital outcome for medicare patients having selected procedures (e.g. CABG)The Leapfrog Group (Consortium of Fortune 500 companies and health care insurersProvide consumers with list of hospitals that employ Leapfrog defined quality measuresInternet ( HYPERLINK "http://www.leapfroggroup.org/index.html" http://www.leapfroggroup.org/index.html)List of hospitals that use quality measures. Hospitals that use these quality measures will be financially rewarded by Leapfrog Group.Medscape Inc. Consumer information source for all types of medical conditions and for preventive medicineInternet ( HYPERLINK "http://www.medscape.com/px/urlinfo" http://www.medscape.com/px/urlinfo)Comprehensive, searchable website with multiple links to external sites capable of finding comprehensive information about details of cardiac surgery.The National Quality ForumProvides to the public a standardized set of measures and framework for improving the quality of cardiac surgeryInternet ( HYPERLINK "http://www.qualityforum.org" http://www.qualityforum.org) The set includes 21 hospital - level measures that facilitate efforts to achieve higher levels of patient safety and better outcomes for patients.New Jersey State Department of HealthPatients having cardiac procedures in New York StateInternet ( HYPERLINK "http://www.health.state.ny.us/nysdoh/consumer/heart/1996-98cabg.pdg" http://www.health.state.ny.us/nysdoh/consumer/heart/1996-98cabg.pdg)Surgeon-specific and hospital in-hospital mortality rates for CABG.Pennsylvania Health Care Cost Containment CouncilPatients who require CABG in the state of PennsylvaniaInternet ( HYPERLINK "http://www.phc4.org/reports/cardiaccare.htm" http://www.phc4.org/reports/cardiaccare.htm)Hospital-and surgeon-specific CABG mortality rates.Rand CorporationProvide the public with summary data about health care outcomes for cardiac surgeryInternet ( HYPERLINK "http://www.rand.org/publications/MR/MR1255/MR1255.app4.pdf" http://www.rand.org/publications/MR/MR1255/MR1255.app4.pdf)Summary of publicly available CABG mortality rates with critical appraisal of methods and some estimation of appropriateness of care.Society of Thoracic SurgeonsProvide the public with results of cardiac surgery over as broad of a population as possible (including VA, Northern New England Consortium, and Great Britain)Internet ( HYPERLINK "http://www.ctsnet.org/section/outcomes/" http://www.ctsnet.org/section/outcomes/)Mortality and other outcomes data for a variety of thoracic procedures. Some of the data is presented as raw mortality data without risk adjustment. One of the only databses that includes non-cardiac surgery. Society of Thoracic SurgeonsProvide the public with results of cardiac surgery over as broad of a population as possible (including VA, Northern New England Consortium, and Great Britain)Internet ( HYPERLINK "http://www.ctsnet.org/section/outcomes/" http://www.ctsnet.org/section/outcomes/)Mortality and other outcomes data for a variety of thoracic procedures. Some of the data is presented as raw mortality data without risk adjustment. One of the only databases that includes non-cardiac surgery. Solucient Corp.,Inc. (Top 100 Heart Hospitals)Provide the public with rather arbitrary rating of overall quality of cardiac care at hospitals.Internet ( HYPERLINK "http://100tophospitals.com/Media/releases/nr010702 cardio.htm" http://100tophospitals.com/Media/releases/nr010702 cardio.htm)Rates all hospitals in the U.S. that do cardiac surgery and lists the top 100 heart hospitalsWashington Post Medical WebsiteProvider of medical information reports to consumers in North AmericaInternet ( HYPERLINK "http://www.medifocus.com/" http://www.medifocus.com/)General information about cardiac disease.WebMd Inc.Provide information to consumers and physicians about a broad spectrum of health care issues.Internet ( HYPERLINK "http://my.webmd.com/content/dmk/dmk" http://my.webmd.com/content/dmk/dmk article 53203)Information about CABG and expected outcomes/Womens Heart FoundationProvide health-related information for womenInternet ( HYPERLINK "http://www.womensheartfoundation.org/content/HeartSurgery/state report cards on ohs.asp" http://www.womensheartfoundation.org/content/HeartSurgery/state report cards on ohs.asp)Links to internet-available report cards on cardiac surgery. Table Four REPORT CARD ACCESS CONTENT DATA SOURCES COMMENTS NATIONAL Americas Best Hospital  HYPERLINK "http://www.usnews.com" www.usnews.com Ranks top 50 hospitals in each Medicare records, AHA The only report card of 17 specialty areas; 205 proprietary database, that contains nursing U.S. News & World Report 800-436-6520 hospitals ranked overall. Physicians survey. information. On the web Rankings based on mortality searchable by hospital, Free on website. List rates, available technology location, or specialty area. published in July, $3.95 and services, nursing staff levels, physician survey. Guide to Hospitals  HYPERLINK "http://www.checkbook.org" www.checkbook.org 4,500 hospitals rated. Mortality Medicare records, accreditation Plentiful information and rates for 10 common medical review scores, physician useful hospital safety Consumers Checkbook 800-213-7283 conditions and 2 types of surveys. Advice confusing design. Surgery; adverse-outcome rates Print, $19.95. Free online for for 7 types of surgery; all Consumers checkbook compared to national averages. subscribers. Two years of web access: $19.95 for non-subscribers. Hospital report cards  HYPERLINK "http://www.healthgrades.org" www.healthgrades.org Ratings of more than 5,000 Medicare records; for obstetrics Cumbersome search hospitals based on volume and hospital-discharge reports. mechanism. Site only Health Grades Inc. Free for limited use. mortality rates for 25 common allows viewing of ratings Site sells comprehensive procedures and diagnoses. for one procedure at a reports on individual hospitals; Obstetrics data available for hospitals time. No overall hospital $24.95 per 3 reports in 18 states, including cesarean rates, ratings. volume, and complication rates. Quality Check  HYPERLINK "http://www.jcaho.org" www.jcaho.org Results of most-recent review JCAHO records No disease-specific volume by national hospital-accreditation information. Joint Commission on Free authority. Scores for hospital Accreditation of Healthcare services and systems compared Organizations with national results. Interactive search features. Consumer Reports January, 2003, p15 Table Five Risk Models for Operative Mortality for CABG (51) * 52 53 54 55 56 57 58 59 60 61 62 63 64 Risk modelNYS CanadaMass Emory VAAustralia TorontoCCFIsraeliAlabamaNNENYCParsonnetNo. of patients174,21057,18750,35717,12813,36812,71212,0037,4914,9184,8353,6543,0552,152No. of risk factors29161376959799108AgeXXXXXXXXXXXXGenderXXXXXXXXXUrgencyXXXXXXXXEFXXXXXXXXRenal dysfunctionXXXXXXXPrevious CABGXXXXXXNYHA classXXXXXXLeft main CADXXXXXX# diseased vesselsXXXXXXPVDXXXXXDiabetesXXXXXPrior StrokeXXXXIntraop/postop variablesXX XXPrior MIXXXXBody SizeXXXPreop IABPXXXShockXXXCOPDXXPrior PTCAXXAnginaXXIV NTGXXArrhythmiasXXHx of heart operationXXHemodynamic instabilityXXCharison comorbidityXXDialysis dependenceXXPulmonary hypertensionXX DiureticsXXHTCVDXSerum albuminXRaceXPrevious CHFXMI timingXCardiac indexXLVEDPXCVA timingXLiver diseaseXNeoplasiaXVentricular aneurysmXSteroidsXDigitalisXThrombolytic therapyXArterial bicarbonateXCalcified aortaX * Adapted from: (51) Grunkemeier GL, Zerr KJ, Jin, R. Cardiac Surgery Report Cards. Ann Thorac. Surg. 2001; 72: 1845-1848 Abbreviations: NYS = New York State; Mass Massachusetts; VA = Veterans Administration; CCF = Cleveland Clinic Foundation; NNE = Northern New England; NYC= New York City; EF = ejection fraction; NYHA = New York Heart Association; CAD = coronary artery disease; PVD = peripheral vascular disease; MI = myocardial infarction; IABP intra-aortic balloon pump; COPD = chronic obstructive pulmonary disease; PTCA = percutaneous transluminal coronary angioplasty stent; NTG = nitroglycerin; Hx = history; HTCVD = hypertensive cardiovascular disease; LVEDP = left ventricular end-diastolic pressure; CVA = cerebrovascular accident References 1. Shumaker HB. The Evolution of Cardiac Surgery. Indiana University Press, Bloomington, 1992 Ch 2 p. 11-17. 2. Harken DE. The emergence of cardiac surgery I. Personal Recollections of the 1940's and 1950's. J Thorac Cardiovasc Surg 1989; 98:805-813. 3. Swan, H. Zeavin I. Blount, SG, Virtue RW. Surgery by direct vision in the open heart during hypothermia JAMA 1953; 153:1081- 4. Lillehei CW, Varco RL, Cohen M, Warden HE, Patton C, Moller JH. The first open heart repairs of Ventricular Septal Defect, and Atrioventricular Communis and Tetraology of Fallot using Extracorporeal circulation by cross-circulation: A 20-year follow-up. Ann Thorac Surg 1986; 41:4-21. 5. Gibbon JH. Application of a mechanical heart and lung apparatus. Minnesota Medicine 1954; 37:171-185. 6. Popovic JR, Hall MJ. 1999 National Hospital Discharge Survey, Advance Data number 319, Center for Disease Control and Prevention. April 24, 2001, p.1-20. 7. Kirklin JW. Technical and scientific advances in Cardiac Surgery over the past 25 years. Ann Thorac Surg 1990; 49:26-31. 8. Relman AS. Assessment and accountability - The third revolution in medical care. New Engl J Med 1988; 319:1220-1222. 9. Grover, F.L., Cleveland, JC, Shroyer, LW. Quality Improvement in Cardiac care Arch Surg 2002; 137:28-36. 10. Lahey SJ, et al., Preoperative risk factors that predict hospital length of stay in coronary artery bypass patients > 60 years old. Circulation, 1992; 8:III 81-85. 11. Ferraris VA, Ferraris SP. Risk factors for postoperative morbidity. Journal of Thoracic and Cardiovascular Surgery, 1996; 11:731-738; discussion 738-741. 12. Hammermeister KE, et al. Identification of patients at greatest risk for developing major complications at cardiac surgery. Circulation, 1990; 82:IV 380-389. 13. Tu JV, Jaglal SB, Naylor CD. Multicenter validation of a risk index for mortality, intensive care unit stay and overall hospital length of stay after cardiac surgery. Steering Committee of the Provincial Adult Cardiac Care Network of Ontario. Circulation, 1995; 91:677-684. 14. Institute of Medicine. Kohn LT, Corrigan JM, Donaldson MS, eds. To Err is Human. Washington, DC, National Academy Press, 1999. 15. Carthey J, de Leval MR, Reason JT. The human factor in Cardiac Surgery: Errors and near misses in a High Technology Medical domain. Ann Thoracic Surg. 2001; 72:300-305. 16. Reason J. Human Error Cambridge University Press New York, 1990, Chapter 1, 3. 17. de Leval MR, Carthey J, Wright DJ, Farewell VT, Reason JT. Human factors and Cardiac Surgery: A Multicenter Study. J Thorac Cardiovasc Surg. 2000; 119:661-672. 18. Kouchoukos, NT, Blackstone, EH, Doty, D8, Hanley, FL, Karp, R.B. ed. Kirklin/Barratt-Boyes Cardiac Surgery, 3rd ed. Churchill, Livingstone Philadelphia, 2003. p 256-262. 19. Edmunds LH, Clark RE, Cohn LH, Grunkemeier GL, Miller DC, Weisel RD. Guidelines for reporting morbidity and mortality after cardiac valvular operations. J Thorac Cardiovasc Surg. 1996; 112:708-711. 20. Passaro EA, Organ CH. Ernest A. Codman: The Improper Bostonian. Bulletin of Am Coll of Surgeons 1999; 84:16-22. 21. Ferraris, VA, Ferraris, SP. Ch6 - Risk Stratification and Comorbidity. In. Cohn, LH, Edmunds, CH, ed. Cardiac Surgery in the Adult, 2nd ed. New York, Mc Graw-Hill, 2003 p187-224. 22. Griswold ML George J, Heuer MD. A critical analysis of the role that he played in introducing the residency system of training. Surgery 1975; 78:349-362. 23. Sloan H, Kirsh MM, Orringer MD. Thoracic Surgery training at the University of Michigan Chest Surgery Clinics of N America 2000; 10:210-211. 24. Spencer FC. Observations on the teaching of Operative Technique. Bulletin Am Coll of Surg March 1983;3-6. 25. de Leval, M.R. Beyond Flatland J. Thorac Cardiovasc. Surgery 2003; 125:12-19. 26. Blackstone, E.H. Let the data Speak for themselves. Pediatric Cardiac Surgery Annual of the Seminars in Thorac and Cardiovasc. Surgery 2004; 7:192-198. 27. Blackstone, E.H. Monitoring Surgical Performance J. Thorac Cardiovasc. Surg 2004; 128:807-810. 28. Rogers, CA, Reeves, B.C., Caputo, M, Ganesh, JS, Bonser, R.S., Angelino, G.D. Control chart methods for monitoring cardiac surgical performance and their interpretation. J. Thorac Cardiovase Surg 2004; 128:811-819. 29. Spiegelhalter, D.J. Monitoring Clinical Performance: A Commentary J. Thorac Cardiovase Surg 2004; 128:820-822. 30. Treasure, T, Gallivan, S., Sherlaw-Johnson, C. Monitoring Cardiac surgery performance: A Commentary. J. Thorac Cardiovasc Surg 2004; 128:823-825. 31. Sundt, T.M., Brown, J.P., Uhlig, PN. STS Workforce on Patient Advocacy, Communications, and Safety. Ann. Thoracic Srugery 2005; 79:11-15. 32. Scherkenbach, WW: The Deming Route to Quality and Productivity Milwaukee, ASQC Quality Press, 1986. 33. Noland, TW. System Changes to improve patient safety BMJ 2000; 320:771-773. 34. Wehrli-Viet, M, Riley, JB, Austin, J.W. A Failure made effect analysis on Extracorporeal Circuits for cardiopulmonary bypass. JECT 2004; 36:351-357. 35. Rutherford, R.B. Suggested standards for reporting complications in Vascular Surgery p1-10. Complications in Vascular Surgery, Bernhard, VM, Towne, JB, ed. Quality Med. Pub; St. Louis, 1991 36. Clavien, PA, Sanabria, JR, Strasberg, SM. Proposed Classification of Complications of Surgery with examples of utility in cholecystectomy Surgery, 1992; 111:518-526 37. Practice Guidelines in Cardiothoracic Surgery. Ann Thorac Surg 1995;(suppl) S-1 38. Replogle RL. Responsibility, Honor and Integrity (or, How Do We Write the Perfect Practice Guidelines?) Ann Thorac Surg 1997; 63:7-8. 39. ICD-9 [Expert] for Physicians - Volumes 1&2. 2003 - 6th ed. Ingenix St. Anthony Publishing/Medicode Salt Lake City, UT. 40. Current Procedural Terminology CPT 2003 Standard Edition (4th ed) American Medical Association, Chicago p111-130. 41. Leach, DC. The ACGME Competencies: Substance or Form J. Am Coll Surg 2001;192:396-398. 42. Kwasnik, E.M. Accountability - the Fourth A J. Am Coll Surg 2004; 199:732-733. 43. Livingston EH, Harwell JD. The medicolegal aspects of proctoring. Am J Surg 2002; 184:26-30. 44. Livingston EH, Harwell JD. Peer Review. Am J Surg 2001; 182:103-109. 45. Satiani, B. The National Practitioner Data Bank: Structure and Function. J Am Coll Surg. 2004; 199:981-986. 46. Acsell, J.R. Professionalism as a Perfusion Problem JECT 2005; 37:136-147. 47. Lang NP. Professionalism liability, patient safety and first do no harm. Am J Surg 2001; 182:537-541. 48. Wells WJ. And Justice for Whom? J Thorac Cardiovasc Surg 1999; 177:211-219. 49. Pate JW, Cutting JA. In defense of malpractice charges: A survey of the legal process. Ann Thorac Surg 1994; 58:1356-1361. 50. Palmisano, D. J. The Hidden Cost of Medical Liability Litigation. Ann Thorac Surg 2004; 79:9-13. 51. Grunkemeier, GL, Zerr, KJ, Jin, R Cardiac Surgery Report Cards: Making the Grade. Ann Thoracic Surgery, 2001; 72:1845-1848. 52. Hannan EL, et al. Improving the outcomes of coronary artery bypass surgery in New York State. JAMA, 1994; 71:761-76. 53. Ghali WA, Quan H, Brant R. Coronary artery bypass grafting in Canada: national and provincial mortality trends. 1992-1995 CMAJ, 1998; 59:25-31. 54. Ghali WA, et al. Statewide quality improvement initiatives and mortality after cardiac surgery. JAMA, 1997; 227:379-382. 55. Weintrub WS, et al. Changing clinical characteristics of coronary surgery patients. Differences between men and women. Circulation, 1993; 88:II79-86. 56. Grover FL, et al. Factors predictive of operative mortality among coronary artery bypass subsets. Annals of Thoracic Surgery, 1993; 56:1296-1309; discussion 1306-7. 57. Iyer VS, et al. Mortality and myocardial infarction after coronary artery surgery. A Review of 12,300 patients. Medical Journal of Australia, 1993; 159:166-170. 58. Ivanov J, Ru JV, Naylor CD. Ready-made, recalibrated or remodeled? Issues in the use of risk indexes for assessing mortality after coronary artery bypass graft surgery. Circulation, 1999; 99:2098-2104. 59. Higgins TL, Estafanous, FG, Loop, FD, et al Stratification of morbidity and mortality outcome by preoperative risk factors in coronary artery bypass patients. JAMA 1992; 265: 234-238. 60. Mozes B, et al. A national study of postoperative mortality associated with coronary artery bypass grafting in Israel. ISCAB Consortium. Israel Coronary Artery Bypass Study. Annals of Thoracic Surgery, 1998; 66:1254-1262; discussion 1263. 61. DeLong ER, et al. Comparing risk-adjustment methods for provider profiling. Statistics in Medicine. 1997; 16:2654-2664. 62. OConnor GR, et al. Multivariate prediction of in-hospital mortality associated with coronary artery bypass graft surgery. Northern New England Cardiovascular Disease Study Group. Circulation, 1992; 85:2110-2118. 63. Reich DL, et al. Intraoperative hemodynamics predictors of mortality, stroke and myocardial infarction after coronary artery bypass surgery. Anesthesia and Analgesia. 1999; 89:814-822. 64. Bernstein AD and Parsonnet V. Beside estimation of risk as an aid for decision-making in cardiac surgery. Annals of Thoracic Surgery. 2000; 69:823-828. 65. Parsonnet V, Dean D, Bernstein AD. A Method of Uniform Stratification of Risk for Evaluating the Results of Surgery in Acquired Adult Heart Disease. Circulation. 1989; 79(suppl): I-3-I-12. 66. Northern New England Risk Calculator - http://www.nnecdsg.org/supercard04.pdf 67. Pifarre R. Open Heart Operations in the Elderly: Changing Risk Parameters. Ann Thorac Surg 1993; 56:S71-73. 68. Craver JM, Paskas JD, Weintraub WW, et al. 601 Octogenarians Undergoing Cardiac Surgery: Outcome and Comparison with Younger Age Groups. Ann Thorac Surg 1999; 67:1104-1110. 69. Fruitman DS, MacDougall CE, Ross DB. Cardiac Surgery in Octogenarians: Can Elderly Patients Benefit? Quality of Life After Cardiac Surgery. Ann Thorac Surg 1999; 68:2129-2135. 70. Abramov D, Tamariz MG, Sever JY, Christakis GT, et al. The Influence of Gender on the Outcome of Coronary Artery Bypass Surgery. Ann Thorac Surg 2000; 70:800-806. 71. ORourke DJ, Malenka DJ, Olmstead EM, et al. Improved In-Hospital Mortality in Women Undergoing Coronary Artery Bypass Grafting. Ann Thorac Surg 2001; 71:507-511. 72. Rexius, H, Brandrup Wognsen, G, Oden, A, Jeppsson, A. Mortality on the waiting list for coronary artery bypass grafting: Incidence and risk factors. Ann Thorac Surg 2004; 77:769-775. 73. Cesena, FH, Favarato, D, Cesar, LA, de Oliveira, SA, da Luz, PL. Cardiac complications during waiting for elective coronary artery bypass graft surgery: incidence, temporal distribution and predictive factors. Eur. J Cardiothorac Surg 2004; 25:196-202. 74. Riley G, Lubitz J. Outcomes of surgery amount the Medicare aged: Surgical volume and mortality. Health Care Financing Review. 1985; 71:37-47. 75. Showstack JA, et al. Association of volume with outcome of coronary artery bypass graft surgery. Scheduled vs. nonscheduled operations. JAMA, 1987; 257:785-789. 76. Hannan EL, et al. Investigation of the relationship between volume and mortality for surgical procedures performed in New York State hospitals. JAMA 1989; 262:503-510. 77. Hannan EL, et al. Coronary Artery Bypass Surgery The relationship between in-hospital mortality rate and surgical volume after controlling for clinic risk factors. Medical Care 1991; 29:1094-1107. 78. Farley DE, Ozminkowski RJ. Volume outcome relationships and in-hospital mortality: The effect of changes in volume over time. Medical Care 1992; 30-77-9. 79. Grumbach K, et al. Regionalization of coronary surgery in the United States and Canada Geographic access, choice and outcomes. JAMA Journ of the Am Med Assoc 1995; 274:1282-1288. 80. Shroyer ALW, et al. No continuous relationship between Veterans Affairs Hospital coronary artery bypass grafting surgical volume and operative mortality. Ann of Thorac Surg 1996; 61:17-20. 81. Sollano JA, et al. Volume outcome relationships in cardiovascular operations: New York State, 1990-1995. Journal of Thoracic and Cardiovascular Surgery 1999; 117:419-430. 82. Nallamothu BK, et al. The role of hospital volume in coronary artery bypass grafting: Is more always better? Journal of the American College of Cardiology, 2001; 38:1923-1930. 83. Hewitt M, and f.t. C.o.Q.o.o.H.C.I.A.a.t.N.C.P. Board, Interpreting the Volume-Outcome Relationship in the Context of Health Care Quality: workshop Summary. 2000, Washington, D.C.: Institute of Medicine. I-vii, 1-128. 84. Tu JV, Naylor CD. Coronary artery bypass mortality rates in Ontario. A Canadian approach to quality assurance in cardiac surgery. Steering Committee of the Provincial Adult Cardiac Care Network of Ontario. Circulation, 1996; 94:2429-2433. 85. Crawford FA, et al. Volume requirements for cardiac surgery credentialing: a critical examination. The Ad Hoc Committee on Cardiac Surgery Credentialing of the Society of Thoracic Surgeons. Annals of Thoracic Surgery. 1996; 61:12-16. 86. Birkmeyer, J.D., Siewers, AE, Finlayson, EV. Hospital volume and surgical mortality in the United States. N. Engl J. Med 2002; 346:1128-1137. 87. Nallamothu, BK, Eagle, KA, Ferraris, VA, Sade, R.M. Ethics in cardiothoracic Surgery: Should Coronary Artery Bypass Grafting be Regionalized. Ann Thorac Surg 2005; 80:1572-1581 88. Shahian, D.M, Norman, SL, Torchiana, DF et al. Cardiac Surgery Report Cards: Comprehensive Review and Statistical Critique. Ann Thorac Surg 2001; 72:2155-2168. 89. Carey, JS, Parker, JP, Robertson, JM, Misbach, GA, Fisher, A.L. Hospital Discharge to Other Healthcare facilities: Impact on In-Hospital Mortality. J Am Coll Surg 2003; 197: 806-812. 90. Mc Greevy, J., Wiebe, D. A preliminary measurement of the surgical personality. Am. J. Surg 2002; 184:121-125. 91. Wanzel, KR, Ward, M, Reznick RK. Teaching the surgical craft: from selection to certification. Curr Prob Surg 2002; 39:573-660. 92. Guerlain, S, Adams, R.B., Turrentine, FB, et al. Assessing team performance in the operating room; development and use of a black-box recorder and other tools for the intraoperative environment. J. Am. Coll Surg 2005; 200:29-37. 93. Hance, J., Aggarwal, R., Stanbridge, R. et al. Objective assessment of technical skills in cardiac surgery. Eur. J. Cardiothorac Surg 2005; 28:157-162. 94. Higgins TL. Quantifying risk and assessing outcome in cardiac surgery. J Cardiovasc Vasc Anes 1998; 12:330-340. 95. Higgins TL, Estatanous FG, Loop FD, et al. ICU admission score for predicting morbidity and mortality risk after coronary artery bypass grafting. Ann Thorac Surg 1997; 64:1050-1058. 96. Knaus WA, APACHE 1978-2001: The development of a quality assurance system based on prognosis. Arch Surg 2002; 137:37-41. 97. Kuhn, C, Muller-Werdan, U, Schmitt, DV et al Improved outcome of APACHE a! score-defined escalating systemic inflammatory response syndrome in patients post cardiac surgery in 1996 compared to 1988-1990: the ESSICS-study pilot project Eur. J. Cardiothorac Surg. 2000; 17:30-37. 98. Bardell, T., Legare, JF, Buth, KJ, Hirsch, GM, Ali, I.S. ICU readmission after cardiac surgery Eur. J Cardiothorac Surg 2003; 23:354-359. 99. Williams, M.R., Wellner, R.B., Hartnett, EA et al Long-term Survival and Quality of Life in Cardiac Surgery Patients with prolonged intensive care unit length of stay Ann Thorac Surg 2002; 73:1472-1478. 100. Nast, PA, Avidan, M, Harris, CB. Reporting and classification of patient safety events in a cardiothoracic intensive care unit and cardiothoracic postoperative care unit. J. Thorac Cardiovasc Surg 2005; 130:1137-1143. 101. Jenkinson C, Coulter A, Wright L. Short form 36 (SF 36) health survey questionnaire: normative data for adults of working age. British Med J 1993; 306:1437-1440. 102. Falcoz, PE, Chocron, S, Mercier, M, Puyraveau, M, Etievent, JP. Comparison of the Nottingham Health Profile and the 36-item Health Survey Questionnaires in Cardiac Surgery Ann Thorac Surg 2002; 73:1222-1228. 103. Lindsay GM, Harlon P, Smith LN, Wheatley DJ. Assessment of changes in general health status using the short form 36 questionnaire 1 year following coronary artery bypass grafting. European J Cardio-thorac Surg 2000; 18:557-564. 104. Simchen E, Galai N, Braun O, Zitser-Gurevich Y, Shabtai E, Naveh I. Sociodemographic and clinical factors associated with low quality of life one year after coronary bypass operations: The Israeli Coronary Artery Bypass Study (ISCAB). J Thorac Cardiovasc Surg 2001; 121:909-919. 105. Rumsfeld, JS, Ho, PM, Magid, DJ et al. Predictors of Health - related quality of life after coronary artery bypass surgery. Ann Thorac Surg 2004; 77:1508-1513. 106. Falcoz, PE, Chocron, S., Stoica, L. et al. Open Heart Surgery: One year Self-Assessment of Quality of Life and Functional Outcome. Ann Thorac Surg 2003; 76:1598-1604. 107. Iglehart JK. The American Health Care System. Medicare. NEJM 1999; 340:327-332. 108. Harlan BJ. Statewide reporting of coronary artery surgery results: A view from California. J Thorac Cardiovasc Surg 2001; 121:409-417. 109. Taylor GJ, Mikell FL, Moses HW, et al. Determinant of hospital charges for coronary artery bypass surgery: The economic consequences of postoperative complications. Am J Cardiol 1990; 65:309-313. 110. Ferraris VA, Ferraris SP, Singh A. Operative outcome and hospital cost. Journal of Thoracic and Cardiovascular Surgery 1998; 115:593-602; discussion 602-603. 111. Cohen DJ, Breall JA, Ho KKL, et al. Economic of elective coronary revascularization. Comparison of costs and charges for conventional angioplasty, directional atherectomy, stenting and bypass surgery. J Am Coll Cardiol 1993; 22:1052-1059. 112. Williams Jr TE, Fanning WJ, Benton WC, et al. What is the marginal cost for marginal risk cardiac surgery? Ann Thorac Surg 1998; 66:1969-1971. 113. Shahian DM, Heatley GJ, Westcott GA. Relationship of hospital size, case volume, and cost for coronary artery bypass surgery: Analysis of 12,774 patients operated on in Massachusetts during fiscal years 1195 and 1996. J Thorac Cardiovasc Surg 2001; 122:53-64. 114. Lazar HL, Fitzgerald CA, Ahmad T, et al. Early discharge after coronary artery bypass graft surgery: Are patients really going home earlier? J Thorac Cardiovasc Surg 2001; 121:943-950. 115. Lahey SJ, Campos CT, Jennings B, Pawlow P, Stokes T, Levisky S. Hospital readmission after cardiac surgery. Does Fast Track cardiac surgery result in cost saving or cost shifting? Circulation. 1998; 98:II-35-II-40. 116. DAgostino RS, Jacobson J, Clarkson M, Svensson LG, Williamson C, Shahian DM. Readmission after cardiac operations: Prevalence, patterns, and predisposing factors. J Thorac Cardiovasc Surg 1999; 118:823-832. 117. Stewart RD, Campos CT, Jennings B, Lollis SS, Levitsky S, Lahey SJ. Predictors of 30-day hospital readmission after coronary artery bypass. Ann Thorac Surg 2000; 70:169-174. 118. Ferraris VA, Ferraris SP, Harmon RC, Evans BD. Risk factors for early hospital readmission after cardiac operations. J Thorac Cardiovasc Surg 2001; 122:278-286. 119. Meakins JL. Innovation in surgery: The rules of evidence Am J Surgergy 2002; 183:399-405. 120. Editorial-Cochranes Legacy. Lancet 1992; 340:1131-1132. 121. Cochrane AL. Effectiveness and efficiency random reflection on health services. London: Nuffield Provincial Hospitals Trust, 1972. 122. Yusuf S, Cairns JA, Camm AJ, Fallen EL, Gersh BJ. Evidence based cardiology. 1998 BMJ Books, London p. 3-23. 123. Eagle KA, et al. ACC/AHA Guidelines for coronary artery bypass graft surgery: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to revise the 1991 guidelines for coronary artery bypass graft surgery). American College of Cardiology/American Heath Association. Journal of the American College of Cardiology 1999; 34:1262-1347. 124. Shaneyfelt TM, Mayo-Smith MF, Rothwangl J. Are guidelines following guidelines? The methodological quality of clinical practice guidelines in the peer-reviewed medical literature. JAMA 1999; 281:1990-1905. 125. Haines, S.J. Nicholas, J.S. Teaching Evidence-Based medicine to surgical subspecialty residents J. Am. Coll. Surg 2003; 197:285-289. 126. Troedter, L.J., Thompson, LL, Rohatgi, C. Training Surgeons to do Evidence-based Surgery: A Collaberative Approach. J. Am. Coll Surg 2004;199:293-299 127. Sackett,DL, Straus, SE, Richardson, WS, et al Evidence-based medicine. How to practice and teach EBM. 2nd ed Edinburgh, Churchill Livingstone; 2000 128. Ferraris, VA, Ferraris, SP. Assessing the medical literature: Let the buyer beware. Ann Thorac Surg 2003; 76:4-11. 129. Dunning, J., Prendergast, B., Mackway-Jones, K. Towards evidence-based medicine in cardiothoracic surgery: Best BETS. Interactive Cardiovascular and Thoracic Surgery 2003; 2:405-409. 130. Sanni, A., Dunning, J. Best evidence Topic - Cardiac general - Is transmyocardial revascularization of benefit to people with no option angina? Interactive Cardiovasculor and Thoracic Surgery 2004; 3:586-592 131. Sanni, A., Dunning, J. Best evidence topic - Cardiac General - Is transmyocardial revascularization of benefit in addition to coronary artery bypass grafting for patients with diffuse coronary disease. Interactive Cardiovasculor and Thoracic Surgery 2004; 3:581-585 132. Greene, P.S., Baumgartner, W.A. Ch.35 Cardiac Surgery p497-507 In: Gordon, TA, Cameron, J.L., ed. Evidence Based Surgery 1st Ed London, BC Decker Inc; 2000. 133. Donabedian, A., Evaluating the quality of medical care. Milbank 1996; 44:166-203 134. Birkmeyer, JD, Dimick, JB, Birkmeyer, NJ. Measuring the quality of surgical care: Structure, Process, or Outcomes? J. Am Coll Surg 2004; 198:626-632. 135. Satava, R.M., Gallagher, A.G., Pellegrini, CA. Surgical Competence and Surgical Proficiency: Definitions, Taxonomy, and Metrics. J. Am Coll Surg 2003; 196:933-948. 136. Every, NR, Hochman, J., Becker, R., Kopecky, S, Cannon, CP Critical Pathways: A Review Circulation 2000; 101:461-470. 137. Atherly, A., Fink, A.S, Campbell, DC et al. Evaluating alternative risk-adjustment strategies for surgery. Am. J. Surg 2004; 188:566-570. 138. Sherlaw - Johnson, C., Gallivan, S., Treasure, T, Nashef, S.A.M., Computer Tools to assist the monitoring of outcomes in surgery Eur J Cardiothorac Surg 2004; 26:1032-1036. 139. Shahian, D.M., Torchiana, D.F., Normand, ST. Implementation of a Cardiac Surgery Report Card: Lessons Learned from the Massachusetts Experience. Ann Thorac Surg 2005; 80:1146-1150 140. Grunkemeier, G.L., Furnary, A.P. Mandatory Database Participation: Risky Business. Ann Thorac Surg 2005; 80:799-801 141. OConnor, GT, Plume, SK, Olmstead, EM et al. A regional prospective study of in-hospital mortality associated with coronary artery bypass surgery. Northern New England Cardiovascular Study Group. JAMA 1991; 266:803-809. 142. Dodson, BA. Ch 79 Quality Assurance/Quality Improvement p2597-2612 Miller, RD ed. Anesthesia 5th ed. Harcourt, Asia Churchill Livingstone, Singapore 2000. 143. Gaudiani, VA. Comprehensive Quality for Cardiac Surgery (http://www.ctsnet.org/sections/newsandviews/inmyopinion/articles/article-5.html) Bibliography 1. Complications in Cardiothoracic Surgery. Waldhausen, J.A., Orringer, MB. Mosby Year Book, St. Louis 1991 2. Cardiac and Noncardiac Complications of Open Heart Surgery Prevention, Diagnosis, Treatment. Kotler, MN, Alfieri, A F%&'(<=dy   }}eVHV:jhRY>*CJUaJhRYCJOJQJ^JaJhRY>*CJOJQJ^JaJ.hRY5>*CJOJQJ\^JaJnHo(tH+hRY5CJOJQJ\^JaJnHo(tH hRY5CJOJQJ\^JaJhRYCJaJmH sH jhRYCJUaJmH sH !hRYCJaJmH nHo(sH tH"hRY5>*CJOJQJ\^Jo($hRY>*CJOJQJ^JmH o(sH hRYmH o(sH &'yz{|      $ ) hp@ P !h^ha$ ) hp@ P !h^h$a$$D`Da$$a$S           ' ( A T i   ) hp@ P !h^h$ ) hp@ P !h^ha$ h q Y | % G W [ n w ׻kT,hRY56>*CJOJQJ\]^JaJo(.hRYB*CJOJQJ^JaJnHo(phtH(hRY>*CJOJQJ^JaJnHo(tH&hRY56CJOJQJ\]^JaJhRY>*CJOJQJ^JaJhRYCJOJQJ^JaJhRY>*B*CJaJphjhRY>*CJUaJ jhRY>*CJUaJhRY>*CJaJ X Y Z [ \ ] ^ _ ` a b c d e f g  ) hp@ P !h^h ) hp@ P !h^h$ ) hp@ P !h^ha$g h i j k l m n  ) hp@ P !h^h&$ ) hp@ P !hGVDWDO^h`Ga$ $ ) hp@ P !h4$^ha$ ) hp@ P !h^hw x u[\demnvw~Lڡڡڡڡ}}}}}}kڡ\hRYCJH*OJQJ^JaJ#hRY5>*CJOJQJ\^JaJ(hRY6CJOJQJ^JaJnHo(tHhRY6CJOJQJ^JaJhRYCJOJQJ^JaJ hRY5CJOJQJ\^JaJhRYCJaJ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tH#hRY5CJOJQJ\^JaJo($Aau.Kmyz ) hp@ P ! ) hp@ P !h^hLM'(./MVwxyz]`!"$BEFO[\hpPYux#8:f즏, j+hRY0J'CJOJQJ^JaJnHtH, j*hRY0J'CJOJQJ^JaJnHtH"hRYCJOJQJ^JaJnHtHhRYCJH*OJQJ^JaJhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH8wx|^ab{|.?C P !,!7!B!\!!!."/"""#߾߾߾.hRYB*CJOJQJ^JaJnHo(phtH"hRYCJOJQJ^JaJnHtHhRYCJH*OJQJ^JaJ%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJ>##$$$$$$$$% %A%[%r%%%%&&3&&&N'P'''((((()))))))))))))* *&*.*5**6+8+9+:+2,4,5,̴ߥߥߥ(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ.hRY5>*CJOJQJ\^JaJnHo(tH%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJ$ j*hRY0J'CJOJQJ^JaJ8$$% %**001133U3V33377L9 ) hp@ P !^$ ) hp@ P !h^ha$ ) hp@ P !h^h5,6,----]/_/`/a/00000000000D2E23O3P3R3S3T3V33333333334⩓ii.hRY6CJH*OJQJ]^JaJnHo(tH#hRY6CJH*OJQJ]^JaJ+hRY6CJOJQJ]^JaJnHo(tH hRY6CJOJQJ]^JaJ%hRYCJOJQJ^JaJnHo(tH(hRYCJH*OJQJ^JaJnHo(tHhRYCJOJQJ^JaJhRYCJH*OJQJ^JaJ'4#4+4?4D455,6.6M6667777F9J9M9r9s9~:::::T;U;;; <=====ͼ|j[[[hRYCJH*OJQJ^JaJ#hRY5>*CJOJQJ]^JaJ.hRY5>*CJOJQJ]^JaJnHo(tH#hRY6CJH*OJQJ]^JaJ+hRY6CJOJQJ]^JaJnHo(tH hRY6CJOJQJ]^JaJhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH"hRYCJOJQJ^JaJnHtH#L9M9r9s9~AACCMMOO ) hp@ P !hh^h`h# ) hp@ P !hVDWD^h`$ ) hp@ P !h^ha$ ) hp@ P !h^h ==>>>>?? @<@@@@@ A$A&A*AAAC C1C2CNCOCQCRCiCjClCmC{C|CCCC@DDDDDDDDDEEcEeEfEhE~EEEEEEEEEEEEFFFFϨϨ(hRYCJH*OJQJ^JaJnHo(tH"hRYCJOJQJ^JaJnHtHhRYCJH*OJQJ^JaJhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tHBFFFFF G.G3G8GcGdGeGgGjGlGGGGGGG5H6H8H9H]HaHHHIIPII%J'J(J)J;KCKKKL LhLpLLLMMMMMMMMMMMNNNN>N@NONNNN߾ߩ(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJBNNOQOSOTOUOOOOOOOOOOP P(P-P\P^PpPqPQQQRRXRZR[R_R`RcReRfRRRR׫ĈyĈĈĈĈĈĈyydydydy(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJhRYCJOJQJ^JaJ)hRY0JCJOJQJ^JaJnHo(tH1jhRYCJOJQJU^JaJnHtH%hRYCJOJQJ^JaJnHo(tH"hRYCJOJQJ^JaJnHtH+jhRYCJOJQJU^JaJnHtH'RRRRRR:SHSMSSSSSSS7T9T^T U$UUUUUVVrVtVxVV\W^WWWWWWWXXXX$X*XYYYY9ZCZ/\0\2\3\4\@\A\C\;۾ےےےےے۾۾۾۾-hRYCJOJQJ^JaJmH nHo(sH tH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH"hRYCJOJQJ^JaJnHtH9O:S;S\WWWW XXX[[ ) hp@ P !hh^h`h & hp@ PX!h^h ) hp@ P !h^h# ) hp@ P !hgVDWD^h`g C\D\E\F\S\r\s\t\u\ ]]C]]]a^e^^^^^^^^^L_u_y_________f`g````eanaaaaaaaaݰݍ{ݍݍݍݍݍݍݍ{{{{{{{ݍݍݍ"hRYCJOJQJ^JaJnHtHhRYCJOJQJ^JaJ(hRY>*CJOJQJ^JaJnHo(tH.hRY5>*CJOJQJ]^JaJnHo(tH(hRYCJH*OJQJ^JaJnHo(tH%hRYCJOJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ0[R\S\s\t\``2d3d(i)iUkrkkkk! ) hp@ P !hYVD^h`Y ) hp@ P !h^h$ ) hp@ P !h^ha$ ) hp@ P !hY^h`Yaaa=bQb[bebbbb`cacccdccccccc,d0d4dFdednd?fBfCfDfGf0ggggg:hhhhiiiiϺϺϺ쒨y1j>hRYCJOJQJU^JaJnHtH+jhRYCJOJQJU^JaJnHtH"hRYCJOJQJ^JaJnHtH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH+i%i&i-j7jk$klknkpkqkrkskkkkkkkkkkkkkkkllllll,m6m8mmmmmmtttttfffhRYCJOJQJ^JaJ-hRYCJOJQJ^JaJmH nHo(sH tH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tH+jhRYCJOJQJU^JaJnHtH)hRY0JCJOJQJ^JaJnHo(tH(kkkk+m,mnnipjpasbsvvwyxy]{^{~! ) hp@ P !hgWD^h`g ) hp@ P !h^h! ) hp@ P !hYVD^h`Ymmmm4nTnnnnnno%o1o3ogphpppppqq#q*qfqgqiqjqqqrrJrKrVrWr_rhr[s]s_s`snsps*t[t]t^tbtctdtetntwttHuJuKuLuuuuuuuu޽޽޽޽콨콨콨(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ"hRYCJOJQJ^JaJnHtHhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tHBu4v9v=vvkwuwxy@{H{_{c{d{p{{{{{{{{{||||>}?}B}C} ~ ~ ~~N~O~Q~R~T~U~~~~Y[]^ &?@DRYZ]cj޽޽޽޽޽콨콨(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ"hRYCJOJQJ^JaJnHtHhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tHB~~̅ͅ΅VWڑۑ{|›no$ ) hp@ P !h^ha$ ) hp@ P !h^hvw |ĄЄTȅɅͅ΅@\]_`hiOQTVWY촢̓~̓~̓~(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ#hRY5>*CJOJQJ\^JaJ.hRY5>*CJOJQJ\^JaJnHo(tHhRYCJOJQJ^JaJ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tH1YZ\*<>?@RSTUVXgcdfgȲȠr[MMMMhRYCJOJQJ^JaJ, j+hRY0J'CJOJQJ^JaJnHtH)hRY0JCJOJQJ^JaJnHo(tH1j+hRYCJOJQJU^JaJnHtH"hRYCJOJQJ^JaJnHtH+jhRYCJOJQJU^JaJnHtH%hRYCJOJQJ^JaJnHo(tH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJƑǑɑʑӑՑ!&stvwyz{ƒ̒WaFGIJ09CDFGIJ|}λλλܻܻΝhRYCJaJjhRYCJUaJ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJhRYCJH*OJQJ^JaJ(hRYCJH*OJQJ^JaJnHo(tH9CDњҚԚ՚֛כ؛ٛڛ5=RWZלfhjkhi³³³³‹xffff"hRYCJOJQJ^JaJnHtH%hRYCJH*OJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJhRYCJOJQJ^JaJ&hRY>*B*CJOJQJ^JaJphjhRYCJUaJjhRYCJUaJ(iqv "#$Šbi]h̢@ABEFH'()2ST\]˸ˣ˸ˣ˸.hRY5>*CJOJQJ\^JaJnHo(tH(hRYCJH*OJQJ^JaJnHo(tH%hRYCJH*OJQJ^JaJnHtHhRYCJH*OJQJ^JaJ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tH6̢͢45-. ) hp@ P !h^h` ) hp@ P !hh^h`h$ ) hp@ P !h^ha$ ) hp@ P !h^h ~ǫCN$depqu~4C "#XY[pt˶씂#hRY5>*CJOJQJ\^JaJhRY\nHo(tH, j*hRY0J'CJOJQJ^JaJnHtH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tH/ghZ[p}{\$ ) hp@ P !h^ha$$ ) hp@ P !h^ha$ ) hp@ P !hh^h`h ) hp@ P !h^h`"$ ) hp@ P !h^h`a$ tuٻڻܻݻw}~wxz{$bcef\jõæõæhh-hRYCJOJQJ^JaJmH nHo(sH tH"hRYCJOJQJ^JaJnHtH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH#hRY5>*CJOJQJ\^JaJ.hRY5>*CJOJQJ\^JaJnHo(tH"kl~]^_}~$ ) hp@ P !h^ha$ ) hp@ P !h^hprvx<E_acd.6xyz{XaklįįįĜįĜ|hRYCJOJQJ^JaJ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ-hRYCJOJQJ^JaJmH nHo(sH tH*hRYCJOJQJ^JaJmH nHsH tH-l} oqswz7= :BWbp̺̺̺̫̺̺̫̺̺̺̫߫߫߫-hRYCJOJQJ^JaJmH nHo(sH tH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJ#hRY5>*CJOJQJ\^JaJ2PS*+./BM'(19rsvw*+򾩾򾩾ߗߗߗߗߗߗ򾩾ߗ򾩾򾩾򾩾hRY>*CJOJQJ^JaJ"hRYCJOJQJ^JaJnHtH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ#hRY5>*CJOJQJ\^JaJ%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJ5pqtuWX[\_|#$%u5jhRY>*B*CJOJQJU^JaJph&hRY>*B*CJOJQJ^JaJph/jhRY>*B*CJOJQJU^JaJph#hRY5>*CJOJQJ\^JaJ(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJhRYCJOJQJ^JaJ-%=>ABhijxy{|MNQRUV_ʾʾu`uu`uu`u`u(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJjChRYCJUaJ&hRY>*B*CJOJQJ^JaJphjhRYCJUaJhRYCJaJjhRYCJUaJhRYCJOJQJ^JaJ/jhRY>*B*CJOJQJU^JaJphhRY0JCJOJQJ^JaJ_ade`adeDEVWϺޢuZJ5J)hRY0JCJOJQJ^JaJnHo(tHhRY0JCJOJQJ^JaJ5jhRY>*B*CJOJQJU^JaJph1hRY>*B*CJOJQJ^JaJnHo(phtH&hRY>*B*CJOJQJ^JaJph/jhRY>*B*CJOJQJU^JaJph(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH:;>?89:=>78;<򻥓ze)hRY0JCJOJQJ^JaJnHo(tH1jShRYCJOJQJU^JaJnHtH"hRYCJOJQJ^JaJnHtH+jhRYCJOJQJU^JaJnHtH%hRYCJOJQJ^JaJnHo(tH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJhRYCJOJQJ^JaJ=>>ij0APkl$,7\# ) hp@ P !hVDWD^h` ) hp@ P !h^h  #$jlno|*+JKLMմմմմմՈô-hRYCJOJQJ^JaJmH nHo(sH tH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tH.hRYB*CJOJQJ^JaJnHo(phtH,\]Ah# ) hp@ P !hgVDWD^h`g$ ) hp@ P !a$ ) hp@ P ! ) hp@ P !h^h# ) hp@ P !hVDWD^h`CDFGQRTU[acdQSVWhp"$'(,.12nx       ! 7 B     ƱƱ՟՟՟Ʊ՟Ʊ՟Ʊ՟՟՚ hRYH*o( hRYH*hRY hRYo("hRYCJOJQJ^JaJnHtH(hRYCJH*OJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH.hRY5>*CJOJQJ\^JaJnHo(tH6AB  " #    ) hp@ P !h^h$ P$# ) hp@ P !hgVDWD^h`g ) hp@ P !WDG` N [         TVYZ_GL1256BCFGYZ\a{~")ɺhRY>*CJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJ hRYH*o( hRYH*hRY hRYo(E :Acjv.56>PQSUX5DERG[^_ظآؙآآآآʇr)jhRYCJOJQJU^JaJ#jhRYCJOJQJU^JaJhRYnHo(tH+hRY5CJOJQJ\^JaJnHo(tH#hRY5>*CJOJQJ\^JaJhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH(hRY>*CJOJQJ^JaJnHo(tH,Ny6X3 ) hp@ P !$If ) hp@ P !h^h ) hp@ P !P^P`$ ) hp@ P !h^ha$345DERAKkd% $$IfTl05$M 64 laT ) hp@ P !$If ) hp@ P !$If;kd $$IfTl45$64 laf4TRST]cdy.Kkd $$IfTl05$M 64 laT ) hp@ P !$IfKkd $$IfTl05$M 64 laT$ ) hp@ P !$Ifa$dqvwyKkd $$IfTl05$M 64 laT$ ) hp@ P !$Ifa$ ) hp@ P !$Ify.KkdX $$IfTl05$M 64 laT$ ) hp@ P !$Ifa$ ) hp@ P !$IfKkd $$IfTl05$M 64 laTsW ) hp@ P !$IfKkd $$IfTl05$M 64 laT$ ) hp@ P !$Ifa$" ) hp@ P !$IfWDd`v)Mkd $$IfTl05$M 64 laT$ ) hp@ P !$Ifa$$ ) hp@ P !$Ifa$Kkd. $$IfTl05$M 64 laT$yKkd$$IfTl05$M 64 laT$ ) hp@ P !$Ifa$ ) hp@ P !$If$%AFGTy.Kkd$$IfTl05$M 64 laT$ ) hp@ P !$Ifa$ ) hp@ P !$IfKkdy$$IfTl05$M 64 laTT[\]^yyyUUyy# ) hp@ P !hVDWDd^h` ) hp@ P !h^hKkdO$$IfTl05$M 64 laT$ ) hp@ P !$Ifa$ /0EFvwIJ    ûv`v+hRY5>*CJOJQJ^JaJnHo(tH hRY5>*CJOJQJ^JaJhRY5>*nHo(tHhRY5>*\ hRY5>* jhRY hRYH*hRYnHo(tHhRYhRYCJaJhRYCJaJ%hRYCJOJQJ^JaJnHo(tH#jhRYCJOJQJU^JaJhRY0JCJOJQJ^JaJ# 1U$%[\./` &d P $$d &d N P a$$a$d    % * + ; I d             8d^8 $8d^8a$  & Fd7$8$H$ &d P  $ % * E G ` b { ~     !!/!1!2!>!d!f!g!h!!!!!!!ɱɞlWP hRY5>*(hRY5CJOJQJ^JaJnHo(tH,hRY0J5CJOJQJ^JaJnHo(tH4jhRY5CJOJQJU^JaJnHtH%hRY5CJOJQJ^JaJnHtH.jhRY5CJOJQJU^JaJnHtH+hRY5>*CJOJQJ^JaJnHo(tH hRY5>*CJOJQJ^JaJhRY5CJOJQJ^JaJ      !!!!!!!!!!!" & F  h8 M3~$ & F & h8 xHa$" & F ) hp@ P !hd^h8d^8!!!!!!!!!!!!!!!" """6"P"T"q"""""""""鵝rcN(hRY>*CJOJQJ^JaJnHo(tHhRY>*CJOJQJ^JaJ"hRYCJOJQJ^JaJnHtH1hRY5>*CJH*OJQJ\^JaJnHo(tH.hRY5>*CJOJQJ\^JaJnHo(tH#hRY5>*CJOJQJ\^JaJhRYCJH*OJQJ^JaJ%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJhRY5>*\""q"""#g###=$h & h8 xH^ & h8 xH^ & h8 xH)^ # h8 x^  h8 xH^ & F & h8 xH"###"#=#A#B#G#K#g#{#|#}#~########=$\$^$_$`$d$$$$$$$$$$$$$$%%%!%%%A%X%Z%[%\%`%}%%%%%%%%%%%%%%&&&7&:&?&@&A&E&`&w&&&&&&&&&&&&&'%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJX=$$$$A%}%%%&`&&&&'} & h8 xH^ & h8 x^ & h8 xHs^ & h8 xH^ & h8 xH^ '/'\'a''''''''''''''(Q(R(W(c(((((\)d)))*********--ߩߩߗߩߗ~ohRYCJOJQJ\^JaJhRYCJH*OJQJ^JaJhRYOJQJ^J"hRYCJOJQJ^JaJnHtH.hRY5CJH*OJQJ\^JaJnHo(tHhRY>*CJOJQJ^JaJhRYCJOJQJ^JaJo(%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJ('''''Q(R(W(w((((.)l))) & h8 xH^ & h8 xH^ & h8 x)e^  h8 xH^)(*L*M*******+ +O+P+++++, , ,$d &d N P $a$ $&d P a$$da$" & h8 xHoVD*WD ^o` ,E,F,,,,,,,----.".#.$.%.&.'.).*.$ & F & h8 xHa$ &d P --.. .&.'.(.+._.c........οvevR=ο(hRYCJH*OJQJ^JaJnHo(tH%hRYCJOJQJ^JaJnHo(tH hRY6CJOJQJ]^JaJhRYCJOJQJ^JaJhRYnHo(tHjhRYUo(%hRYCJOJQJ^JaJnHo(tH(hRY5CJOJQJ^JaJnHo(tHhRY5CJOJQJ^JaJhRYCJOJQJ^JaJhRYCJOJQJ\^JaJ(hRYCJOJQJ\^JaJnHo(tH*.+.. / /0/1/u//}}__ & F & h8 xH$If!$ & F & h8 xH$Ifa$$ & F & h8 xHa$'$ & F # h8 xH  UDFVD] ^ a$$ & F & h8 xHa$.//// /1/:/t/u/////////0"040k0l0m00000001 1Y1Z1m111111111Կ԰԰԰԰԰԰԰԰ԟ԰԰԰԰԰zԿlhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH"hRYCJOJQJ^JaJnHtH hRY5CJOJQJ^JaJo(hRY5CJOJQJ^JaJ(hRYCJH*OJQJ^JaJnHo(tH(hRY5CJOJQJ^JaJnHo(tH+hRY5CJOJQJ\^JaJnHo(tH*///////!0"0m0001j & h8 xH8$If^8 & F & h8 xH$If & h8 xH$If & F & h8 xH$If & h8 xHh$If^h 1Z11111J-$ & F & h8 xHa$|kdk$$IfTl& !  064 l` a p T & h8 xH$If & F & h8 xH$If1111111122n% & F # h8 xH$-DIfM % & F # h8 xH$-DIfM )$ & F & h8 xH$-DIfM a$$ & F & h8 xHa$ 1112X22222222 3 3^3`3d333334#41434M444444 5 525L5}5~55555666ŷ𷤒ŤŒŷŷŷn%hRY5CJOJQJ^JaJnHtH hRY5CJOJQJ^JaJo(#hRY5CJOJQJ\^JaJo(%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJ+hRY5CJOJQJ\^JaJnHo(tH(hRY5CJOJQJ^JaJnHo(tHhRY5CJOJQJ^JaJ+2 3334243444mHH% & F # h8 xH$-DIfM $ h8 xHp$-DIfM ^p% & F # h8 xH$-DIfM $ h8 xH $-DIfM ^ % & F # h8 xH$-DIfM 44 51525~556l! # h8 xH$-DIfM & 8 xH$-DIfM WD`% & F # h8 xH$-DIfM % # h8 xH$-DIfM ^66666>6?6@6lllllI"$ & F & h8 xH@ WD`@ a$$ & F & h8 xHa$ukd#$$IfTli"  0 64 lap T66?6@6A6666667 7=7>7F7K7L7M7O7]7}}n]MAhRYCJOJQJ^JhRY6CJ]aJnHo(tH jhRY6CJU]aJo(hRY5CJOJQJ^JaJ-hRYCJOJQJ\^JaJmH nHsH tH%hRYCJOJQJ\^JaJnHtH0hRYCJOJQJ\^JaJmH nHo(sH tH(hRYCJOJQJ\^JaJnHo(tH+hRY5>*CJOJQJ^JaJnHo(tH(hRY5CJOJQJ^JaJnHo(tH@6666>7H7I7J7K7M7N7O7999$ & F # h8 xH$  UDVD]$ ^  & F & h8 xH$ & F & h8 xHa$ & F & h8 xHWD<`]7^7777,8@8U8888<9O9P99999999999:::;X<==== = =Ϻ}ni^ihRY\nHo(tH hRY\hRY5CJOJQJ^JaJ hRYo((hRYCJOJQJ\^JaJnHo(tHhRY5nHo(tH hRY5%hRY5CJOJQJ^JaJnHtH(hRY5CJOJQJ^JaJnHo(tH$hRYCJH*OJQJ^JnHo(tHhRYCJOJQJ^J!hRYCJOJQJ^JnHo(tH"99:]:{:::8;P;t;;;;X<<<=%$If 8$If 8 VDWD,^ `$ & F & h8 xHa$==={=======~oRR$ & F & h8 xHa$$ 8 VD^ a$ 8,8UDVD2WD]^,`8 8 VD^ ]kd$$Ifl 4064 la< =z=|===========>>>>*>+>V>q>r>>>>>ǕǕǀmWWBBB(hRYCJOJQJ\^JaJnHo(tH+hRY5>*CJOJQJ^JaJnHo(tH%hRY5CJOJQJ^JaJnHtH(hRYCJOJQJ\^JaJnHo(tH1jhRY5OJQJU^JaJmHnHtHu1jhRYOJQJU\^JaJmHnHtHu(hRY5CJOJQJ^JaJnHo(tH!hRYOJQJ\^JaJnHtH$hRYOJQJ\^JaJnHo(tH======================>"$ & F & h8 xH WDn` a$$ & F & h8 xHa$>>>>>>*>+>B>W>q>r>>>wwww $ 8$Ifa$ 8lVDWD^`l$ 8iVDWD^`ia$ & F & h8 xH$ & F & h8 xHa$$ & F & h8 xHa$ >>>>>>>>?@@H@@@@A>>>>>>??@@@@@ @H@J@@@@@@@AA@APARATA|A~AAABB!BBBBBBBB6CuhRYCJOJQJ^JaJ%hRYCJOJQJ\^JaJnHtH+hRY5>*CJOJQJ^JaJnHo(tH hRYCJH*OJQJ^JaJo(0hRYCJOJQJ\^JaJmH nHo(sH tH(hRYCJOJQJ\^JaJnHo(tH(hRYCJOJQJ\^JaJnHo(tH+A@ARAAA!BBBBBttt_tt$ 8z$VDWD^z`$a$$ 8VDWD^`a$$ 8iVDWD^`ia$$ 8lVDWD^`la$Lkd$$Ifl4"0,::64 laf4 BBC"C/C6C8CDDDDmEnEF>G 8 8WD` 8|VDWDp^|` & F & h8 xH$ 8VDWD^`a$$ 8iVDWD^`ia$6C8C9CJDRDmEFFDGFGXH\HHHHHHHHII,J:JJJJȵȤȎ{hRA hRY5CJOJQJ^JaJo(+hRY5>*CJOJQJ^JaJnHo(tH%hRY5CJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tH+hRYCJH*OJQJ\^JaJnHo(tH hRYCJH*OJQJ^JaJo(%hRYCJOJQJ\^JaJnHtH(hRYCJOJQJ\^JaJnHo(tHhRYCJOJQJ^JaJ(hRY5CJOJQJ^JaJnHo(tH>GHHHHHHII*J,Jwg[[ 8 VD^  2WD^2` 6WD^6` 8~VD?^~$ 8~VD?^~a$ & F & h8 xH$ & F & h8 xHa$% & F & h8 xHVDWDf^` ,J~JJJJJJJK2K4K6KJKLK & F & h8 xHWD`$ & F & h8 xHa$$ & F & h8 xHa$ 8 VD^ JJJJJK2K6KHKJKKKKKȷoaH9hRY5CJ OJQJ^JaJ 1jhRY5OJQJU^JaJ mHnHtHuhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH(hRY>*CJOJQJ^JaJnHo(tHhRY>*CJOJQJ^JaJ hRY5>*CJOJQJ^JaJ hRY5>*CJ$OJQJ^JaJ$hRY5CJOJQJ^JaJ(hRY5CJOJQJ^JaJnHo(tH%hRY5CJOJQJ^JaJnHtH LK`KlKKKL LLLL(L3L4L5L6L & F & h8 xHWD` & F & h8 xH?WD`? & F & h8 xH"$ & F & h8 xHWD`a$KKKKL L LLLL3L6L7LOLôoZG1+hRY5>*CJOJQJ^JaJnHo(tH%hRY5CJOJQJ^JaJnHtH(hRY5CJOJQJ^JaJnHo(tH(hRYCJOJQJ\^JaJnHo(tHhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tHhRY>*CJOJQJ^JaJhRY5CJOJQJ^JaJ1jhRY5OJQJU^JaJmHnHtHuhRY5CJ OJQJ^JaJ (hRY5CJ OJQJ^JaJ nHo(tH OLPLQLSLXLYLbLmLLLUMVM]M_M`MռyfyySD1%hRYCJOJQJ^JaJnHo(tHhRY5CJOJQJ^JaJ%hRY5CJOJQJ^JaJnHtH%hRYCJOJQJ\^JaJnHtH(hRYCJOJQJ\^JaJnHo(tH1jhRYOJQJU\^JaJmHnHtHu(hRY5CJOJQJ^JaJnHo(tH1jhRY5OJQJU^JaJmHnHtHu+hRY5>*CJOJQJ^JaJnHo(tH(hRY5>*CJOJQJ^JaJnHtH6LQLTLULVLWLXLLLUMe & F & h8 xHWD ` & F & h8 xHWDP ` & F & h8 xHWDp` & F & h8 xH & F & h8 xHWD` UM`MaMMMMMM(N)NUNnNNNN.O7OrO # h8 xHH^H` # h8 xH & F & h8 xH$ & F & h8 xHa$`MMMMOWOSSSSSSSTTVV!W"WXXXXȷ{h{W{W{HhRY5CJOJQJ^JaJ!hRYOJQJ\^JaJnHtH$hRY5OJQJ^JaJnHo(tH$hRYOJQJ\^JaJnHo(tHhRY\nHo(tH(hRY5CJOJQJ^JaJnHo(tHhRYCJaJo( hRY5CJOJQJ^JaJo(hRYCJaJ%hRYCJOJQJ^JaJnHo(tHhRYCJH*OJQJ^JaJhRYCJOJQJ^JaJrOsOOOOOPwPPPPPYQQQzz # h8 xH`^`` # h8 xHH^H` # h8 xHH^H` # h8 xH ^  # h8 xHQQwRRSSSSSSwm  8$If $ 8$Ifa$ 8 VDWD@^ `$ # 8 xHa$$ # 8 xH^a$ & F # h8 xH # h8 xH`^`` SSTT{  8$IfWD 8$Ifnkd$$Ifl0' P0$64 laRTTTUo 88$IfWD^`8  !8$Ifpkd"$$IflS0' P0$64 laRUUU[Vq 88$IfWD^`8 8$IfpkdƟ$$Ifl0' P0$64 laR[V\VVJWq 88$IfWD^`8 8$Ifpkdj$$IflS0' P0$64 laRJWKW[WXq 88$IfWD^`8 8$Ifpkd$$Ifl0' P0$64 laRXXXXq 88$IfWD^`8 8$Ifpkd$$IflS0' P0$64 laRXXXXXXXkSSS$ # 8 xHa$$ # 8 xHa$ 8 VD^ pkdV$$IflS0' P0$64 laRXXXXXYYY YYYYYYYYZZNZ[Z\Z]ZZZZZθq```N`θ`#hRY5>*CJOJQJ\^JaJ hRYCJH*OJQJ\^JaJ#hRY>*CJH*OJQJ\^JaJ hRY>*CJOJQJ\^JaJhRYCJOJQJ\^JaJ(hRYCJOJQJ\^JaJnHo(tH+hRY5CJOJQJ\^JaJnHo(tH hRY5CJOJQJ\^JaJhRYCJaJnHo(tH&jhRYCJUaJmHnHtHuXXY YY Y!Y"Y#Y9YWY|YYYYYYYYZZ & F & h8 xH$ & F & h8 xHa$$ # 8 xH^a$ZZ7ZNZ\ZZZZZZ[["[k[[\\\\ & F & h8 xH$ & F & h8 xHa$ & F & h8 xHZZZZZZZZZ[[[["[&[O[j[k[o[[[[[\\\\\\\\\\\\\ɴɴɴɴɴɴɴɴɴɣɴɴɴɁk+hRY5CJOJQJ\^JaJnHo(tH hRY5CJOJQJ\^JaJ hRYCJOJQJ\^JaJo( hRY6CJOJQJ\^JaJ(hRYCJOJQJ\^JaJnHo(tHhRYCJOJQJ\^JaJ hRYCJH*OJQJ\^JaJ+hRYCJH*OJQJ\^JaJnHo(tH#\\\\\\]]9]B]]]]]]]]] & h8 xHWD` & h8 xH$ & h8 xHh^ha$ & h8 xHh^h\]]B]]]]]]]]^8^^^^^^^n_o_p________n`w`3a4aaڶڶڶڶڶڶڶڒڄqq_q_qڶ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJ%hRYCJOJQJ\^JaJnHtH hRYCJOJQJ\^JaJo(hRYCJOJQJ\^JaJ(hRY5CJOJQJ^JaJnHo(tH(hRYCJOJQJ\^JaJnHo(tH hRY>*CJOJQJ\^JaJ#]]]7^8^^^^^^^_$_B___o_p__ # 8 xH & F & h8 xH WDy`  & h8 xH & h8 xHWD`______`=aHaIasatauaa & h8 xH$ & h8 xHa$ # 8 xHVDWD^` # 8 xH` # 8 xH >aEaGaHaIaqasaggggggggghhjjjj#kĵٵ|kĵVB&jhRYCJOJQJU\^JaJ)hRY5>*CJH*OJQJ\^JaJo( hRY6CJOJQJ\^JaJ+hRYCJOJQJ\]^JaJnHo(tH hRY>*CJOJQJ\^JaJ#hRY5>*CJOJQJ\^JaJhRYCJOJQJ\^JaJ(hRYCJOJQJ\^JaJnHo(tH+hRY5CJOJQJ\^JaJnHo(tH hRY5CJOJQJ\^JaJaa bIbgbbbbc=cYczcccc6ddd.eUeeee f8f & h8 xH & h8 xH^8foffffggggghhh@hBhhhh$ & h8 xHa$ & h8 xH$WD^`$ & h8 xH & h8 xH^hhi>idi~iii j j(j=jUjtjjjjjjjBk & h8 xHh^h` & h8 xHx^x & h8 xH#k$k%k@kAklllmmmBm^mmmmmmmmmmյyhRh@#hRY5>*CJOJQJ\^JaJ+hRYCJH*OJQJ\^JaJnHo(tH hRYCJH*OJQJ\^JaJ+hRY5CJOJQJ\^JaJnHo(tH hRY5CJOJQJ\^JaJ(hRYCJOJQJ\^JaJnHo(tHhRYCJOJQJ\^JaJ!hRY0JCJOJQJ\^JaJ&jhRYCJOJQJU\^JaJ,jhRYCJOJQJU\^JaJBkCkllmm^mmmmnnn3nKnzzzzzzz & h8 xHh^h$ & h8 xHh^ha$ & h8 xH8^8 & h8 xHh^h` & h8 xHmn>n?nooZoopIpLpSpUpYp\p]p`pbpgphpkplpppqpwpxpppppppppqqq˵˟{j^j^j^j^j^j^j^j^j^j^hRYCJOJQJ^J!hRYCJOJQJ^JnHo(tHhRYnHo(tHjhRYUo( hRY5CJOJQJ\^JaJ+hRY5CJOJQJ\^JaJnHo(tH+hRY>*CJOJQJ\^JaJnHo(tH(hRYCJOJQJ\^JaJnHo(tHhRYCJOJQJ\^JaJ hRY>*CJOJQJ\^JaJ$Knhn|nnnnnnno,o=o[oopp3pIpJpKpLpZp$ & F & h8 xHa$ & h8 xHh^hZp[p\p^p_p`pqqq~!$ & F & h8 xH$Ifa$($ & F & h8 xH @ UDVD] ^@ a$$ & F & h8 xHa$ & F & h8 xHqq(q)q.q/q2q3qEqHqPqQq_qbqdqeqjqkqsqtqwqxq|q~qqqqqqqqqqqr rrrs sVsXsϼii-hRYCJOJQJ^JaJmH nHo(sH tH(hRYCJH*OJQJ^JaJnHo(tH+hRY5CJOJQJ\^JaJnHo(tH hRY5CJOJQJ\^JaJ%hRYCJOJQJ^JaJnHo(tH$hRYCJH*OJQJ^JnHo(tHhRYCJOJQJ^J!hRYCJOJQJ^JnHo(tH)qqr|!$ & F & h8 xH$Ifa$bkd/$$Ifl$$0$64 lar rNrxrrr^^^!$ & F & h8 xH$Ifa$ & F & h8 xH$IfbkdZ0$$Ifl$0$64 larrss&su`ufuuuuuuuuuuվի왉xgWgEW<<<hRYnHo(tH"hRYCJOJQJ^JaJnHtHhRYCJOJQJ^JnHtH!hRYCJOJQJ^JnHo(tH!hRYCJOJQJ^JnHo(tHhRYCJOJQJ^JnHtH"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tH-hRYCJOJQJ^JaJmH nHo(sH tH-hRYCJOJQJ^JaJmH nHo(sH tH%hRYCJOJQJ^JaJnHo(tHhs|sssssss t(t:tntxtttttt u uuu&u!$ & F & h8 xH$Ifa$ & F & h8 xH$If&u.u6u8u:uuFuNuPuXu`ubudufunupuxuuuuuu $$Ifa$$ & F h8$Ifa$!$ & F & h8 xH$Ifa$uuuuuuuuuuuuuuuuuuuuuuvv $ & F$Ifa$!$ & F & h8 xH$Ifa$ $$Ifa$uuuuuuuuuuuuuuuvvvv v vv v#v/v0v=v>vFv෭|iX!hRYOJQJ^JaJnHo(tH%hRYCJOJQJ^JaJnHo(tH%hRYCJOJQJ^JaJnHo(tHhRYCJnHo(tHhRYCJnHo(tHhRYnHtHhRYCJnHtHhRYCJnHo(tHhRYCJnHo(tH%hRYCJOJQJ^JaJnHo(tHhRYnHo(tHhRYCJnHo(tHhRYCJnHo(tHvvv v vvvvvv v!v"v#v'v+v/v0v4v8vvBvFvKvOvPvQvUvVvWvXv\v]v^v!$ & F & h8 xH$Ifa$"&$ & F & h8 xH$G$Ifa$FvGvOvQv^v_vvvvvvvvvvvvvvwwwww,w-w=w>wNwOw_w`wqwrwwwwwwwwwwwwwwwwwxҿұұұұұұұұұұұұұұұұұұұұұ hRY5CJOJQJ\^JaJ+hRY5CJOJQJ\^JaJnHo(tHhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH%hRYCJOJQJ^JaJnHo(tH4jhRY5OJQJU\^JaJmHnHtHu2^v_vvfC"$ & F & h8 xH$4$Ifa$kd1$$Ifl\ p 0$64 lavvvvvvvvv{ZZZZZZ!$ & F & h8 xH$Ifa$!$ & F & h8 xH$Ifa$ckd2$$Ifl4|0$6X4 laf4vvvvvfH''!$ & F & h8 xH$Ifa$ & F & h8 xH$IfkdX3$$Ifl\ |T0$6X4 lavvvvvC% & F & h8 xH$IfkdF4$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$vvvvvC% & F & h8 xH$Ifkd@5$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$vvvvvCkdH6$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$vvvvv!$ & F & h8 xH$Ifa$ & F & h8 xH$IfvvvvvdF%%!$ & F & h8 xH$Ifa$ & F & h8 xH$IfkdP7$$Ifl\ |T0$6X4 lavvwwwC% & F & h8 xH$IfkdX8$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$w wwwwC% & F & h8 xH$Ifkd`9$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$wwwwwCkdh:$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$w w$w(w,w!$ & F & h8 xH$Ifa$ & F & h8 xH$If,w-w0w4w9wdF%%!$ & F & h8 xH$Ifa$ & F & h8 xH$Ifkdp;$$Ifl\ |T0$6X4 la9w=w>wAwEwC% & F & h8 xH$Ifkdx<$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$EwJwNwOwRwC% & F & h8 xH$Ifkd=$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$RwVw[w_w`wCkd>$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$`wcwgwlwqw!$ & F & h8 xH$Ifa$ & F & h8 xH$Ifqwrwuwyw~wdF%%!$ & F & h8 xH$Ifa$ & F & h8 xH$Ifkd?$$Ifl\ |T0$6X4 la~wwwwwC% & F & h8 xH$Ifkd@$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$wwwwwC% & F & h8 xH$IfkdA$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$wwwwwCkdB$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$wwwww!$ & F & h8 xH$Ifa$ & F & h8 xH$IfwwwwwdF%%!$ & F & h8 xH$Ifa$ & F & h8 xH$IfkdC$$Ifl\ |T0$6X4 lawwwwwC% & F & h8 xH$IfkdD$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$wwwwwC% & F & h8 xH$IfkdE$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$xx x xxxx,x0x2x4x8x>xDxJxPxRxTxVxxx˽ݽooo`K5K+hRY5>*CJOJQJ^JaJnHo(tH(hRYCJOJQJ\^JaJnHo(tHhRYCJOJQJ\^JaJ+hRYCJH*OJQJ\^JaJnHo(tH hRYCJH*OJQJ\^JaJ+hRY5CJOJQJ\^JaJnHo(tH hRY5CJOJQJ\^JaJhRYCJOJQJ^JaJ"hRYCJOJQJ^JaJnHtH%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JaJo(w xxxxCkdF$$Ifl\ |T0$6X4 la!$ & F & h8 xH$Ifa$xTxVxxxxy:y*CJOJQJ\^JaJhRYCJOJQJ\^JaJ hRYCJH*OJQJ\^JaJ&{||,|U|{||||| }.}V}m}}}*~D~F~G~R~S~T~! & F & h8 xH@ ^@ ` & F & h8 xHT~U~V~W~X~Y~Z~[~\~]~^~_~`~a~b~c~d~e~f~g~h~$ & F & h8 xHa$ & F & h8 xHCklځ[}cdƒЃˈΈJQSŴtŴŴŴŴcԴŴc hRY5CJOJQJ\^JaJ.hRY>*CJH*OJQJ\^JaJnHo(tH#hRY>*CJH*OJQJ\^JaJ+hRY>*CJOJQJ\^JaJnHo(tH hRY>*CJOJQJ\^JaJhRYCJOJQJ\^JaJ(hRYCJOJQJ\^JaJnHo(tH+hRY5CJOJQJ\^JaJnHo(tH "CJYjyz~ʀۀ!7H & F & h8 xH$ & F & h8 xHa$HI\nہ,[~҂ )Fc$ & F & h8 xHa$ & F & h8 xHcƒуكڃ/huuuuuuuuu! & F & h8 xH@ ^@ `$$ & F & h8 xH@ ^@ `a$($ & F & h8 xH@ VDWD^@ `a$ & F & h8 xH hHI  nڇۇ!"{̈! & F & h8 xH@ ^@ `ITUtuNO@N & h8 xH8^8`$ & h8 xHa$ & h8 xH@MOVXY&ʹʵʤyhTCC hRY6CJOJQJ\^JaJ&jMhRYCJOJQJU\^JaJ jhRY6U\mHnHu(hRYCJOJQJ\^JaJnHo(tH+hRY5CJOJQJ\^JaJnHo(tH hRY5CJOJQJ\^JaJhRY hRY>*CJOJQJ\^JaJhRYCJOJQJ\^JaJ+hRYCJH*OJQJ\^JaJnHo(tH hRYCJH*OJQJ\^JaJNYHr> & h8 xH$d%d&d'dNOPQUDZ]  & h8 xHh^h`!$ & h8 xHh^h`a$ r׍ F}Ȏ,G> & h8 xH$d%d&d'dNOPQUDZ]? ) h8 xH|)$d%d&d'dNOPQUDZ]׍ &F`|ǎ"+eȏُIJ[ؐ3Qruݸݣxx+hRY5>*CJOJQJ^JaJnHo(tH(hRYCJOJQJ\^JaJnHo(tH(hRY5CJOJQJ^JaJnHo(tH&jUNhRYCJOJQJU\^JaJ hRY6CJOJQJ\^JaJhRYCJOJQJ\^JaJ&jMhRYCJOJQJU\^JaJ)ڏޏ9IK4st$ 8 VD^ a$$ 8a$> & h8 xH$d%d&d'dNOPQUDZ]./efҒӒ:;FG_`cd{|ǓȓɓʓѻѢѢѢѢѢѢѢѢѢѢяѢѢѢѢяяѢяя%hRYCJOJQJ\^JaJnHtH0hRYCJOJQJ\^JaJmH nHo(sH tH+hRY>*CJOJQJ\^JaJnHo(tH(hRYCJOJQJ\^JaJnHo(tH1jhRYOJQJU\^JaJmHnHtHu1.eҒ 8 LVDWD^ `L 8 VDWDA^ ` 8 VD^ 8WD` 8TWDl`T 8 WDT` Ғ:^_abc{ɓ 8$VDWD^`$ 8 VD^  8 , VDWD^ `,  8 t VDWDL^ `t  8 VDWD^ ` 8 VDWD^ `4{nn $ 8$Ifa$MkdN$$IfTl0`64 laT $ 8$Ifa$$ 8#VDWD^`#a$$ 8$VDWD^`$a$  !';>QTUV` #*.16PQS֧֧֧֧}wneWeWeWeWehRY5>*CJnHo(tHhRY5>*CJhRY5>*CJ hRYCJ%hRYCJOJQJ\^JaJnHtH-hRYCJOJQJ\^JaJmH nHsH tH0hRYCJOJQJ\^JaJmH nHo(sH tH+hRYCJH*OJQJ\^JaJnHo(tH(hRYCJOJQJ\^JaJnHo(tH(hRY5CJOJQJ^JaJnHo(tH45NefzXMkdO$$IfTlT0`64 laT $ 8$Ifa$MkdgO$$IfTlT0`64 laTȕX;$ 8$$IfUDWD]^`$a$MkdP$$IfTlT0`64 laT $ 8$Ifa$MkdGP$$IfTlT0`64 laTXMkdQ$$IfTlT0`64 laT $ 8$Ifa$Mkd'Q$$IfTlT0`64 laT <=>RSXMkdwR$$IfTlT0`64 laT $ 8$Ifa$MkdR$$IfTlT0`64 laTSTU`ɖ  xCPQRSTvvvv $d$Ifa$ d$Ifd$da$$a$$ 8#VDWD^`#a$MkdR$$IfTlT0`64 laT SZ\kqwxCPTUijΘҘӘ$%MNfgxyәԙ=>RSƚКњ(hRYCJOJQJ\^JaJnHo(tH+hRY5>*CJOJQJ^JaJnHo(tH hRY5 hRY5>* hRY>*\hRY5>*CJnHo(tHhRY5>*CJhRY5>*CJH*nHo(tHhRY5>*CJH*3TUbdegiXOCCCC $d$Ifa$ d$IfkdWS$$IflrR G 7(b|064 laijXOCCCC $d$Ifa$ d$Ifkd T$$IflrR G 7(b|064 laXOCCCC $d$Ifa$ d$IfkdT$$IflrR G 7(b|064 laΘϘИјҘXOCCCC $d$Ifa$ d$IfkdU$$IflrR G 7(b|064 laҘӘXOCCCC $d$Ifa$ d$Ifkd{V$$IflrR G 7(b|064 la   XOCCCC $d$Ifa$ d$IfkdDW$$IflrR G 7(b|064 la "$XOCCCC $d$Ifa$ d$Ifkd X$$IflrR G 7(b|064 la$%HIJKMXOCCCC $d$Ifa$ d$IfkdX$$IflrR G 7(b|064 laMN`abdfXOCCCC $d$Ifa$ d$IfkdY$$IflrR G 7(b|064 lafgsuvwxXOCCCC $d$Ifa$ d$IfkdhZ$$IflrR G 7(b|064 laxyXOCCCC $d$Ifa$ d$Ifkd1[$$IflrR G 7(b|064 laXOCCCC $d$Ifa$ d$Ifkd[$$IflrR G 7(b|064 laXOCCCC $d$Ifa$ d$Ifkd\$$IflrR G 7(b|064 la̙ΙЙҙәXOCCCC $d$Ifa$ d$Ifkd]$$IflrR G 7(b|064 laәԙXOCCCC $d$Ifa$ d$IfkdU^$$IflrR G 7(b|064 laXOCCCC $d$Ifa$ d$Ifkd_$$IflrR G 7(b|064 la67;<=XOCCCC $d$Ifa$ d$Ifkd_$$IflrR G 7(b|064 la=>KLPQRXOCCCO $d$Ifa$ d$Ifkd`$$IflrR G 7(b|064 laRSTŚКњXSSKSKS$da$dkdya$$IflrR G 7(b|064 laњ!Λϛ *+HIijԜ՜!"x%&2kmտժժzngg hRY5CJjhRY5CJU hRY\hRY5>*CJhRY5>*nHo(tH hRY5>*hRYCJOJQJ\^JaJ(hRYCJOJQJ\^JaJnHo(tH+hRY>*CJOJQJ\^JaJnHo(tH+hRY5>*CJOJQJ^JaJnHo(tH(hRY5CJOJQJ^JaJnHo(tH&!t^kdBb$$Ifl4$!0!64 la<f4 $d$Ifa$›Λ~uuu d$Ifkdb$$IflF$ $ 0!6    4 la<Λϛݛ~uuu d$Ifkd|c$$IflF$ $ 0!6    4 la< ~uuu d$Ifkd,d$$IflF$ $ 0!6    4 la< *~uuu d$Ifkdd$$IflF$ $ 0!6    4 la<*+8@H~uuu d$Ifkde$$IflF$ $ 0!6    4 la<HIU]i~uuu d$Ifkd*CJnHo(tH!hRY>*B*CJnHo(phtH"jnhRYB*CJUphhRYB*CJphjhRYB*CJUph hRY5jlhRYCJU hRY5CJ hRY\hRY5>*CJhRY0JCJjhRY5CJUjjhRYCJUҞӞ/w˟lcccc d$Ifkdk$$Ifl\k (0W4 la˟̟ DMРlccccc d$Ifkdm$$Ifl\k (0W4 la?~lcccc d$Ifkdo$$Ifl\k (0W4 la679:=>~ɢ  <>?@ghvǻǮ|tgtZhRY5>*B*CJphjuhRYCJUhRY0JCJj*shRYCJU hRY5CJjhRY5CJUhRY hRY5hRY5>*CJhRY>*B*CJ\phhRY5B*CJphhRYB*CJ\phhRY0JCJ\jhRYB*CJU\ph%jphRYB*CJU\ph#~lc]]]ccc$If d$IfkdPr$$Ifl\k (0W4 lawja[[[aaa$If d$Ifkd#t$$Ifl*\k (0W4 lavKLX¥å_`atuCD$:<=>TU[\hEFȪŶߟߒ߅j|hRYCJUjzhRYCJUjyhRYCJUhRY5>*CJH*hRYCJOJQJ\^JaJ hRY5hRY0JCJjvhRYCJU hRY5CJjhRY5CJU hRY\hRY5>*CJ4դAȥ_jaaaa d$Ifkdv$$Ifl@\k (0W4 la_`atuڦGjdVQHHHH d$Ifd $dUDZ]a$ 8kd9x$$Ifl\k (0W4 laWkbbbb d$Ifkd,z$$Ifl\(4   0(564 laQEkbbbb d$Ifkd{$$Ifl\(4   0(564 laEFUkbbbb d$Ifkd}$$Ifl\(4   0(564 laȪABNiklm խ׭ح٭cd׮خ´v´qdj hRYCJU hRY\hRY0JCJnHo(tH!jWhRYCJUnHtHhRY5CJnHtHjhRY5CJUnHtH hRY5hRY5>*CJnHo(tHhRY5CJnHo(tHhRY0JCJjhRY5CJUj~hRYCJU hRY5CJhRY5>*CJ&ƫ7kbbbbb d$Ifkd$$Ifl\(4   0(564 la F{ckbbbb d$Ifkd>$$Ifl\(4   0(564 lacdͮAukbbbb d$Ifkd$$Ifl\(4   0(564 la>?uv./0jkyzɱdzȴɴ˵ՠՙՙqhRY5>*CJnHo(tHj_hRYCJUj}hRYCJU hRY5CJ$jhRY5>*CJUmHnHujOhRYCJU hRYCJjhRYCJU hRY5hRY5>*CJhRY0JCJjhRY5CJUj]hRYCJU,uvۯmkbbbb d$Ifkd$$Ifl\(4   0(564 lakbbbb d$Ifkd$$Ifl\(4   0(564 lakbbbb d$Ifkd$$Ifl\(4   0(564 la!xkbbbb d$Ifkdt$$Ifl\(4   0(564 la˵ֵصٵڵxy,-Z[ηϷ%&45ŷҦvcZvMhRY>*B*CJ\phhRY0JCJ\%j%hRYB*CJU\phhRYB*CJ\phjhRYB*CJU\phj{hRYCJU hRY5CJjhRY5CJU hRY5hRY5>*CJnHo(tHhRY>*CJnHo(tHhRY0JCJjhRYCJUjAhRYCJU hRYCJhRY5>*CJxy߶/Zkbbbb d$Ifkd$$Ifl\(4   0(564 laZ[fķ6dkbbbb d$IfkdX$$Ifl\(4   0(564 la5detuùĹ!"EFG򾩖vbvKb,j(hRYCJOJQJU\^JaJ&jhRYCJOJQJU\^JaJhRYCJOJQJ\^JaJ hRY5CJOJQJ\^JaJ%hRYCJOJQJ\^JaJnHtH(hRYCJOJQJ\^JaJnHo(tHhRYCJOJQJ\^JaJhRY0JCJjhRYCJU hRYCJjhRYCJU hRY5hRY5>*CJde~wkbbbb d$Ifkd*$$Ifl\(4   0(564 la¹ùĹke\\\\$ 8a$ 8kd̓$$Ifl\(4   0(564 laĹ;gkd$$IflLO)`9 t0644 la, 8$$d%d&d'dIfNOPQ0 8$d%d&d'd-D M NOPQi>`agͽ4mf)~9' 8$d%d&d'dNOPQGUVuvԾվst%&˴˝ˆp^pOhRYCJOJQJ\^JaJ#hRY5>*CJOJQJ^JaJo(+hRY5>*CJOJQJ^JaJnHo(tH,jhRYCJOJQJU\^JaJ,jhRYCJOJQJU\^JaJ,jhRYCJOJQJU\^JaJhRYCJOJQJ\^JaJ&jhRYCJOJQJU\^JaJ!hRY0JCJOJQJ\^JaJ9abc`Z%2fgKV[bhor $d$Ifa$$da$$da$d' 8$d%d&d'dNOPQ&-2_`bdegKZ[ab)GHef"#DEkl ;<RSghɯhRY5>*CJ hRYCJ\hRY5>*CJH*hRY5>*CJhRY5>*CJnHo(tHhRY5>*H*nHo(tHhRY5>*H*hRY5>*nHo(tH hRY5>*Ar} ),Ff՝ d$IfFf $d$Ifa$,/2468:<>@BEGHLNPQSUWY[]_aceFf d$Ifefmoqsuwxz|}Ff d$IfFfFfCFf- d$IfFfoFfY d$If !"#1356789:<=?ACDEXFfFf d$IfXZ\]^`abdeghjklprsuvwyz|~Ff d$IfFf d$IfFfFf Ff d$If +-/01Ff5Ff d$If12456789:;<BDFGHIJKLMNPQRSXZFfaFfK d$IfZ\]^_`abcdefghsuvxyz{|}~Ffw d$Ifh?@cd  $%ABVWpq CDbcfyUV`ǻǻǻ#hRY5>*CJOJQJ\^JaJhRY5>*nHo(tH hRY5>*$jhRY5>*CJUmHnHuhRYCJOJQJ\^JaJ hRYCJ\hRY5>*CJ@Ff d$IfFfFfFf d$If  01234FfFf d$If456789:<>?@TVXYZ[\]^_`abcd{}Ff' Ff d$If}~$ 8a$ 8Ff= d$IfFfFf  d$IfFf}Ff d$If     !"#$%34Ff'FfM# d$If456789:;=>?@ABHIJKLMNOPQRSUVFf* d$IfVWbdefghijklmnopqFf2 d$IfFf.Ff-:Ff]6 d$IfFfAFf= d$If 56FfmIFfE d$If6789:;<=?@ABCDTUVWXYZ[\]^_`bFf=M d$IfbcdtUVabc & F & h8 xH # 8 xH^d$ & F & h8 xHa$$pPd^p`Pa$d$da$Ff Q `bcg78BCIJlIM  !vw|}+/ +45CGxy*./3G%hRYCJOJQJ^JaJnHo(tHhRYCJaJhRYCJOJQJ^JaJQlm*+*+ # 8 xH^ & h8 xH^ & F & h8 xH^ & F & h8 xHBC)*./RS & F & h8 xH & F & h8 xH^GIDESWSU#'&[_fJ {|  Y[عععععʚʚhRYCJH*OJQJ^JaJhRYCJOJQJ^JnHtH!hRYCJOJQJ^JnHo(tHhRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tH(hRYCJH*OJQJ^JaJnHo(tH<"#&'{|Q[\fg # 8 xH^ & F & h8 xH^ & F & h8 xHg_`JK   & F & h8 xH^ # 8 xH^ & F & h8 xHBCcd !st[ & F & h8 xH^ # 8 xH^ & F & h8 xHBGbcd!%eftxZ[KLX\_`nr ae37Cc˽˽˽ˮ˽˽˽˽˽˽˽hRYCJOJQJ^J"hRYCJOJQJ^JaJnHtHhRYCJOJQJ^JaJo(hRYCJOJQJ^JaJ%hRYCJOJQJ^JaJnHo(tHhRYCJOJQJ^JnHtH!hRYCJOJQJ^JnHo(tH7[\WXmn  `a23d & F & h8 xH^ & h8 xHw^`w & h8 xH^cdGHhlEI   j26HL  goIMosCG:;VWx(hRYCJOJQJ^JnHtHhRYCJOJQJ^J!hRYCJOJQJ^JnHo(tHhRYCJOJQJ^Jo(NdghDEjk12 & F & h8 xH^ & h8 xH^ # 8 xH^GHHIn # 8 xH^ & h8 xH^ & F & h8 xH^noBCWX  # 8 xH^ & F & h8 xH^ & h8 xH^ LophiTUhiJLJ L  & F & h8 xH^ # 8 xH^ & h8 xH^imLTJ       lq5:%*<A38W\Z_ [`]bMRk m  $hRYCJH*OJQJ^JnHo(tHhRYCJOJQJ^JnHtH)hRYCJOJQJ^JmH nHo(sH tH!hRYCJOJQJ^JnHo(tHhRYCJOJQJ^J>L    O P         [kl & F & h8 xH^ & h8 xH^ # 8 xH^1245;<23 & F & h8 xH^ & h8 xH^ # 8 xH^YZZ[\]_ & h8 xH^ & F & h8 xH^_`  !!!!""##f$g$$$Z%[%&&&& & F & h8 xH^ # 8 xH^  !!!!["\"e"f"C$E$((=*?* + +++,EF˵͵8:ƸǸȸACfhiѨኆ}t}i}hRYH*nHo(tH j+hRY0J'hRYnHo(tHhRY j*hRY0J'U$hRY>*CJOJQJ^JnHo(tH*hRY5>*CJOJQJ\^JnHo(tH$hRYCJH*OJQJ^JnHo(tHhRYCJOJQJ^JnHtH!hRYCJOJQJ^JnHo(tHhRYCJOJQJ^Jo((&''X''''}(~((())"*z*{* +++$ # 8 xH^a$$ # 8 xH^a$ # 8 xH^++)fŶ MwwwWWW$ # 8 xH^`a$!$ # 8 xHgWD]^g`a$!$ # 8 xHJWDj^J`a$!$ # 8 xHiWD\^i`a$!$ # 8 xHgWD]^g`a$ utura Pub. Co Inc. Mount Kisko, NY 1992 3. Complications - A Surgeons Notes on an Imperfect Science. Atul Gawande. Henry Holt Co, New York 2002 4. Complications in Cardiothoracic Surgery - Avoidance and Treatment. Little, AG. Blackwell, Futura Elmsford, New York 2004 5. Carr, J.M, Krempin, J, Weintraub, RM - Ch 67 - Clinical Quality and Cardiac Surgery p1103-1113. In: Sellke, FW, del Nido, PJ, Swason, S.J. Sabiston and Spencer Surgery of the Chest 7th ed. Elsevier Saunders, Phila, 2005. 6. Bojar, R.M. Manual of Perioperative Care in Adult Cardiac Surgery 4th ed. Blackwell Publishing, Malden, MA, 2005 7. Cohn, LH, Edmunds, LH, ed. Cardiac Surgery in the adult 2nd ed. Mc Graw Hill, New York 2003 - Ferraris, VA, Ferraris, SP Ch 6 Risk stratification and comorbidity - Grunkemeier, G, Jin, R. Ch 7 Surgical Treatment of Outcome Data - Vijay, V, Gold, JP. Ch 18 Late Complications of Cardiac Surgery ( Examples: John Streider at Massachusetts General Hospital ligated a patent ductus arteriosus in 1937 one year prior to Robert Gross. Clarence Dennis closed an atrial septal defect utilizing cardiopulmonary bypass in 1951, 2 years prior to John Gibbon. Both patients died perioperatively from complications. ( Stephenson, L.W., Ch. 1 - History of Cardiac Surgery p3-29. In Cohn, L.H., Edmunds, H. ed. Cardiac Surgery in the Adult 2nd ed. Mc Graw-Hill, New York, 2003. (( Critical pathways, also known as critical paths, clinical pathways, or care paths, are management plans that display goals for patients and provide the sequence and timing of actions necessary to achieve these goals with optimal efficiency. Every, N.R., Hochman, J., Becker, R., Kopecky, S. Cannon, C.P. AHA Scientific Statement; Critical Pathways A ReviewCirculation 2000;101:461-470 ( Two risk calculators-simple additive standard Euro Score (Roques, F, Nashef SA, Michel, P, et al. Risk Factors and Outcome in European Cardiac Surgery: Analysis of the Euro Score multinational database of 19,030 patients. Eur J Cardiothoracic Surg 1999; 8:16-22) and the full logistic Euro Score (Roques, F, Michel, P, Goldstone, AR, Nashef, SA Logistic Euro Score. Eur Heart J. 2003; 24:882-883). The later gives more accurate risk predictions for higher risk patients. ( Hawthorne effect an increase in worker productivity produced by the psychological stimulus of being singled out and made to feel important. ( HYPERLINK "http://www.nwlink.com/donclark/hrd/history/hawthorne.html" http://www.nwlink.com/donclark/hrd/history/hawthorne.html)     Table Three (cont) CABG, coronary artery bypass grafting; EF, ejection fraction; NYHA, New York Heart Association; LVEDP, left ventricular end-diastolic pressure; CVA, cardiovascular accident; PVD, pulmonary vascular disease; CHF, congestive heart failure; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; BSA, body surface area; BMI, body mass index. Directions: locate outcome of interest. Use the score in that column for each relevant preoperative variable; then sum these scores to get the total score. Take the total score and look up the approximate preoperative risk in the table. EF <40%: the patients current EF is less than 40%. Urgent: medical factors require the patient to stay in hospital to have operation before discharge. The risk of immediate morbidity and death is believed to be low. Emergency: patients cardiac disease dictates that surgery should be performed within hours to avoid unnecessary morbidity or death. Atrial fibrillation: sustained atrial fibrillation requiring treatment with digoxin, beta/calcium channel blockers, antiarrhythmics, or cardioversion. Table Five (con t) Preop Score e" 7 predicted mortality:9.43% Outcome Process Structure Accountability Accepting Responsibility Preop Score d" 6 predicted mortality:2.27% ICU Score d" 14 Mortality=1.66% Preoperative Assessment ICU Admission Assessment See Figure 20(a) for calculation of Preoperative Score  Personality Character Competence Availability Affibility Ability ICU Score d" 14 Mortality=4.Ƹf\ȼ &LWD^`L&`&$ # 8 xH^a$ijZ[ǺȺѺҺȼɼʼۼܼݼ޼WX[\h޽߽m՞՞՞՞ՔՎthRYCJmH nHo(sH tHhRYCJnHo(tH hRYCJhRYOJQJ^JjhRYUhRY0JnHo(tHjShRYUnHtHjhRYUnHtH j*hRY0J'hRY j+hRY0J'hRYmH nHo(sH tHhRYnHo(tHhRYnHtH-n[4 "24DFZ\| $WDd`a$$a$ $7$8$H$a$$a$ #WD^`# $WD^`$mnyop4?FG "24DFZ\ ǹǹǵmbbbWmhRYCJnHo(tHhRYaJnHo(tH(hRYCJOJQJ\^JaJnHo(tH(hRY5CJ OJQJ^JaJnHo(tH(hRY5CJOJQJ^JaJnHo(tHhRYnHo(tHhRYhRYCJmH nHsH tHhRYCJmH nHo(sH tH#hRY5CJ\mH nHo(sH tH-hRYCJOJQJ^JaJmH nHo(sH tH" (*JL 028:RThjWD,`$a$ (*HJLN0246:RThj$%&56EFGQS~ssssssqUhRYCJnHo(tHj>hRYUj UhRYU(hRY5CJOJQJ^JaJnHo(tH hRY5CJOJQJ^JaJo(hRYhRYnHo(tH(hRYCJOJQJ\^JaJnHo(tH(hRY5CJ OJQJ^JaJnHo(tH(hRY5CJOJQJ^JaJnHo(tH+33% ICU Score > 14 Mortality=19.4% ICU Score > 14 Mortality=27.9% why, how) %&56FGQRST$ # 8 xH^a$$a$ST!hRYCJOJQJ^JnHo(tH5...()()())))() 0&PP/R / =!"#$% 8$7&P1h0/R = /!0"#$% . o o o))()()P/R / =!"#$% 8$." " " " " " " " " )()()P/R / =!"#$% 8$4&P 1h/R . A!"#$% 7&P 1h0/R A .!"#$% 4&P 1h/R . A!"#$% 01h/R / =!"T#$% DyK yK :mailto:tpezzella@hotmail.comDyK Dwww.knowledge-finder.com/philosophy/parsimony-fourth-substance.htmlyK http://www.knowledge-finder.com/philosophy/parsimony-fourth-substance.htmlDyK http://www.ctsnet.org/doc/319yK <http://www.ctsnet.org/doc/319DyK www.euroscore.org/yK 4http://www.euroscore.org/DyK yK N(http://www.nap.edu/catalog/1005.html)DyK www.clinicalevidence.orgyK Bhttp://www.clinicalevidence.org/DyK yK 0http://www.ebmny.org),/DyK yK 6http://www.cochrane.org)./iDyK =http://www.acc.org/clinical/guidelines/bypass/ExecIndex.htm)yK zhttp://www.acc.org/clinical/guidelines/bypass/ExecIndex.htm)iDyK =http://www.acc.org/clinical/guidelines/valvular/dirindex.htmyK zhttp://www.acc.org/clinical/guidelines/valvular/dirindex.htmg$$If!vh5#v:V l465/ 4af4Tw$$If!vh5M5 #vM#v :V l65M5 / 4aTw$$If!vh5M5 #vM#v :V l65M5 / 4aTi$$If!vh5M5 #vM#v :V l65M5 4aTi$$If!vh5M5 #vM#v :V l65M5 4aTi$$If!vh5M5 #vM#v :V l65M5 4aTi$$If!vh5M5 #vM#v :V l65M5 4aTi$$If!vh5M5 #vM#v :V l65M5 4aTi$$If!vh5M5 #vM#v :V l65M5 4aTs$$If!vh5M5 #vM#v :V l6,5M5 4aTi$$If!vh5M5 #vM#v :V l65M5 4aTi$$If!vh5M5 #vM#v :V l65M5 4aTi$$If!vh5M5 #vM#v :V l65M5 4aTw$$If!vh5M5 #vM#v :V l65M5 / 4aTDyK http://www.americanheart.orgyK <http://www.americanheart.org/DyK 'http://clevelandclinic.org/heartcenteryK Nhttp://clevelandclinic.org/heartcenterDd k >  # A"bu{Eߝ-nu{Eߝ-PNG  IHDRN1+sRGB pHYsIDATx^-MVof9g9 ̢ "2 EELc@FF1Je s9;}]]jkUK߳k /}K^kž?_/ſ?ǿW\k_U~/վW{yoͿqozۿpG6o6_+eAԗҏ?/+4_K{-4w Iol5j~3ks W݃M{ cČm$_o7K/6Y~|/ſJ_+cWZ~o =Z__0+^pr |76/yxf-\b@g7ݿw'}'y_omï5&W XzʿwW_ы_|wzˋ}OIQrpUW7&~oM7'f_c6jIxbR3\rVDغf|~ZaE<+^3n O ́( 5~P\o-\e(0;Oi5vӉ!جk2_2lk+\{{?QD+P3I0W3UT T%Fh4jtH7DTG}{z #o-Juaf9Ǽ@ܨX:_y!!UG}k@.[`ho^Յ\6rM';8{?B \U8.,mP\G/>X~}3Ѹ[14~hS`(7qeYzHǭ?ϩ=l_ s5#ƛtʟ_#R@VAz`z0= = O3Uw` 6^]A|YY(oP|F|o[E\ Yhq!kvfX{ڔ' O]Ϙs?sحos?]hVQ]|Yׯg3 Pd׽3Ϡa1aIϙ|}7[b G[CϺuzM Z»@oiSF&R8Qԯ8=%'1 2@K]Kh")Ÿ?2:/G@[Wyr?!S"UܓIy4(MxOѠrlO9B[JG;I b8'U\ ſ?#?nTh|VoVZ jIU`€R רMs4}u7 7;~0qwwy̥㮕ccD9 E۰ʩ5UY͂ ~/~bka@D+s?\:ûFO4''py{;OWtKF 1a6d΃yA4x޸L$JHoBY7?"5~Dn arE02nBר]*Hc68MhJ^ҿ o ,S$WiRb&)s B7!31ʚ,'׈? d8, of|rEf-8P&a"EXOWJ] _7R([Lע\E7I?Ǘ O v*1 pWp(+}>OISݮxx+hكyq|ud\"-_j➬r U?"Bi[1 ގك3%~dES~OgRt^b%#֪?/+,zC1=ރ`.&";N6~ VDOc_;~DYЌkiswyw̨ڳފXY󙪻V(ר-06F~}A?M-xf/tUgpKљYɏ/eooX$&O|V+t6/jUWvȍd ̟3XIeFqE쮈.e%SEʆƾ )=O\A U)X `+Z{6xT]5&$8^_|oDPx,➷'Й#Q녮^հdy GGer.l~yެ<^Ԫ/('x'QN4YUֹC$_Q!cw@Nk%dR>W_%B>8g`O?SOa)u)D0R=cySi?FeL_>᱉;|S-C}\]CῠoͿJ6ZTSAG~4zRsyhEe%b2Ϗ?RRBN: *`?@;9,B(E+3[a6+_isTį&e5qe Qu=%7P!Wbn{:q%L#*wv1QtU^A&?PC8xxcL3b TmI,a'5]9_{=J/U{묔Q)*ۛ ipT_3TLuT<6GFeᲾ+?S>v1G8$UlY]v/Ug]F5JgjZI }ug1IG~w{7+'sԇ3<[ n;˺'5^*ڑc,lFL ; U+r{Q? ?;7p)~/"Tօ-[a{.Gih9ӧevOzX}᫟) ~܏+{p_ ߕ)M&h7!*;uXÓm``'{YY6迃"2{'^?yU7 ScQR;~G{OZT:WDÓeя\rEܲD@ r?g,'i8Ł2\?Su׷pe W C. X3MyzK[~ n9{CڀYKq&PTVmO R4w $TɟyujOQu&a:U/J})GD'J6Tyԅa8C?C%J>l^{d>8B59?pTL:(%6uO=9?lET=;Ym!;NnJV$jty mE K:XSIg3٦HEhhɊIw4 y Wk0N9:_NxѓWf&!CLB< Df\ۿ}\ʸVndp! J'RCUjGfZXN=o:&|?iWd ^?}u#_2ys͝!U^/^o3jӭ/?1qyZj xuXG-1[] KbՃKk< q5*ض"xΚ'۵[IM4># [ՕP[OȋnF\ѻtI!ݸXHL}+f>`xrCf]nCb4x(&u/Ug@؉LDCaqD-N-BξϽ{6\*aލc(9_ޒ 6 xm60~\ dt;_Տ]L ۷)?,F1ֲOá~t2SŮGww'l&5J!aY>~2=5Lխˈu)a=[ ѱ&|rm""Qu"FI*bD;'%kA8gPBlJ)WKުZ*&{k9L_J·>1MGL1svIQz=`RF-MhP䬡닸5 .W _e:ц }ny61,vbKˉ}5D{Q|QFc" UCMC4$#yB9ICp`EZڸ<7 LͯW2} }~*MĔ!!P|hMd_{g ~V ِF-V`)ǮNÝ?s?s$k'ua:qt ~1GPz©ƾ=_Ǖ׾/EsYxd䭽ǙPGzWʃ8\i`L}.G(0е&r/2,zBK|O~+ {>(-; ?TJ: k7#8"Ccȴf9[M{ؠqk+=:T*iqT5RcT]H:ZkMb5OĊ< `go]F(Ypxr}.Y>J?(V\1aGhC?E?LH =+5Lb2^,ˊpf^ԏQ S̆7瓟փTċcZʙ {CUЀBs#{Q4xTL%J5Gv^Z9RB M4Fs4qj80ː{ZB>^3dƬz6)j͋mk  "|wE,ȣݛiVCK|}R97Z m W+"VI$( ?W=<1R N]͢`8sa%"SDQPaHHa ;D> 5KP$ؐ$I13UؑohxZΗIw_+=Ϗyx+_zi2bŬy<ժ=s老~?WNi?F,{> F"),NƩ0HaXHlZ7kn½x_Lu$I@B) 2*y5lؽ\N)/%DVmki?\+Q56y4rpwģي=g. Y!œ&p\E)֍( +8 ڄ.VbΈ[.ZM7zQ¹ɚKnGak CLHGQj̝! kVsny괋|ԨZVC~J '4Sո·CZDw+H7y=HTx;wEQD}6=pnxDzZj{V>1UGA!ˊPy)6IRVv=:_)<ޤԘ.kҹG;J'G>hks v"|llqr?{Tdxt;qHKs+cݏQu^/SeTª[ćѯ^ƵBpbb5}=B{"~h_VM /Jvsf:߸*_~]nGsUuG|fUi~+z$ ;Up%ʸXeUT pKT{22 ={WڃV@iɼ$'z:Ox1.Z-u< ^ ֗O^ޡXŨWuͭ?4#5wծP0(A0()V إٵH`qpWV9b̗*lǦn6<3<|vH%(V=d,)'/d !W-Pv` Jl6*ļvg_]6g(Wc, {c#,.-]R?j,6{0 6 T%\Y8$zpc_8f씾°׾RSr_aY>!z Uw+cWۖ1{\?n35ю=Hț]=bLnd%/# *91tcȄ543Օ2'`i5UM211*$&*$ӳ2.S\R *8g'۵~Uv=ke7/O5bs2$0TՆ,:t*f(J+%QoN-u%L_١C31l/eO8VgHV2w`Dd[c׶־7 mvo ABSdL6\D-":F>z4u lOûABb:w%!Ò(?[Ey Oʦ;q+uul@vt,b*rNa6M +Xx MTZҦ=>ǭxxI\ ͢?۽\䄾6<nkd<֭bji ǏQ@kY6>PUuoRb[7QJChsc]*AP=aB[Ԫ9 }t.+^\F@C(<K]?e= cSL!$Xr}dH< vZG@Q錴]VPyJ1 X6U>?o%L7jRE1#[1{O隥mNzL V42Ev싎b*)b˾b$Tr% ",W8k2]nnJLţba{yXˡ&>-iQ?"h0 l#^Ŭ*$#xW+gNtWT `F4`ۥz<{9c>80$fFX<>Liz[uVUToB@ VAfo9|ъ;{cE_b{(Lf4'Ɉ@7ab bd z Ga):YNF+sd`&sdS<r*) i - !0!pr5݌Yύ l턔9y={]-QβLu}lڣiCZyXzwJρ%l:5t p}j Ȉ(mxWi8Kg60ʌxJV^=}U% {16tY.Ǐ<Sýngq5'N-~E^ɄuJ͸ BvΉ]tҏ FW+"&7(xuuY9MŤ0we + 3}3Npk USgdi5q$_Alk9m $ّ&IrO)yIQ!Q?aNoSZ *EYBYeZꖂWZ-{TT|hA}/WlE9ìm]9P"D nv0zl2zVtΫGWu&@ 1!wSu(9H`׈O{#wVa#킎n.ʓYJL tn$<$I3i5BLPKsL!:,lgC9I&T#^- ygmԭX;V[m$X6%WOOQQ}o64ݏ bI8MkEB%CvsHs6\>bc)@gqX`(LsYc({QcO䘞)+Ucp[xv)|8aqxW'8cVVkL\ItjbB*C "&DE?I1UcjyP(dgp.oxe˻Xւ窿dpg. Eҁ2 g <.LO Qp8;&(L5L%LAq:LL>3:/UƠs\59GRGQ [G'% ?yXBCޢW֦8V6*~g:*}&Qi[ц2LVFܥ$K|9ѽ:_ 6 WA :9*c|e\,"ڕW5h4SSˆSC |.PiLbtI=hV 0 0 X|}mPBFaZrLjJH@S*xO:(s;LAZoLp/d:tI/Nw~wDs n%R-.kV0_VYn "{eR*LQBmMZ"AWk$/F*JLcMJf&Aa̱4eVe~ CYHMHes=JK3uU+b-Dێ|pX.5?,:́f~׊IID 22^cuat<)0430%79,< 'L!74f-r(`qխ`ү8]ܖ0M1=߿l?b'B;fܕw+TGSji7L#4~ QbS|f<dpNmAKYb>[{@HRZšO+a)<>jRJsp!*6Sc., Iڃ\,:CI2*k=d:Fth]|P&`&0fGxtEJ7X6 qK=՞,{onv]XRLi9 ʫe㸰yW1̭`{4L.b|(& {I_XX1 , <|){2q5&wA}R +x;oE8^ikDPؓj\+4HP3Dy8E(WLA+G?:z4&2l47h YdWaAj U( VsacZ`TlJ#2o[U;!\3 e.F0~*8iK2VDj/S)j'mW+T]ڃm߬T ]꬝RCIA !aat ZB,B *H:?FG WH;>`GNm;QVA0KnUVyc5 KmY&.s\ q6xWW!DTaм .CCɉBG|q}4:S3w9R\Ac1wDSK;Uζ[37XIjO؛o2轝DIQ`;i7R\(r։%[UGEDD%Tyr8b}*m!GBsUЗg&J JɓEcNG:"Qbk-@`@ѭFș>k"{3p%Yq`$fGh.Ｊ"+Wd x*f6>TG@kF d0 KRZ> cҬ-f:zPō6wru՞7*HcYVl$$M@+> UK!\[EՐ$n?>\aKr瑥UBpx6` j|ZhT]BdQJ&$/#' -~֏θLPf(T mD/%i"8".PBT˭TR*oHcV9gKmYsW{#*2Mneoe#6w Q^8x}`WdXxcI IHؗZ,BY}Dw6i@$Bݲ4+S;&ⲖV@dw8x2N*8^oC@]m+F `DBvVkqreG8{.C & O*0ajRx |Gj\b<#|$,)&P &W pOⴛ̺$R$&onAoJ{OUH7!K?CPrH:Ց+-ܿm UF#nR7bY=)nD'UAFq$#HF&\'e^!FKnlb>y5˜%n]C}HAPTb 3*̵'>frhV]D닙ψr[aX*G.3eKt[AˬSck5qH%{g_kɲ4RNs"3+t#س(]b27y)XPQ>xkUz~MQ] eyM;N`>[_u۷KX@ljwu[-[6O1xpi6c$BPLCx+*nXOPjYuνs'+тfB1=\/WNEWN%+ f;D]g0KI*+rȫS$v% /HUQZ7S/ ?mxa۬փl<3\QMkʄ&WKg|W=~RUL4g)Ic(pwJ-S e^3'v{+`o uNPəUAWw1ULKʤcgkc ւ؏XH K83xtƋ+4:b8wXWuUHX vڶ["1^)yӬ9s.H9RYy{{l0Ky M auӷ ?"0%-a[y0 MS?yM?{N<-qEH!o(3qT4m"L@ >(UbkۏNOb•8=JNUuVi2jJ csEZ>wyW'*m,tQ1b ,Ӭ4 B4CpAx"eFemѿћ'`?Rs qG;gGx enj(f3GS@d>VSc팢'9aP4)BD}VGQ#`rJNꂙ+/?OLņ[}8TrBT UL M'Hm!Lv&v*jvH9,-՗C9ZWu8]YFrpCκ$qED[Ntz{mJq =UXVKBܩ+F–PŇnꨫt_B0]͈,WW1ܽk0^-04< _0,iX}c935]R2"+3D.cGdOT%ͼLP|V*`[vIch쉞*,_4> سȘ{T|N F$#@,=_Yh (TX@vy(w% 4/fݽg^&y? +"Ց4Pg h;zp Td VFCE{}nqe0ua-D>[">G=@KE:# ΄V+98@._l"R(o$^Aѽm+U'F+䐊}%#Cdg͌g]Gۛ{7D0@TXևi,d5Jlk˦$b=.\~()&h)<;s?WZb=)Q;H^:6膲$Ka(:"L྘{aPd|y CtЉ֒QS\ kHeKs)8lLr}=! D'{]D!.J.M95xLfD=}e"y} N:pgG$FGzDK"rnWpul}pvcfP=) ʲF*0VfQ@9*m&?3ÕRaQt_eȶ<~{z?J-\S tl,^̇T]#Gw4L\0-ѠR [Y~JE/{ɸ2شmWTXLhK"l̫Kox U@Ѩѕ(@Qv' M,:^/DF}H~lU$`&pA9P^%|ނi XWǀЙ >\F_SޣVuH? P,#(6nYj1j&9ĤSڻGW˽je!@rN$$t+.d}#8okR*J$VP!yks9}W FʁKlXk!֙Ҋ!>Qw/ HQފՠv 댸)qBFsuq$5 <-(>i2Fub-9ր,`).䢝gFGZ1CK0rH}hf7|F|<1!ubԒnk^2atMG?WwK[0EU+8o+e%>mVh/_:B_z*_YX/"M_oǴኡ%f1v[-6 ʸ5LTQ;Z ]Nh2/,.eH6iG ԔFauey}i0f/& ^lvŽgzB_".e *.7'rhC {4Gy6[3< ;gi'&›\mVh15X2ULIWp(GSL(cO93_-t; Mu PJs@SP’F&꘮9׭@щF9󾺽ͱ/Ix!Q&`fR hW$҅@M"<#?[|L 1 ݦP **1Xn(NH-6w7ChRCBJ3᭎>ߙ;Jm7`$# Պ762k lJđpGT{GlsRo6C1۴'x|6< 9x$W؈2\ҙ[l 篞 c2@; E҈5 atv;M׋\Ovp6R+}ͽp§x3it5ke1Ww'G ǽlpgUuV9&D3!`R}pyE)HrMf0>ONP_"95/l3;WLnyd(%O"GH"V`X$ahD 5QؒiЗYYyAWXhc]Z*k,+w0̜%J;Zd֘I;):Ѻ(eQAÏ3Ǔ+Rt|Te{)ղY@dwD( 찕 H,4{ɡadLH5}&U.JKYtz'T!pU=n%i7+hg2ёxV-,|7 W`L)hΆ.qt-fÆ7 buSjAZ|odC˓ck& Lr!JY&z@Xo9VrT]`\Mԛ [OA-GR+P ufRPY7{1 57.EmwEԡ`)d9+ud *g;[mh%Y4nCH"zCyAϩRԬ'O&v,= xR9REKsƒ!usS`Fr˼F{rHT B0 C6zN A bd͇#Ԭ)J{A%mU2gj?əI`j@#e^- v`*'X2<KV vau,tdJ3(rUVp%qi2useָ WC<2M꒏B"x/dBpf ,5Plt%+eaI#n[&Y#>wYjPO[U6⊧ؘq5ߟQ i m(qc]p/]+r5R3ts obZŁ 8_̷WQ B:0Ѕ%.)IX4i| ;qRӴ?`bֈ_[gH=sk&j)Ρ Oe MpцpV_(@O`)ވz|HhRW48Qmi8VBELJOӻi!̬ބ"ҕU6S,9ii2f,kkRQ lelajIh4 udv:9gY{GiQ &H/Blh Ϝ}* \z>ZUa2MD va|.xM_3n7t &gئ@2 K蒊ԝIփRiUtnj10aLV/룺CuƢpx;y20 RԂVvǍ}a9Z(s MH=bHF+V'TIϼ127dSpxq}1YբR/\|(dO5D?CV*;>BJC Yc{VQ>MZ1ehi%QEFpo{,4bv]l-1QR{Ɋ17S,'Hkf>.#7wi0I(;dfDeC&E.^w*"gB\PP :"ӕ'Lڥ65@e$q-e1<T0\H[1e`K!b݌b%.rb>6^ױJ- pYŒ_ڌM7FX"0U@Mӈ(~֬N렲}㹘[b=J&) (6+HR%D }.&`,)QΑ vNjU飆2.6Gb4I}"mC;cW?餱ܓ^mxa"H NX7^. ݐ]yf kٗJj8;0a,lh`pFB0.dUB+< 3E]lq^c&&Сa$ e"Y+_n9\NYSYRu Bl"X@IjA!UR%Eǻgj%2CA,>W>M,Zk.g#7R~Dcp/R,?LĊahll+ë+jaii.&h:k}Qm`]):o+!jtk\*,)ƚqHĬPX;M0 V\-kᙥaf'46b=:UmcE^5+p9".ëEY+ $i{Jx鈚X8B@# bC m+3 Unr腐UZܚHz=ΪCtԧЋYIi\+k›)\i r:.tûV ;H}&Fog o/WܴޟgdD7`BLuEbn4^>^4?`I;S<=>JUm"Ѝ=v ;s6~bhЮWj̗LA qSyuPWOK\SNMJcu9Ш*zsyl c TfY3Yp_pz։A5&AA -@7Z˷ jE+,:pKa[o~T?#?UbGaOJ\M%2OȹE1Qؠ+fSBOWuf^L4䆸`dܪA x.9"c]}E&a'\)Lz3ȍh,xR"ԯlDRNnCz s߉1f8 ]0+26hg&Ǹ(zewцƒ &f7dn){]f!<~bG<ÿ#r[ߨȕ0L|6o6H+f]z!BC Gof\.q! LQxSnFG,4ڐEHv=3H7zg[/hiN^9%ߕ' WrDj/O*GyK}_P*asQ0^t(!!V82h +te(}_ lPb_\C[dZ5qJf>XSzyL2:,.ckւh5HFF  9zdIfQUqi,1,I=9RiCԪHWг,]b:6$n6^@Lϴ2Ҡ/rlYE75uE)VzQus?p&ڎ"x/$!)]J=5 _|mnw^9 @nQQ^Ψ7$ F$݉+;RX+7셁>Ľp &B'Mdrv{N fs|ubK#}+ ԯ 27V$$K%\qo>A8]5 qCG6sOY :g\:ؼ:kX(6npb$7hmS6QCLI+bI҅v͋#a,,"YfZ ReAx2U$ȠST?4{QUNE!QK2J s s@$! qPXAqIi2^ 3]%4ƕhd='g04 N) ޜ B|~еcDTxxFX$t6Ugb]YbLbItF.mU]>u f2!:u#84^u"?' -|'3|y7fbHxKg 篈=3gQIs}QF:*ߢk}qԲ-ta5ojblad$Cb'nYq6@?ViP!lq'g\DL+xi#QN JɄTȆjHL$qlƬRL ]̢׼8:9ZpBFe^9C}d']aȣq, WIGU]KQ,]iğDqQ5JRρY݋=ˣD,[]$s"5L9kHaZ:|n {n{UwM 4;)z}\Aec VВw|E@Y6b9bcX ՎrĐބ8Gk&+ A8rùmF-]eʃ>#0A30I.[ 25X>9iyY׬]qK]͆8ڧW A䆛H)"MBmX&aV 3g)'+7sc=/VCLl40snAxlSK0Yd= h9汐,Eye$"袋qW\!ǂⓥDQ<&<'^` ґbרS)] S@KlpJv2Ĝ2Y>I[5+tv~ du;%2rMG5D0#QIY\+W`uMDWBQƇ5.6A{PA.b({RM3yI!z.`Q0Yo'/ƒB&Oʋ՝ȓDZaV̸rޢD%E|djk;O8⥬b0l D.P{a!NdIhs  pϥX&rzG3\VGI\<6u^qQCkw#cVsS^y r)ƉU]0/'IA5QS̓ WJAUsgR.z(^ڌCDm&D^M$-P: k '2\=įRE{a IkJP?;1/m0Nٲ$kV4ԝ3HZXz`tUؓ 1&Ru}I4 jͺ׿ \E]Ly`S,FIڣBe`aT8ύyY'j3I{*YJu5@)#b 7Y6&6<~E߹q)H3\G|46K?+ RuWe҉GH˞ yg@9PuN(@3dZ$gM#<4 ,]a@&f7b-zpb@8D'}ϱ_ pu(ene^]CQD x-,fTMXHz,r&L"D5F*ewX_O!qxfx?]$TAqlhҼP]^܋b/W$ U]2*e+iS%G5D%PEG;='rL<REjT\\kA9pp h*t`NGgL1vÿgLܝWR1a|h"؎LL{[n;j@Y,qmQ@1镎.zA4Sb/d~>( ;s.Q+ogꫡ/GRߑzJ?ڔ' lLt"lE6ZSաbl9+RDKxuYUDN^%ëZ~l:"?sMG[uĎ:÷3D^?c#18'ICў3;Wzu ryAY=Yՙwfh:;ƪT:[*~JQb^d /iu'ivX(5ܑ(fz29{wYxƵoI$GԲ`=]SFِƂ{2B Ƚ^$ @Oɑh ISzpYO' tAdssޑ)Ŋ2<rBA]]!\ J+:lTEOՉ}6Z >kdAa+gQ'&W*O~Zj^(;)f^Q/pZAp\TKp9t&d*Kv0Rt8|6Jfh!Je"WT 1IZĉnP-t\:/ T{eŖp}_2Nm !0ZT ]ft+v'_6Ǫ ) g0W|D?)`*k 03ެ nc?egC8|p i}D?L!eѴ(uJcJca)=UM9dŨT^K7KV Mq6 lF )kf|fU8#X=*fTU@шmbFnq>꼢3?35DWщrf8SɈoUC <ϋ<##tK!c W1AMfjgR3w1k!"l]ѝ1)q9_AF͡!.PG^dT@7PWǏhĠ1Tꨪ.(bhK_C6!8)Ek͔z#4hϸ}. *]ޫf4(/#zGOlnXjk0V Aqe"]#8b`L8ĘSl9O8>A%߬5!X+{jxkQP%"'o|7Dh#LBy b:hꁭ->Ţg;9 V#|IsWm T @h14vkX%ø845 ;L^v !*½>oF+ m6aea3ˏfZ z ZdLRIWxyR/Aѐ.AT ^0 2CoŽQ I" x@+{*zbI ,'~g=H "$Â/Fȴ%C"֕$cg@`jt ߯+BxLkaAN?M,r@GUn5 ̆HH%1Hu9+fj= [/Z -q7p岃VqSu^) 4y XQu 65ìzXUhnnHi+)TV:?K&]ڊ Fq HcR隻)h+<%MC+N "* 9R&2FW`ł=꿞a\CJӈԛ{U\[K$tdqq4uo!V/թj Y $SouOMy` @;Qa36adJ( 9σH1#IZzN@RjG4рrΙY'fu"RUSYUK%.BRv.t'yx`>76|1#WB$/͊sY8 '2HdQ {E@dKbLRI M[2GɹffU*VrX+rxMf<ӌJ$MiOqG0T s"،&bn[ۇJiө-6TCТ;iYͩ0TCѵW/ đ1p|UL/]&RN;LYqyMA,JAsC[E|kFwN?83j@C ZTNEqqx% IUǬr4- `1€„x9QA@=tRϒk>WzE`Q{$¿}+m=1_aD3 Yí yklSG ^Me.0G ls뒚=V.-A< OUˬz $MrhVNc{>GΨkKђjD3X1lkwc0ӫ]%7I|,t!t*츬QgchƱР2M{n5njB+C,AYJ}6{Q2ֲAꧩ1p-Jz|5\f# 18Tи"6X/ ee_#ɽ NTA0eU՞pEO,j]&;grjQ;tQ^%#K`AŢR<+Y>Ha`C]7I{l0)rVs;} V\ 1r*_ 3=9ʖfDY{1(b.~LE?%ݣU~tH(d|0 $,PE>"K/>> sm^q~xRz:<)b )9bl^W ش/kJ#g}1\*`I]?CH>7KL赚 M$ eҝxu!(&Lq>N{B "[2/ƥ]Dv, n =1h;N[NC5&L߫Ҍ2f׸+vrY6^!\)&V-Пz-̧9rEVs%,GFҸuc.x>3esfk3!yť ]ž@ M远vpY`4p P*s8';$s#g^] c^ywn*e ǛVz-NvOU3 ,h  @p7шx̘,DJ[ Ǥ0@^:tcoGBb&B]%(746C|GFtԡw!(Bl 0Ye6!M癡wyc:zdEtiu7qbǥ_do& $m``qX S5`t]]C/jK׼T׼Q`Fs! k]R9}ړLXڎܑE,˜- Rid4-HtZuOyQ+o.Ew(Yc'{F\',-vs: 0esEz%2՛Ym&뤆pޗ*M_y  LctxE%?P=hNM'OŨt 5ڰzp5|t3( Ψ[ywnroA G ,͚ST:+-=DT֑ԥK@#FĒV`d>#b{IA迋"oVE0MPy[C}o9{(bvcy}bhɀ@'0T%5`l0Í3P_G1F,6Yfqz%|;n &%D6Sto,=1(+ RϮNHʉ 3 ~V4 fKewEFcB)(wytez+"=tZ`׋B|ؖǼm[ BkoY"6'Zy{]GƲIadh4UOq/Z^s(OwLbF=R&qz:EWR +k¦}%BxuưSEUh,yҾ,%={O zUmw1+[<SH$M RPl&+g қw)[wOtȦ&Y}&鿒|D˜!x̖0nYO ?i<U0 C`s)tȱfcx~6+ce 2#c@~Y)(fX g:7`4TؓZK S2Բc¤m8NP׌OEѹyP';vpeR}77;,f1qΞnU6wSpAi%$Oے TNB8ƪWB (Yj` {mTu$Mm.~bAZ .0C=I&'OaHv%Ak& vB7p.+v_ŗ7Eʪ$2JJuD%Hs-!4s>YIjC%"qYi CWxHak qx[~iQXgbٰoz57# xcނ"H Ԍ 9B1r~ MBmV%Gyc`z+-x [ͷWkEc v(uA%L 9ꒉpZki{ dvOmY WTx<. i{6GRskX$E 3dr&8}ܢ q5{Ng,q&%F=j*Ւt2:T]ebެ DW?&:9l3I_CsZ򇊒ḏ^${Fɛ:OS~Vl?GꚽzUw|2x̨8f}VP>r?b:\eAZnP]M( }sgYj([f!ksltNz)UZ8m7,NAQm6$ۆ؜aHְz^~okhd͡p qT7zI^>C3FW7m]0̰; "BsER11c/ Ϛ,)eUЙ-!@s4r ޘӠc`Î3BJ7#)1Uń 1hθ&CIlρ)_Rh+;n^Wjo1]VD4uxS6|&'76o$&H)2GUd^$b%4ܯN,oll-WLxK(U&B+56n6 mmbI7< q= Hj2Clx!&翚0^{#򊢱MdGZ@3Ysr_4Yhb gZ9^| 0-Ϟ+ !S8PV啌r 3A+|b&ջo`¸ZtX+!ZWޝۄz3WBnJW.["}Zvya$!ad\]o d!u7lR*e&X/ݻIPiu!J* _S5\/EKmZf6_sbpc=Ɯp,FުgPl6ع3&4-.@\C9mz4zBL!~+ynArG+S ؔifcp }}vBw&135hDNSPM:CǕL"2`?eYI{_P.Vۤ6B5@͋ΈtIoR86ns>d)mn3o:wK3J7a/Qc֦A&d1?5V! Ɍ$ǧFI- oEgBmBa`mtx#)K= KPlHIC0^w߼'.鿝6<1#8+r:#q |CG|65Jx'ëreuymEDuwQ['1Yvŗ` eade_Z ©|Ѡ ec5faJ"҃}r3Maa%j۴ɄYӖ=M#fshMg# }A>+~X +߷Gk}8 u|Kwnv\d.$.7)SmFd(s`,#d(Jd:Z^4bd w&g.y*JƬpto@[J}Nl1ID$ʍw0*lܞa]ywYWug.'U#C f -]xgG13(ѽˍޢnڐ~R:d#P@pFʒBWRyuiʮDDKɉBѷj%l|u!f\GԢR9IES9Ohv~a/mhG Rc*`?s7QRn 7jSpjE-O8Snui{o2`z.n8\}Ljd\8gQ!rX ιЃ](T.%<aZ 7_0th}tp5c]dnó0\y OprȂbw++ pBcMo1ͼk)%dUfv~r" H4^k !ae2y!#vG گt!Bqxd^-i Sˉ'ȯhhg//jtJf n;$Cd%Ҽk:QЎĎA cq1G5:<@;`^ggfۉRxh:@ZBH~ 'a\{l xq ᧆAgyh^)p)Y SeULٻ!'tH6p[Wd9vYh5 ,vQsp-[;'h ?HʱS_f6d3:g$m,*-jT"J yNcP #hoĵMinzK 䂈?%lh6! ].w9jE"P;H^"ǽmb6{,"j_66Q>E,=zQQ+E3C7_E Nw;-%O`eed.ozg쵇, FIU{qhyUX-!ѯYN 願v_]nL,A!6`'r9 |%vLx;_/鄛$@#T&K4 m&aC>ܱ4LqE-fFu9x`fRc sKl-9;yq+ލmY}!MڞuE4ޙxAE;$p-:D"6bf(iQI"Sit޽{qV6>RÔ>#7I7Ƃ&aLS*˃JOW1c;}Uc~2BҴəîy~fpҏΉ~ yNZ`~R0@Cm]I+A 'EZ?i-0Lf/#W"[$u^ᐭǒugg~F"@՝NtXRL-̔ibc;f#X43+@_Q(Iy{6Yk+3l+!Ba5B2>".,^tƄڛc.,hbAu͒% iwSN`dJ4-,3v@Ai-wW7zZȼ^:a5JRr S= 0Lڧ)MUW!'px[W4/ k^lhrLעު4PdKĞI*'+̂O_bQ]T{s; R6iҋ#A1d<\n{3w0Ri{ eGZA)yultAf^Tz3gOtlAicdJ3z.fygZ';A/?ťghUYzDC0^6BK..E0qA%3Pd>(I!0%nQ6icqo LMG6%NOc ia3'iy3}+&Z2e%+mn /<'ou{@CoYXUxdsxd|cz)& LV'fν,-gՀ'7>e8}^'zq2*%/!~j5}32`gN?Qgܝp,q]5c'$!KPABR%GղS9 MeΚzΒϴ>ioEu=G9/ գ -"{ͪħ c:zϺ£F$]~,IG܈5bcөyZ`@F<(iv:u-VG~0 i3qYøcM-Urꌏ W&-eR9 .$'.Pz2gH6+%N j WyË1ZR+ELXKnzlYYʻsX_~ifJmQ0?.}Byy"q \ڮ \UBUQ-Ej\f3GanZ0g[d\Ih+"]e\1]WK֗tKUubJKOܦ=:jb*60.yՠz3͋@*<** 0zC<щEnl}DO"NCygAD1[ <^-hs*grΪNY0;E0-d]C}݌>3B9hM(#3^GyB$/!' WL/n[ͱ +dחku7P8)H3tL^T6Kq>igQ4"O h Ҵ{ \.K@́n@tBf^W`P˺f+#UsQh;'tr V<$Os/z0 55CpL*ysԆ1B!ʢU<$${9k)"!n5ns7#ftȺءpE.Tߋ7"櫼7cu7*Oyu4WWz 74`茮tic@,:WbfzW拯}`wV(2koiL)\a Afqٌ Ŵf>x9$Vd_6M 5sQ yH1paiE3&8aaC~*N_. {ܦ[s%R dᑑ=;꧎HMXvș)qA<$a2ȕRBE<~3ψ) x*Wቅ /”aF@T$Gd^pUBIf5G&Zz@}H| O.B* .5ldohՓPTEɷn}>O,U-ӸOf=' $3w:FIpyC(d^Iqŀq7E9g, ލ!,?oҤ@aRm\zˋ *tEiI67hp ,O (\HZjI9_A6-Ц.<2_5%u_4MFE5G[f-b _͝i3Xfh.n4dBDQp٠XOTfpR[g#ddw%~󡐀coygx3{o>$ z)M*,6AMyc VB"/|87SU)ľȎ%({pmG&buΖ>%ȢfD3"E[:[𯍉5$ <avP{̦60(wmee͝ 6cETO=11-gk=o!Tyxdeso1սHpj|s`FV3mLKdeP,\as2$B8DziI\t\s7b~`2!oƜ? 8?5-Z6ifԹMk; ya]M.r.g,nެfu 'qe IsP1q**cxĺ碗ΎW;:j?9a )*2/L46tn5(| 5=_6v=u\<7\ 69!`k O|4!ewg3^D:9LfMvSڨyeٲ;駸hŖ%rOXe'iFҝ8;L #SpD:= /m!g;AF:lN msw/Iѝg ?,FZ;ȸTr6I1HV[n-\K[Ftf'HwIFՃfl߫l4Ϋ*^(8ۦbrfIw`]ZT> ƙFn\z"@H"lPW&=_:FƋѹ"XQv^I0"xJ-PÁ 꿥? +)*'a:,XV%ox}xu+k+iETsC7u +zC7#Zl̆őmͫ^]7ng4˩%`I 7l ƋƵ ȗPƒVn6fΨ4fzU3dYN7!=:FdP^ŗIC" 0al4!)tOQ~ s$u 3:U;j JKtC\ #ь8~Is׀ŋhڙLǣ@0\b2pB9ɟ˫LyW|#U}*M@5ҕfatSh+e]ָވU zn8 J]dRFyERқuEOdji8.i %[(ȱ~2YPj:A i\{k=V@A,-UQ J>':T臫 f^*a4=}2/ abOdy, "%/}s$-LgPub_ 9=c:c( 2B07K{g&c+`y`]>#>'}?AL%͢9Jvcfu`P_Y\.|֗APdfWl4єHDhЦDl?ٸhf[1Щ7Z8ޕud(Tlݍ"^Lr{,*;O>@1ҩЕ)uR!*XveZVt")$;$~ؑު%Z,+^pwC.?%͸hof̧$lf p c..7fJ"/o\pYbFo P0%65n2@^m 4!N2"8x"9wh4:twqƂ6"{nߤFW)7=wݹM5s]yrI 4<(0P9'`ޣE$]BӢ&ޅ_qL5ٔSj1 zq\[H, tPQTú6RYX ϬB E5,#ZL"Zn=܀iW:G40M ?ͪȍ ƴҳ,c@/mplyo]L< C9Џ&):B)oaxL^=+,.\FU3TXUWM`%fzH &rO9ݺaCcQe߻fcyۼAy뢊 Fj]j"BᄟJ!6P(2p!7LfcV`'^n a@fg b1E7;VѲ&ĽOuoPl,!zXjlƾNAEyԎ5`$ISɃ[cL(]\'E2؊{T)u'ky0ƬAŐMG@M\G җib0X=`Na4z׬O"9:!v?Hw.z>QUȗR=owFGXˇHV.Vˀ)& . +sAe>s&٩TX4aR5}8Xo,2EJDC1s׳z'^XDlo& ~4dVqT?j{2ec%JX@pF+Ш7P'>e0n(0_{W2dzhΤݽ>}9FḸrIMQZ;%\`5UC$&!Fi9gcm<3=D'kڨѦ~#N%c%14G iyOMC~C˹%M#(~e8"S5gHa2X+\xȍK"M)'ur.4MA%p[,. *, {a ^K;j *qlz7ѿ˪hKI6w6toȍ'^)!ڠMmO^ !q\&+b$ԦHz3k68BCq<bʒ ۟n7XH &:{|;D@RWz@DVd= w#Rv u"{d2o㋝ C%Sp$ߕiFɒ,t˹!=AOE9Xxd] yH%{ù'l@W͕*HOPa譲/&~VRJ6U|-:WgӑR#O8<лDv' cs$pjۥ@4#7njNO]pB$MR3!M|'{FF3 h) ewA 0Me&=yrY$ѬlGC녒NW1-gy]&?f3O0L;`+PaϳWgK Q聻o^H3`2#,O#3C{ f 0Qo`xu!}f1"dh*$.6_حfOyj8ӌ+2Te:,[/ N["%0@:Ice҉r:Wc͕׆jg3( ^*kNDл!^ʲQQ|ы2$3ƥ{5i`hWXڨVyJnr֟8Jf" DF/$[COw7ҏ`Ѓ+lލɖQ3YS'62*kI&ބꄗܘQa5KUK%}O5$ឬI G"YWe\6"lPO5} 9Iptnqʧ\~ x3r0 aL" I,UQy/ˠRQif{*g`B6*!0cvݨՐ *+۶9hHzAf8Eߖu]ú.D힠+ \H ʛTf{es[5p>HI?cšF!K9C8=}}F~ 9QX9%@Q)L(4Ttu[8&n.4ԲY:@Ч_=IhD P#Ff!u8xCr[AW~\wֳMސ56w }.DPfG2:&%N6(+!Khō6U1A. ,T)Tup7]#Rƥ[5V#Q)8Xs/`cF -C7~0S#92(V ydΌ #4PQ.[+f Zs 8ɌUUԏ9v0/)UiԌ[35.VC0}4T`3 hۓHCS7 (s#prBdiMCĸ#@h5Cե7@q%(UQaF<ٞ,LC|@ Io XzyR8BG(EC7x.b/mfgPA;,sS9[~^so +PE4 ;s*P">/%3Yh$Q;MI=1NA?dFpHe "$Icpz^pBne^%f.㿀XuBWdh^"2F3t=I\|um$%53  6M"~~a>}+smvX!'ʔ ul!}'/Ћ1W{^ 8=(Ub(Yf\'GR{:kSС_^#C rO{]Jc~! J&"zh| 3Ew61ŜғpU16Uڛ"YY:XKCB`!1q1`00P6K_2sa] @ԤqQ[uU[G#dIgDX6?ՈV͠c?=WmԅanhOKFQgXȱe qA0Vܼ'VCc6,?:4^Ⱥ$6C&q 1pj7rP,܆gW?G 5_FrEtM\Sktm|~*s@]?Ùm}3 .Ko}MX!iza&6)#ϔ0Rj&)`MY9npL(ZO$׾Vφc[SƆ5̂ģCQ8{RJ;MG}OzP}fge"0f9PR]R|W=vVm<D*z?CqǟfI{esd϶:s.BL-6"3-7 '4 7m Lz$ ?ruH_ädTE&"Vb-˴dJ= `HRX9R {nnz>h!Nm92NsC )Py LF:E(wi̋`ԃbKY|nND3t/ĄtKMC-[,b99O56J]UΉN%Fe6.PM&$ElTsPY=|q",UWnJ%^7^GJFD668fa1gr/tO/B[0et8"+8#دaċOop\z =H@T KpA= " S这ڜzug2ndr7PFԃdiQSsnkDb^~ZHܝ!; ( ʦ`PR(ذ_~ItS$AGFR9Jbwe-bWh:\$ 3j2e_d %p+@HsH^vh-ft*OzH1U{2Ha,nv+{'ihD *B4sB4{W}Xcvqpԃns= Ĩ 8A(F$܍`IvƤh-!LMD[&Au>roՖ$ ֚8,QLp|Qb:''CY#?jOKYV\)r] l U! K Z,Mӎ=4)ֺoM&v (+F8OcH tivu$e͘m"Vq47.(J{WIc5W -Բ Dzґ tJq32,y,ѕ̮_-7ݹ.I{g45v9!&iVq6)A\fLr ) Pj!(T C'!dq]!{0&Acrsʀev`1f?ެ$N6mɍ9YU7NU߬+I[3gctH0ecG)U*H3S*Aӧshy9IGCv Sҩ#?fxf>L,A)lD^OK~lZ7F# 40 ТN<بCnjnMgC;5f~`c#0FRCՃ܏N,~@u uRO]M|2$d. 0#CG$~1℮VsC ì'dA4! yQ}І}G%6Xq<'j,Wҧ701k߽5I74 tϰ  y)0H /OKz({ެU$Xf <2  (b_[(ճn|OEJCtR:agnP`^X%L(oKMܠؾf6kc `qS=ZAfex~S Tenxm0?ʺ~6b}M3 fv_D b"$C%.r+^Q-?R0+jFBetq#-Am铠ig޽#+ ې* j DG>0PHu,Ǵ -@∧@[bh=l5G 7jRYRh}7NCq`8a-&50_ejHJVGo(=:09 (+NZ3夁 TmKjW[lrikNPfVf^1d=/F-#tZS5vd=_jcY&3*jP|hAWRhKOHQX?mDƃLJx|nP'+O)^)gC"a1x׆^Waf7bjhVc<=Uo9wBt+EWWgh28]nC&,ګ%-i>]?1庠JY>#=KYnְ%epWf6c«ʛW cR8}R*Q!b Q^ŷ8A{H#Z$FBdL$ WjmCnPdr^ҡ ᯭ~{=jkC{_L2N=5y0 J5#><OY?}iGBX"&ǰg:hJ6 A]VBy ߉CfO'83&=dA7cRZ@b%NEl9Zw~u5`im=7~ВT-Q{V.%m(UiE^W' 2q@qRixpezq3bqKk/9MglrgTWцg* KhY уeumCoDXdq*y!Rr~.>V\ ͵ɱ; lI;G1kKfGߝ`Y\7L\:#협G9/Smn&6fh, H~AZBvaxuuO^eu!E<[H3\k` cg`($|]k gN0(,>Ic :.0 祌 pQ@s*!UAΦ'.mܦ~s5L74GoƎ@(x},fG*R㨍:B EQ3|<7P4C%I]?Ml{-aϻ*G2o W)'Ǎ#C%3N{b 7&JEO .P#Hk*lsab{=m*yB#]68p𓃂eA4pd3EMGt\f̪rtR3h=LI3qaU-Q$S&7ʘOr*: SW3b3@OFs ћXH|hpBV/>W,$0yQwI*2d3l%+pJpa~BN4/\Cpn &Sq і BI"Of2bBT&uב2 ]_ta 3[7E4 q Td.DGNx`(1PsPF0Oھpt07"[{-]n_J> ;$(}=t=9B)tp-;4mH3«ibARv"fjst{^WfQY!Ynkdڵ˴2GKW1V9!* ڭSyg]w8WݽwnMy!06gTW\^ k!0+10Dn14kYmj6| 'VRA\_s2;UDXeMh XX@rx.7 ~H{" |fDz&y,J';RZ;Y YgCf@FylꭍVNIt!(3u  oh $+sS8]Y%в20TZCh ;1fhwZ'ӳct!fwnSM--T+QQ!Ew/}09{}Ϟ9pa*Δ {"U*2S╈Ć\T]ftDNf( QFCY㲝#LU{#( *T+xB2=7"QRxu#]-()<|ۡ@؊~t>٢pX^磴/(Ȅae<D 4Z=cΚ8r 6؆Q` > ^Psdz/%^vpn;^BM {$]6GT,ΛNL dt-\ L$=ѧ%63eOJ@1dWһ$1^.Q"if3oMP'E|Xm]m1T7%f5\F0 bAW]}l5R c$uVxx33610Vj;|4#Ȭ َ%`4b$2F§{{aCXT=k?<#T+eӱ˴ 0t*oƭKκdXfpQƚ)Qjj~^3,O;Px8Kܡ(fDZ+\H軉aƕB3mD~Ck%œ'Y59?K}fv} Euy&nY9{*<l+ 1 O2`61|[5U~iӋ, ={RΕdezXq]2% [ML.(-f h ^"-ѳYЯ+XTɖV pH9 '^ 'IKC#"&u-LDi bqM @R:A<`H֘ *4ցC0R}"Lsq9GT|Gni-[~;2 Ls$e:fKRuuNJqBz9Y\ix0( IU{7L9{DEBJ7ѓn9s1uspF9z(~n-| zZeG49"u4STиګt~Rbаu~eG`@?Ẅ'h@͈d@KxΏ. ER+jɈ/9ϋ$$晚Eƪ:t2 qAf ,<)HnYAO }aūL_5Nnpx*F ww^G2_ W[Pe!fkt_7dhٰ'Ptu֌'e9CW +㭭[~dL3#gnZDa=0d<OW1Yjy/tlG>dL0ifj& oƯg@fXOeWcQz,!JCJK)#W5Wp/FqVlD 2D6ALd)fcv$ <,.l[M0)qF:@9ϸ>z[vo4N 5 b7/qD930ZVWBm$5hZw\ٙ^.qB6t!L`73g:CͬL˜<vzN`ceo[L;-`KXk NsK6ERZX# >c D&orI_kS2$ 8(hXL*u0)6qn"ApWb7iajOd/FF)!}h!ܵ>A9 ~Ni vg0.gsX$~6MiuF3j%5* XoyEM{|[V&o~:O~ի3܈Q=-ISVS攷f=/xCmy#K.T]KADr=j21ĭ^AZ2L$g(:YGC8lYKO Pc czˠ4- 1R{_`#nRǘtXKo,NX݁wHU٠rCŞ0߂f6QpA^o /!k`^_VݝRoLꚗ)Έ-#Wd+h[ăs1㬦I!DT ktn-CRv.$[0 q  s>=\qEIDAT-Id "3ke<|cQlsl?nb cF Iy NK{?/{3, Q 6!"UhDE_ XOo.0A}g Jmb!4n[I $~?`o%jCeȴO0'd:u锥Ys+&b5̬7MA0$K*d@|JpdA (1~ HDfم/4,4wj2(fy-'.5MnzRђ5֢X:-I1e,I Si >)'(C:!eOiUBr1Q(^o-U2ˋe-? XCLH 6y,pa*RX2]g\ ƣHdBu&n";7!Hvq ?&Ro{Sb3eaBv-EB lamEcJdC]W\n_扪 ɠ%@|9Q3=|1/č~ՇE@_By@EA;, ̈ZPw^E,,̠7NA*)>қK3Rap/*0jIRۙcٝ˺9K@rɓů%[RI 01aՆ؏YX6qPHӯ1_iR^RuJ}Y_+7x| q4^$Cfss3/ |}B;O@lC`@fQ6ȂMg ;w0$G l~"^Sׇ$fUtKEFCψJj`=3a&(3# )vԶ`K:2c߼#\E=qd}7\Z[4)<*0)AJJѳɲofT|n\;4]#/#fȉauDݬ2mv6C ۪e19:=RZC*mTs0PlhvTEVO-<.}<㿦n(Y͈WW86k-j=c {kӤnW#Uv~1e-tɸGϋK#eeA6UTl%Gn@qruΐRT8 MvY' ~#,%s``K=6Tqpmgbu4\Nbn{vdhZkQT_0UK++cÍ;"aeZĸp}Bl'/σH2q4#0K˼Hkql3E$~~JB5?'R`#Yl,` y܊eR*r' wYghzKh' L[FF^ 6敻"J|4$DRWy(8oc,]CH`c!CG芩C6*gH骟Z/M8u đ}E||V U5zQD J?܀T c;$}N~-\$n)yfU!R/F9w`0W8sz0Fˊ% "b\EȵYtb|kgxئS 跮B)f{abnOEX,`Z9<%Xdf8/0ݰi23լ-mo";aB"2qYWD\B8Lk<ygH_>L5;% w x'utF >YmA^ZR{|ŠFgVȓJ9D%hBsHU[kJ ǐeˉ"I"L !}*M&U=_ϞR[|':"FGxx,H!ɡY뚩m0#s*5n ɞN \XC&v ?:YJ˕81}vPWz12ax@dx%]6Y_yZ*6ANZ6ԃuWR!<1RO)z͸G6FD HdZyȩ[^ [#^]P;׸*'JP(;^Jۓ'*Pa9 y Ai5ir%Dȗ-2 rvwiO?}ѾY3#}&F@VP~`0S!b">t/KiYĥU,kPsBٰ,/ O/z^_r wf9fq؃^Lhl\TK{P"敖bt8ˬQd2?KkfM6glt Ƅ6zkҰsӻzKx6􆪪 ~4l.ٛO2`c6ӹ:B>D-.5Fn@0 p^n;Vd\!BvAi6 ̢z!y\.dm!;gyª {!0 1k_xibq5ѰChnoJY?¡yZcTM审4K5}Br%-p{u[MGxI bMP ]R*NDM3ҋ |hIEkM- F-Gr+]Sb$  QrsuFi5CZ?Ek]]kLOrEi5 uiЪGL?;D۽c*KC)r[~;@[[[?":}jYr`xrP3U/+CCUd$E)o^&WP6f3 c a'$yJO3%@kԶUFnʋmD 0>0E=č;Dy,gQEGӚi.fyOͨ[M˝}C`&߯-SpB Ge~ **r zb0"$ jwb]Bv\sno)2ɦ6Zƍoi,wln5kB{V A91v8SEl@fӎ~݈1:pH:&P? m2dfk7NX߳j} N'5mW%x #.T|+sUU7Ndl"׾5lOV ;aDŒ0N PCw؆LiCb'JVeH];es<68f^EKmܵHH-@縈tʸ"U" /^YYC<Q\L&KıUk*::riW#r;1 </Nwٴ#d3 >=0vO\rՓ~ZѽƊ5Pf>4ԦɨqD1z/2 LgkfܘH-W1(V p(S[m|9қcb0>ECq친C9sW| 3t2?9f^[iy@ 2׉uh4 rtlP8C*o8M2|fbN3ALʮIiE7FQF*Q"`ߖ4b)a:\A?H O a4_)ӧY@UMջăcX ,=DRJOf89?A!0Npg.U.>&4~oS H7Guī^b[FpCNKVdaYE$T!=+9-;sL} 5qihbhⓩBCwnU @o ]"ڏ!e OliGY;8\B;zB%@<̕$?_?ޅdnwQd1i%ӽ;2^+d L/(+!"RAlqH _ӵ?w L qt’gga<3"ыdz/H RKԼ^D&~-?77%Xgr3fac!E82_: kd{Pc4(!n(2`1f " =ms?c$6M/f8 Mv"IjP @v[GxRaD[|*ؠ.=;@FLiGP N 29a6(E]deY#(#J3j QOW_304Fc[JȾے@\zpt JBK#$%9T{vd3ytR5&gں(Zf+g\&f#Νwwڐ!x` ?xävO 4<;'L-ߐș8/͘nbSŃ~M3C߷+ 7P'fuаwuo'\&/t$akv1AHvqiL{R團j8 "ӇsP2TO=u=l=A,\wuV^Ź#Ug.wM<#u~"!M9o:Su=1MAcYVMar4˻t- ̋ f$dsL2Pa5xXi5-;WR%X@,_^_f׋gp\>Z(*[ A5+kgjV* 'RJDUx')F0*&R) L:^6W[ h7;dA\-z˸zwSjԕ=KkRu D*iSW@nŻ:bC(X)NN+[!D"-勼y m"E-Mf&0ŬT:Fd}4 όm u Bѕ)g%$4+Q D_Bmm8D1ҹ'ߐAbD_a&zh07b`cFI3O$~ԭ' ɭY0 qkmvdFDT^2S31TfoO{[Wat<+딫trci#`e3D%iBm<@1gNQ'ps{JODϔ۶HL 5M"04^l=J3kEV2RuCOZD2>"fA:7f܄\' Sk k*tn ø'[|\1/Z&ЩLRߓ9z<@wGs#t  ' cF?_s aXbgizM'8(cBNdsX%Bl^ Q~R8AXk`֒V? h,xYǴc.蝇Eu~B' {h7ؑH7amdEk71&X#,̑zΣMvn'Y&=+_.. sgpXĺwD#v3Al0:V)@NU^2q۬dHZl9|N T(ZdjPHbHdleQh;U @BiR7tihZQ-F'zff"hPJR)Z? a^R8Q9/SUYԞP"ki+s75f4@=!{wX6GkC1d &[ aC704Ǔ4T39,Ē;?H[ " **u]PhI'<vU vJVBplmZJ]# ac]]BHY\{bX'yh~Cg`! hl4Dtf^Ĺ*$\$Pt1 )hqZ  2$iȆ;)3:!3=x wAA ʰmKZ.&+Y3_֔!4"nćۦD;.ʴdȌb-U !օ0P jw,ʦx RCY@5 WM/Y@x14`U}LjvFunkx2@.=+$R<<03 uaJ`ކr2뜆m0 m!OiYH8͓~Y1wxDJCxyt=ȏyf))Ľ J&[β7o\v ;oMpAh3 vLJm\}G+j Y1ai缍AF;:1+ 7}#C"ԉ>Jb%]R#awsnJoCm#V ވuCt$Eϵ9fo 7+6#-W!FWЂC?AZ*6﯈9ļԀ:&)7Y@uZOf4fe"qRz G brRIH6@I#\”F?w1 iܻmҚAUAMaTY1.b 9jQx G='<3QpdnIs;-K,7+'90oCac`p=6Pt$[MlL;m4>e.*wMJEGhY\m$Spz&qcքF/`O(9uB$Ha y- DeMkl/fW{A-y1VoA+.q7T'y\[ɜ'ö@bWږBkӸH"fM&;RH*=VD?t| E\KQM =7FQuYB:XyDltŢ4{Q"P,U^GOGVd1HdX(CFV_yBY V˃[㺒9]V6M{;op ŮL 0kUʵқ CzHtKcH`ċE,ܚVIgwNչwB~m $D%w'YFG<sI:QpĬȊsxz%H`T$&XYkE"?i찦V7&Kf@x9wZ8E;ln02)9XH E$̓hP,3Bb0][G7R,AƅCU^4BNiʣ&9uJ,TmX=w% ҡ}9`P@Nv? 6Wh5L,rg@n3z6SNʐP/:}l37ט]dpGq6-_Tuh0Å_iFsܑ3,wq!^XqRR?WYz%Ա:JA*-w޹\̎ϧR AJEfh6b+#eeVUĩMՏT AОXY!Ρ/?:x(g̲Fij$ je(PhNaH7{@ +& Cm)pأ*0C:t3nJ7#EHÕ| wá>EeV(]d΋ȣ$'5ͪ|5f2QUGj>PP>N5Rx@sd"|]I-!!tBE>~1҉{Ω85G&ѥ0يO+sx͡tKpEI:ɔVr LJVey /ꡕ6)*9~Ko~E{lX8^WOMa6evz3`.S E<>3kH4 ³tړK{*Ds.Ԇ3P>_ M"BRKv|0SI EAG(6jjJ+h]l. :{0y-He,:J[ )toa) _`}40<,!j$}<Еߝ 2@`qm`(^S9~~NUI4vw qrEz,XNyBfpo?$.ʼJψ$<ψ2pmʩȉ>5^DbV?л(Qnt Rնd*0t+K?"<1alEA;)ᡱP,`q$9űU3fk T DͺUq8-$CrGma`B3<'*qH[~.P^ϨX[8XҫH!33#L:xixu,vѼ8_=14`7w 1qRcRr~ 0b#U$t(' ";!S$cFc^/ BT)@MAFdyň~2(&goF2mj3y0 Kɖa_LHǎ^4cT܄lGs'<26z6jC䢊r*6.`f=V >H8Ӻ*οE_5LkggU 0 vx`߻)^08U=ou9Vs lFm!K霶cQm{]v's0؀ ܣkY4D^iC9sFüR͎!& (FQp[3nEk?.EͨyNzQҧ.=ϫ .q\U E( _yXo ȷ~j)sZ\ M4N RE'n"6>wO9By!d)>0B#tF1QTc&ٳY5\U9jYpOA7`SٻJ)T6Ax;yci&+9&T:0|,LsR޽jc OhälfyѥZ:mZ(]vIҽyCnNPr}kX81eoS^F'n/ڳL6 N?D6`"kbd̿Xyѿezz Ahv4r#_"|w d!V͔A۷<)lEuJCDTխK&W qR@ROpޒIM{t<103aH>ݣs Vb+w.~iAX+ w 'ۺ 'v2XY!%TS f-RUDe2#? :|tx%M뿋UZ*XlڟxG ܘںvVnIkb!S0,d?!"[aSp !|^ݢM'U1aiWX qo^ݲ4aͫKm!,FD6EgzF< Qo|g:岋ʇmVwZfX;~.Nt'NHX^zU·4 9Ýy] 2YpGB/=5xSv`.4VmDdO<*CmC_PU~íV b k7?tѲ-r2Lk.Z-×ۡM.fX4-H;yF)EOJDҼ?؊3%F춣2P`"9C蜄b$6I̒v x넶3/@Eߛ;m5v atX ,xzp'#4@q5_C ; č~rG\TGO>;bL +xe]@ĈZ||2uѮ}ۮJiOEa2`XLa.i~MeÊ\4fs ^@V&z9`mV)k߹@aa!ZU? `WUHuNhe;6w,tڋ:¤X2zZZY_>Gc-tjܻ 3oiNuna;WI6ѭQ6Rk2tP\'b(!37/!o:Y:C;EV*a5ϷC"UD-Q !fϨyZW`Cy֙; @" ,!gYW{הju4L>ɀeF͓dm:ՒIt9$ɻ69$;) !R +#.9 C6$ GM6uUiongZK4lV,g]; 31/ef:E&ը)PT#Ѱ3MƦB {~:)'ۖC`r!~)Hȹyv앶Lik*1S#)i̵Xk_:G0X]!ЉRlRj*GT^P63)d ފḫٗd9'BKK\@'sh4r 9OxqabVPRH)6Z06ðAm^ѷ^'KEzں^-]Zj%\JTܣ%歨H賞 5styff>6BJ9 +U0fs %K^@:ߡ k5F{։bw Y947 E8 v Bڤ$zkơIZk<2PV_B)L>=2HV17g5jT/ˠB,X:]HG'ق^<;6B(\pW338>^X^L;:?)EVg6i0A.DyEO%7pP8 /0G8TXdh5S8vw"wx܉Nit;@0?fhO'NGpu\AQ!O1](4K\"-"O^ [sۄX4"HieH)ݐYEք*Hbj:jɋ~'ԋM. o4ff"&JaT̆yZ [Y0a[˅ Wڲ9[{7:Dj܁WZd)^ejnӚ))?]g h KOIÖ,S*΅T8OI! ^WLLł3AzF]+8s1 %iBbH_$E,"] k(=3F 'i\a0j7#%t>v:]qVD dJb1B%: jqO"W-Ivdu!<[СWC!NU#ĻI0ϣޡWi 4 P s*f57 GzfBUċA@0M+QSlNU' 1vpؘ!*<9 C™Mѓ2|K'|5G!A%9#17DzlJ1vn4)2k(̊4aZ$L!ZdKdyW-QBGRVlYY9vmp*M']y.1mF^1.ZllVy Zf- AVe5qo@r-]R}^HM*C+3BV 4` йc ,ԁ{w{~ "{<(zQa+;@O97 9G^Ko$(}h0nM"qKg:UvtLW0f.J Rbd迂9Yn0F>L虈3$k?mx:t9z0_,6D @Yl(*p ~֠m'1rɎ2yKD}gOg Ȁ|wLuZhL%7˘C4%4sif&m![]¼Ri{([>d!AAN Vkywi_9gVX(Bh׻J_x;5((цʌtaE>K"X R3@Io)a)H㖳woв~G9Tgā1c&$dgTGƌ(IyºJ.rd  ~z <YG$⨹Mm^p 2oU!'s WIXV}sejdG_"$/{4H."v3pxtk,Ejq #caW!6}鷅ҶE^/x3z4`2s_lIz.j`,cvR[Vu ʴ RH mQ N ,?8yVi1Y‹0+(J褹)Wm^TqD)Nv~N $fجB(GSQ ɮ[ K\R*$hsL+@0tH#YE8nRTH4G#A*5&RU=`˃ߪ`HE3/B}*MkWQ 43ٕpajĢ{n=DBlx O]p^,88xyݚW@BR^@>enYFznJ' ԹA+*x6Zt^jyg ma%iͼ6`|ı$Ϊ Þs~=Q[e eY|x3oUK FB;$iGAZ/Č0Jva ז֒[ưcYf9t&MdB0 ((ΫtbgݤE^důp"7loqGBtcyS jy*dMsxWD/kDVVގHU% Vm1ԚQN}ί:[^|*`h7/ZMR<{ݼ`n6t"K9]]^ ~Ƌ;z.\G8qɒp\0@JyjAtC?REY4,0Jқy%]{!twCIyh[?/kNC(F^DE0+4CCIʓO调ku氿QBVHgꪄ^B$I̴YFv@+OXfѨ"jN'Ȩ%y؁Cc!H-I=C3_tfcK=,_z؜oHE]3ͺk<ږf;gRbVAu >-w.~Jx-rf&,HnWA ь%_xjԲ+/"&I@(fttV7 a Ff_yuaaEs էpJ"E_EM\TmQ,Y)hɔ'`Nn# x&8{2B2+ba>sN=^BE3:CN!ǯzCnpz#3d4D˓s&.*-$_naWavMFSlvA;nՏBZ6 [Ëk,$Q fH lD7sC#fzW/z^a0/]hGsbhx%e7AO--bz+V࿂9Lڤ yZU ${񁠅bĜ%ƇfMoq5SIgV2Z(gAC+ˎ4|IYAf2d pg} 3BB*xw۳hPA-(XOڞ$/fssG>ޞUÆp`@bPW탟°}C+$LV|?2I<2bW4Y_<- Vzt@*ңb#M(-rD3N6~29i vyirOX*=j t؈7]B0spN9 -2DNDܣ]⛢8(q3I?w:U406O/pf@N-Qv^o5@^g*E$:u_1SX%9JԌ>Q}{ )L/:A,k|RuLR1.De.Hsdegf2+(cdD1 < oH(kdI!KB~g)Td%P2LU<S4ӛp2$?Oމ>ivnj ԩ N؋1^WvM5`t'YW19:L۹CLTZUL:0} m@^EnVR01\5!em=bEHIO-FAM%*",ĖW+:q!r[&V 9q}s [_2+ӹKͽl+`NCatJET3`.n-Bo0w_?KaL Xb)t9=֨z$he loyҖsDIK*K5kXS`( OA;ܳ`Fv4dٙ'FDgkhXdɠEDH*XC ¹k^w"<9B6fRkߗWCx4t$% {֬qn}MV{[D'FBЋ&poQ4(ɽXl \C3g)rkA1-NX˾\_a+ 5FE qyB*Jb}nπdLtP4]c.zK?I%_$o1ht _wm9gPsDpj2&|XqY%Ch쒷v.LW+J**cjAT9"N yQ>OzŪl~?kfu<\m@$!KnXLUcٲ]qH~d}2VXSA숿%:AyIYLK7Nyn3yx"i;d=de(ÊtI1G~/2=؉afD:ynkD虆jCc h^LdaUS4d^1łsoF*a8ә &"1 wV= )h$L'7ѝpEA4( a%Oz VF 0ng8}du'D;_虼"xY6*N jR DUŀT1]{k|M.+S•#Te+ّKuRNSR"f2ةHAʼ"_2$%Ug78V0 ݃s Ɗ*>fyC&^V(Q8Rc (CA P9  N+X4t ,]!MV_,Tl׹%C^4.$pYWiq`E| =E*`ȗ-pRWuS9700iH|9QP#&~y.*qKHcۿ]8k(-U]ԋlQM Ro3n_TunDf|Q%C|OD 6Db!lڅ݌6JsI4t=+ei".PJ홝_I^׭'dXQ]q"X8wCP>f!D+QZIUjӹ wY[ DqLW@h\Š ]*A!vtA>}vgz F`9Vu&Y' \fP.h`Ȭ~|kz2I eA4ud,lC@Xb-#d7݈ `@ pE3CX"FrÞj=XZ45-ge ޡfJS>'FJ_OB+ڥq {7z .,-tZ2kXDm0|į wG˩|YɶGdh#L87GڤE < d@G :t_Џiݫ'UPD$ib yj*t>nw-U,z^"`In9t& ɀsgX3_5v]7N1_=*SI_ ;떷RCgN! ;$pҝ&,uF4!CE (NQh8Ynb,mH*EubB^G-#սVlH8Bƀw~#M$r.ٜݕ*0llDv,d%'r7RGMKJ#wr3'%o'8S0@Z\݃ E fCJ3bE i y},/ VO釪9ețry#'!8@-+ wK$$H4lh2-00Yp) 2_ bW#odb2 ~0}/a+:w_`As",UU/A qIɟٟ ́2.KXf믥:)#ZĴ!L6n#[BG"6-jUVidG -X/I;f9XAS^;FtGE03ÔW \%>MF]Y{.ck:@SEL- ӊD9(d%( ř߆iuee%b=I\N/ysܕ ]TxcPHl Dy]-5:ÛFcM} 3H餢U˟YM.^]l)2nT@&r_/ܺIi%xdJG2rbO0=MZeCR360BAZ^<ƯGbvac^ߴKU`Wd/)5qUy$X7L=-qY!ou9%43Lch9wJ+A8>br ;ID2rtqNFf7zB,+됞,7*^6P"nɸհcWADhMA^ Ώp~u;҂fT{Yf)cQ!ff*H07tF;;[+_-co!Q7]Q ?GhoAr S-y"cjøTiiZ<i0?N x܍qJV?+rCkP&>AsqE:'56z<cohgr_.XŒ2pY--I"I`*֪dz%"xoGWg"e='0`7BY1<{G !ւ 0۹a/c1(kI-ߜWsPYCEr#t(Em3%_l1 )LqGUĪL@1Hyyk RG6)e#&9)똧3S؝EhNY;0sfHQ{na;%^Divx 3 KCƨ4 !{+PTm'߬ @ζ%.Ar% OTⓖW NĦO{K ȱa˷X ) ƙb3;ݩOȚl]=‰6WePH7ɣ}Pz$f{XRN-|ٝ\Nm"~BuXVZq|]esOܝE^{KWOG> k.A0̓s0lgaPFSզol%/ɕ"2;ݎ6!hbHA!EWz$ 1X ;h:dfVi gWBա x2o&9πloDia%@tVu;8d/u"Mdg_%N/SZ4NRعtCWڣ%,vBghhፒOԼIY `4+Q7yя_R9;@pJKz442=L`eǝb3 or''E\Zb]U7G]N) C!}zddqUtn?8QCK/D<~ k.Fs:&%mok_kmLK(>/4_#-jLSNh.|ϖ%K/(<9TptG><8[ 9ș8trJ69xZ˛zJR']("C*WWn *;ǕۚO&Y$_@ vU +Ą,]UW%PoTL(b @8rWV=61wL:5 }Uսc7%*o@/ղC{_;Ĵ%aH>,FaûM(^~o-c0FV~"#|"zi.Q{X:'a\ ėQTpf;x}!3Y ͜ -,N=(0MwLoF}E V 3[T^&ߝFHCӋL>>aZAK)2z;FytD'3XQ#D?u>!ArJm\AeilGر,Xgꝁ6&bjL3! =JP2X^ͥ+X\,26(qli>[lK.7bPZ bXGmJFW,t iLWQrN !o!tΡ J-z4K:ջm9%Z/$ (6t0Rݴ'bc?b2@œ*aso ni&KϱXGGlBR+g"*Qk۞_F,/e,{%HT,NI99WoT:@ME~b\"Odշ3~Ee.f L,Yf^!Nq(çtG9M!=g xb푞Yw{uC%FwȞAcٷІK\.IsQuchW9>k 9/L>' gp;MAZtW~ffxpg ׌e\-SrCbGy}(j&KG`NQ)[ gT(wGO^$Gyef$7 k8Deh1N^XhE4C>GD"0IoL*T^>HyZ>Dl)a>X=Q֤soI~; E = )_T bq3dKmMیڢ ej2aL<oXS[r݄NV{P B AXKŀeRBwzփ&d,?w4Llqows6ע8D~(y0s~įqG5HbFA!=,߽_]EХ]p'v'XS(9fjw&@*f]PBͅ~:<.{J_-tiz\ n &BB+|q`TFړpTjii mոz:ѣ>DHfL_"c$ G6)Ko?{]ï`~>{K*P,L̙`hqa>s\Ȭ G։VB%tyi6ydy U2BĒױSG:ȵE7V`_y!^,ktUcd- /,|)G%%WL;Z+ ѿh VG; sL6 v"#sR :"JG Ȼo7sag0vCr(C'f&C EJl.̠N~āYFDD#Xb3e!=9÷R !KZоVx~EQ[nAq4%'i͊yRF' Ɂ\PH6Bo~ 4 bd1(ê= f8P.,Zy_9-zmWmIhϠHPN_Ôw3xHՌOغ]ح eҖώ\ŌJ qFl! \jI{ߣ`Mm&qۢ) f1GK5+ GC\eiR5ħ+yA;3բ}2E udRﭡKs$7YО' 5Kr"|V'M$[\J0Cm~@e!>bb dKi%0VojdKV,$z=ofD2@ύ}UXGNHI[ϋm>zn%%0а~f]`pZ'#3Rzv7Gא+-m>3Tjsᵎ!H.ciFv+7b"JRC6KuSPկ< ϙc^ew %WD 7ڋϹ~pİRX!/'mFA$Ug;>1Sz1ˡ7J zcj݋%Qu5UA6Ę,qv C di;s6UInR fAE1olx!Jrl)Jnf9Tޢw&W@sr'bA MK0iIsG^Blń; Ăzpe#Bvե3i0Os0# (C+>K+?m-!%kl`9* UׂyC?ݎcA i ak"'hcB~۷}ĴME1d/:50r.5nYA U{Tm2xz< zpuOf(]{w@B|ޱ2hQ\ކ%H7;3ٱ^w$z!&L^UȏgB)#"Z8C}d"56ElZWx"9? ,m`lNi[X<1YLh6kf>Q! pԛ;73JQo ,ӹ G40]\H| e27e^e1He;OyBly;mwxKͨQv4gG$,{>,&y e ]6SZD t;z,syX8gk Y,%[b`ƭ9/* >ъ2\4 K4 B~j2N'yec,WX//EG5ٚkK/v4'jLX҄ڨ.i1UvV̈a2@i33 wϨ:l@( sϲwκ By+rSulNcEܫS g?jxf;xY4'{!cUځH\^K?̦ GAR˄IyCVSuBT6=~4(3KO}Y@C~QScʠ?Ga_x=ъ-am 8"6zG. 8ʜϥf;Cc"N."s@2x`d=#U2C((Hm "TLQFoaW7 =H|dwӦ=s=Ke2[>9FwM-gN[6mU. bqw]g)!UJ V :UC'nRŊ Y-ݼψ'Ƿ/0SAW_h$25鞕!eш S%+MlMdK4[?U >,t$#2Isojda=ˁ.p@b^ELW鶼Av NɯN~ ZBJt[v;ˑdNS>P':^WGrlH*9L?$~""0A7&7i[ߛ!S*<]uK˷3ǝ6uf)rGaCU8w&@cE#Wθ;mvi󌪳hIq9(Iknk +2D*%qH7f߫|z&ٔUudԸ1(eڈM-F;*ŭ0Y ƻXE gev}F?'G&ΎBo .l\if)ʎjU]V[6Zڎq5Pvֈ#j3(jRE%'L\a<{+.yl%'Ʒn̑%mZ?y35>Ȏ&36 h<NSL䡍>^Z18eX*fW,/Ux%/D0 J_ |euU0 x6bW#=IȂ;jkU"L*65LPfCn#X(ѯ+ \l} *2.,1}CHet߲o9)<\lz>UQ]4/U)ڄ̢3 GpfwвX, Gܢ%Jz;a4]@bv#NTGOUtH/WU$+-*S"uYh,]O^Oo9%äκ_'cṒ\8ٌ2MNXT?ǡ" \P`w{o5:Q`p 9w@oϚʄժHEW=L!8bUnψ#kB:Il8-^:yb>*K^s a$^ȷxzޢ-,ѡb#:uױ y$RHW=GHTjiTAhӠCUmz$:A#|?H,|)6ƴr9gC@ez*`CiLkf.?EX EcͽVl5#OR6õ~YXHUHqŠ3jriݡw3s|wfپ*mm8sT$(ŝ%ɆY0$5v("c{ޢ-, As a&:67`0gBeK{t,ߙW=SU'c[#3?yFN%V)Z-3N;*@m`Ve ;2vFczu%L7bJ6!pxψ+5&9$ nh !Bpd3՝seWGn ,~r|UtI.)TGQ˶R<,z:s P|+m&ŚM i >A$V3I^5ї>p !}߫^tq1^';LT#x%wrRG{0xy&䓋3i( ,,,0o2ʣ*w,O^YhE@O(p$ZvYsϻJ) |,,[z޺<'/ʫK`ku(|Z{gcu(NN$,`v;_u/^(G! O Yp-!_ ²(N;9D9kژ zwd|w٫%,0v2CEYl$~?2Jk9+iXTHږ8;ǎtp^]LfKQqH:C݋$3 ywvuU/7$lx;xfADOl*w*4:[&#^D}QBgI&_<< *m37nuB1/7jѭN*04;@s_wsGc][X; ,S9>)ŋwGX3^0eG0*w::<*ؙ*O-~ǕeJK+䎰Ãm0U,em_U$)%` H u;=TG=:~ ~?0ѝwJ;rDG,>\n㊣j'{Qf;\#T׀X0b_ZU7B3/K DEhQFzF TJթvXDRf NXKdm[_{T`sܪ Ƥ(Lagwg/p r2F f(VSQYţ:45eNLqiR̫| >:|CE#.ꖻfja1 Jomw2RX$a$TR%;lG^>;Rk~:G0Ϳ* aoܘJ,j*ksg9 ):Un`_wW;h#zvd8G rq%?d\fj9 񛪺=AѸjTU3ѦB'C8F>2^%f̥[*j;hav=[DBNԗBU8w24_)=_mGeҼjRns~vX鳥0 -j1>ވ0<9X0'yz'(3 dj9w&$;ܱ3R=Գ{k(ЅoռcbJΩ8Јfg_kv<xqZOZ!mueC0e 램&(D̤/M?IU]z-0j Ezy7`AWu c;t"b)Io8i{i2p{eّE 󮅑9{ Cd' <)] O,\2O Rr O\N, v=cAC*JadD'qH4^uOY#.|iӵ(§gL;XK:&"QGCUXRv9X;rgFPAkoNi!R| TFE1wz2Jr",lfMG*]ms4wx#84ycQ:ϖ)\.Bx(W9 ~y ŦG1X*U5t/26铪h_aU+'d)k⣃U5Nv0^ϰ?G"3ꦘjCB;cJΉ8[週O^bbsSHɩ;_M13 cD= yxo#oUp\T‰)̥9E@ ŞJeӇmp [2Ud͟k=ܐ)#UQ?ZLwkB1[f!P"QԸMoȫctx7C'D%+'(E $xy<(lU,1[)l N&>rs\U5sdouuWQoCu`ᡤq(%ik, 0 PxtA‰?cpN;465wϘ8Wya=m'&`牭_2^ߙ:i?{*tR{,8se-sՍX"[VqhdN)N|%C R$QyuRcTNj,+͞37K8HL*(U XAW̏z6-ggi^Y|iq Q[-=wZk“ĘKcf>lP6h>Yέ8Ńnk<.#I/:?Ꞧ롫S@ 2WW(_\]a1Ȯ;l6 n\A!9B+kOd:>Û 1'^10޾} w$P=oCqmbeS(.,u1'>P=P6cX@6 gPu &X8Jv0!o:/5<굘alܢ%9.jQJ`NJܕ\Fֱ ,Pe^R&A?H% OA+E5Y{6*,薺Y,}GIE-Uq"Ǜ >|*'nLRlj Ґ0qZDɼO}{ks^HUe4>ͅ/t%P2ҕ.MU ;ˑx-z2RGpp! ؠ~ĎCSsniD:f_*st?ZrULJN▌vRJ, ^2OzLn_>-yQyzf9vR*.W൙`1=6aCr*nX9LH=hiK _?yCXkY/N6,&K_f1UydG0!HBe{pnNU㝁NT]ACƝa0I>qXr"Ѩ}; `L,.v!ǒޒžxC[(0U]b&-Z0iZ<-T]Pvڟ壛Ţiޑ;mھw?HU<#;fg8QJt$Xl.N 9~!ܘB1 l\3ML X} ;Kf/#q>U"X}e6:nJ VZxZm^K̅jSui2bg)wZ֖2K\ aY/DE R%cN٘Id|HFRE^z*d&SݱoRɲFH@,~EbaoI /A rTaBm\K[0+RV)\Ở 2.s 6L5ԡ< =SgP3GP'MN)&Q s(z}Wd2S|PjfZE2\]}[>f쏾#:Hmd.\|V1 1uw P^Wq l;kO j`0nF˜SIg*VIOUdU5ۂ ;zFN~oWq{$m $30M:ա9iI'ܟ}^[(y-ߴT]| Le.ȏHe!B;Z}=?kG\35U(]-SctSkaW늼NUo41?;kwu]^UKyW< T}}6MrF`ܡ3\G|dZ?m8(üp'WygTg.{º [ċ7,2yD-7ZD긯ZM륪ȗG4V.0;jG^> Z^_ !A~K?o^r]ES$ϑYսH~C".bkR)rQ #5 Zɟs@G|Zqurq ;fzU ycd\1u/3<Ϩy=klsUev>Y u~%JvXMj~lU^mD'RR[Dscg%T@9;^kUoT`^E%(՟"^->YH|h-o$fh 붿 ]z3gM_??hi;qKƇC(*zxGs|-3#_ \yϴ߁g'[&sN0av1Եs h>y-bw>*gilB%S "w[>cdA5Uwx.>ZUGVF)SI8ːc6 r^egx<#R/ʫk#Nrf6:(;)є3,>[|V8mYB6 aOBo4$|nHfMboׇc7d |0͎U_URdGON_2y:j])hxv\c'˜ O\"=;?? 6}9JaԎn8#s>\U"!,I;‰:>ގTNnSpˑfS:*OzfM>=y䝠8C}3hzwgaJuLn'{=KWy-TB jHm$}3BUh`瀸R *^k ]5^ eܝ j+(%)G9_T@3׷ʹ#:˺:z7h\d wz3LMyfKxY}{Ys99WWi3H;Sۡiy9W O[>,&Tú4ީfPu),.ruJYp "T;8krH's6aE03mp:;i 5g lƕ#ssi:G;mN*V$]tdΨG*deo3zJ&UR]a-qbsbSu-n"ع3Y +| `-xK/w?OVWc\0R'; [J1\[/3~.MZ;bၖZeeפs%Ra B󱨄 6+3oJ6RwF#<f7yuU7>|gzDfF8CcJ߂wh->)37pa9H [}:nTȫ0Y"g81JQBV a!v76=?UwU|\ 6_φJzP‰SasƇS'N_f[%v[jR5@:|HnɁMes\RT ̥%o1ǫ#6;m-zUrh}(8QY}Ru'^]nTd9نJlS˂c:L/.;Zmvձ3B}~v`،6 ϭU;/B>E›p"C+#P~1O\qb _ǶU)W=eW&S) 3'MJ< 6S\fkoAG2GGJ ~GtgueYžV:7* stt\uR6ڴ[(t!~\Z@Ƈ8A)-%!W⤟zT~@0=OQ~4 -HoLZ t-FcwQ#j_KQqt_k;0꼮|`Lh;k_I|B&e]xӁn#+Q}u)YU'^F Q`I<塡@bҎ QSаf̈E1jr0}%p=x>e|Ϸ^,>ʃ~$.[B ]KwNAX+Yv(iw_!}JB 'Ҡӡj:lYq t=t~R̉mJ\J1 %gMFL?%ܯIOn)cgD'UwwUKP1s܆4en7P)b}JCF/=٣J H:p%^{0ؑ4,"I,^g}Ri\7G!M'~bM}-ܑ; ` uhs$P-6@IZ RcS6./ji5V'p6"wZ(o\;ܴwmvDإZ,rZ;}v$Udge\pS .,e, ^B=Rp̙S{}ScOܲ8 >uOJgn ޒaQz^|qikrfqv}jPj( ,A9#P xTva9MQ IçhIJ~F|Udݫ,dͦ*8* :ofUWAK\ h8yÏ8-X?.\5~!_dE %W%exlJy#hp$>Pg/̐\ *MјH-=Y;gsjmI=F;x{-;_Gʁ!lw,:u% X*u; qc^j[Ʌ[ Tׯ"}(nT#VeSu狸~"o ۤ2~)rfXW^ oNjU$nKRxf;2hG |3uYʧɊܴyOչaʻvUƿ&߮MV⾊5k[.֫Ԍ])LJ J<`ײ籮w->3#sUyS9y)ԓʣU4m -‹3;c >6{v' |' |3`ة1F}䃀 0 q׎eOX1| )/9k OD4o'=YmQ~)Wډlo1)]%z-*Ʌ^ ;}f6$UU N#_9T]]NRnzYm-|S7@{1}Ko>T:a`JJu`C+|}vҡm\TGrmnAaB׸TFWݬ?u~"pD#;#>lA?,ʝ;ۢ=]G~>2 ^W(TݾB0.N|/*m>\]w_OvR@'vbe?~5>b1 :o1?6?'ӗͱk;O(e@@)̅Tj'@O ~O"8HR'+xI9|W4>}u$X~sGcEsg^sygᯎ{_1vba: ϧ>a`nNf d ''w??.?p%ͷLoO;zyG H6yu~=qlQJ`v檪4yUp?ǀx=X/~fD?_ܟѧ)5<0AwxK qBׂRYRri];3HQf1չ͜ m?oWYoH@ܢnس;~|H?v}{pO;y~poocʌϹa>v{|n<|g}{{ _Y|gxM~ S'< ʼ؋}ghYU|NuҦƽ;"FZ]Z{_GKkp5 tcmi}-+i_3,ؚ0ۘ%*9 5`Y:E=vvi6q5`]@8??dng{gKV?G|Ga||$tUT,&.C}<eŒc'?ɏzԣW%U71:J-W0DW^uOiF?P+Y7. 5`qZ)~-[x;+ѻ_|^v>"^^;;?\ @^>a#nOOW>B^~?oFoNN??J}G6~SXyC]}}OmmȏZ*qVro{^90>?{{pM71I_rq{|}v7͞zSc˿KNͽͶbE@*$֯گ.1O4B^ؔw?s? ꫾*>?c?Vyi$f }/ggǕ>;㛾XKd˿˳5+k__+CL~؇}Nw&2L07bu2/2<ÃMȇ|xb'Hlx~sO9 _u^~^^Alk.뿞e,H"Poگ?}LtkD.s\kf|͹nhMLP1|mYwkܶZ KC;Kp[xQ~(!ֱ%?}Wy^0M`Q'qZVhmRn{۾1c?c1KnApt:a^^y+{v $eoXHlل+y{QJz: IG34EiS1c'O+Ϩٟٻ//ӓa#` 77%bkYymۼ }}g|'|'l#.b*9<18ie-6;x\=YEp! ]+C/k6|^va>aB}n: //)֠77g˽6˾,+zJ~o{ʯʂ_avnMkkdy"x,R~ז0 *̬̬~?SP)rɫ~{?ÑH ʀ39^({%Iyy@9 [X;G"/+9ZC55VZ, ߛe Ϋ_=a~%$UQү؞ؤ yՈK$]n`'D*RNJ\?$2H`7NNl9b+y"F[*@9s3:Qf7fcjl1YGsibMJIMeS|tCGs%l27e+:-(퓦$+Rt&-P3o=WEXYLa[KF^uHM{~-[~ؽmWww8Y$ C_m'cfG F9Mɯnp1PK`‘[Lkc3<),KYckY ~ܨ^x3QoWm00WO5к8m7284+;0D♘$Vhl/=&ȿ7$lAw8t(E-uOON!}#>W(Xw`l739nkfc}m^t9PL#~A~'NG)]gY|7kh~uA ^גx ֖m;Kh߱ͱIԜse^2> E^EsoEw|} 6j7X'}'aиc=18l<ޞ5vVtՙ3{7j,:xY*??xe,K@HBldu#8F .•_K<;*v4"Yus7/rRtX'j9$sHAYWn  w4uW~W XNtZ}(-wz'lVQ|Rx VMvEA!PL l)FO'.1ua4c,Ѵ`tp}AuJ119Ҧ&5?wbC1[6XZlJ =7˪nIH׿ 9ĨL ( )̈́e:s)tRpSDqP-< O!hG; 27]:wټ[J%(YRU8( p^'&N6f 1Dx YH%bNFyȏq:A N6>Վ.3:J"~ȶW0u\ε&վKmWә_cU 634pLhP&-uװzS{,i.2a% O)Gi\#NpIG78S]O*8?3G"+{:Z:tסX e&,?lKu<_]4V8 9:̾H2Pҧ=)5+6EƗE)@&cЯI[آ!_ "UJ*Uk}lnyBKxq]sy=lxf.p~dm<\3_k`H=:ß&r:u#N߱@2,$nL2c!\ <&Ekd_-iCt~En"E%к3{u/7E+@"X:*\2LrsHҵ0O7GAd4.r>Rm욹ko=7f[8˱k\lófKx^W#׭e֢w^սaA{o 92fkݞPN ơݭ/[pS υѳ\$4km -(µ ݼSc_A•.,Iض mdΎ6纞ÒcKrm8$9KlD&P^_Xe{&BSpnm{R\ lT\qe%Ɂń &rxVր!a!%ARA6*ΔW|IpݹXS`͚ɱsmvsjͭЕkd ܖ7uD)z%ٶmkjhAvXR^a0r. KgjBȩa0;bpۊCQƥ,kr`EѶ~] %G2y?9qr\:7#a*.N(fsLR%,HKۙYC|&~YɾBec'NR1 пs SvYΉ:~nEwf;OTf lMl[~&guJn[yId4LIYa ByiNa2˜_BjTDFa17)-5AF14patc~(1ťM DյbouεL:ɸs^9KrS]duJq>S-FV}eJϻ馛$֮'>m- #zf<,:s@݇2YGuN!Bk[!S[%`Cy_jxF'm m֍ 0SSK@um*8Z8pŴ*HVXޣ"\"%slSDA26,@Kl%źm`҈`f+]\3Ƌ`6^!bk!qw7CFmNVξzO'{Υ֒\8{`XV~jLA B9% 3j"(Qrl/,{V *B)mtOuF-i@[[9evکq/!zAN9QҮ6DZiiK6+o!^3=#&X_NdKfw4ri N˦=쎁CA4'RנfX6XkR֔6hl[wXwq'?)]8u_u_M&䭊AaXNt}KRJSN dABs P_᪤Qv\/mUh' lkavlg~gtW3G ;QS}c?>Ld`3vCf1b{7ۜζp-,]f v5öe/l~]ޅALJA%>e $9͑X.ҵZTaIR|:G(Au~ DoZY!\2*qL^D#s"#B R8l$:x19#m>~ڸj,1p}ra`[=#>:ZD8Wi18Κp8Pهp2ZlOp\o qM2<ҋv(zM%Z<NxF$ G}Qz_ $Qהܗ [+@Ɣ0QN2T`@1>Bўuت.!)"^9". BOTtit&YdBπ0ZУ%IL}p9{1p%z/]btJ'@'ÁIDrrG4 oNݲI~5,:\ 6 zskRYKww lk_m&|Ds{8sC;X<;"cX>BP?w&جkBc֘=q-#3Kb. 6@M Vͪ!.HTgn;fqZܷ6{<2ײ)#w_m.qRk:x9]o_vr\Kd02t/Dx[Lqb'nLK3}k?-/W҅v\㚱kSF Mww~w>dOBN=~ӿK8%)bƒ-%#yh|yC< Cy::/]Re\4]s8h*⑖*V';mn#SƧ#idJb{ţqI7x{A.2¨{i7bRh9|f'ƸyE9cŔ!b08iyC>٩:IџD|쒇Kt(^$.H,o'Kr gdcTb*}싀,wvƴ. bUrj-? Ը8&dr\i:(xk<.v:/ו=9L1W㈓'Nuɖe6=1aKel}7} B2bz!^ v#Uѡci*έ5[DzP0HQ(6?)Gfh|%nomۙ?D'$e|x6*ޡЖM䄇iT켎;`%'=IL%V2`tX-C*yQ|zVB KşPm|hKXmʜgvya>:JDZ0Y;Z#z/hQVW t}p^kDoJ5&Nq%zlJ^3%{ݬamDɳa$RfhڎJiz* (FK@e-a;/ \y S=q6rf!JPS%ixS9rYc *!,NZ xhϫMP,w0Z2e-,FZ\\Vl*C&wgUl *K i3|*k#+vów¾j4lٟY2|Ž}- سVb^h<]nw>(0֥RK$fsUg.of* x{ޓ̉їavLrPr!u1\y^ORߘ8r sqz>-'HlIGBv̧\>; cS 'i`=(yѻKhzdv֎qeHv{h:ZzT&J-/;=yмd֌en~͸~b[ 5C' >2b垰}!O[>{{}gp͜nx^qӚb=HOXavptlϙ߯J!Nq%kDĪG-, @)0N4kɶe6W[Ϧv, Q4%Dg$mRX=${PH[syH&c?cZ)RkF wk)`Z҃i5e9tĦvUFmnEZjk@,Ŭ(J )|]Jv-!1jZ\O5gM|~Fܶ3Z]']EKm/l4b`]'(ŧ.'횹|ghgalz5m3[+т*qf+⶝I +KT6&HcG9DzعHi9s v!`F;Ȟiǡ#0bt$e?Aњ}iJ:_C빓lB+*ov+MU^Hz*i3+RI$PQҡABd؅ȥQF`pTn 6*^i\ XM#,.H uGS!odaI;gm7]3k@Wt~,s',9PTt("u+Dli7SxSTݠ`T~{Spȟ<ye~ӑS㒮LdKo|%B Z컊CPb=LN  .ZT 5:yy"q:; uqXCP~pSDxSђCe˓V꒚|c2&w#B#_xN#H&D2I\3ٸ& ڂe[6Tte)N7}.*k\bGH-b)P\ћN("lFbwʱj: W+J)WvBGteZp;%Zp(a5ow1ma>?nA!Ptl:j1OВw+{FJ4zՁVhnBRtH?PK6[Hn\O3akhYeEg`d-.fG_v&߄1_7+9y0K*<<;cr7~V<Nzf.o!Z 'a!I2҅UI%CP:S.JL0_ar6пd7D21oCsG6pys D֪GoVHJk\z lfj8ZINoֈ=3^>2<'5k^^}P7QZe*~?euEQr$a,Ӝ6|Zn,v[kLcV&g'?;<&#GbS#{+WZoh~f%1Ѹy*Ԍ%BZ*>g:YI;1GE e,2>(M-EKgMB[P׫fN~#rsѼ<,1Qc נv c[]e{"sT;(q`jY`^WClk†:mN]-xۈTĢ Vf59^RԂU,䅷Uw`֚vaD_)7pU/E N05]3M5]UU9XxMhkU`=X0wk‘|tmk.SC8o'id7P!Ç 4ɎnsaXÛ}"Xal<+^,UP>\~[G fZMDGbux&ʐ5&"2M&qiĽ\kQY43AkPWk_946Zq?)KKVY*'T4"2ڠ }j4L<'SlRsf;Qaj63 K~oA~=niikxq 5˪n\]FDz\]<%P?2ڬ+)#wTifIXBq|JJtVT$ak'k:fN f,u 9n DhRf|7zU`9OxF$&$!=X۠ mw40Br2#K'BW[ͪaMq!R ^O9k$V7SXHȚE:R^)ܣ% 9mlMPIQqhT)i_ c#b]IJ\*fFˁ%-h##aO.x)åk%z5kƞ<>JB6eWY9=`$[p/[`Ɲ]MMfVJWN_(,*AFN(zby\%kxw@fz&5,<J!3'[b| r$Op ?q̚^'a,RYY9L4u攅4ׇ6 WA}Qɢ%\I/+?I2$(A\Ġ٤5+>ư#(AVge:쓎r(pnhh"lAhj09 o2fSMCc($<=! 7n+<0B8)GnD PșX F{v*%0 {JVTTByGj4TF620Aa:[ܴiu-آY坢< Ւ0Ws+hRzJ. fޭ~7OV(K+ǽ]9g f_A>-ob k| K/\_0\&E5xf<,qT/;RM_`6瘇h@`RlRNrl~3>JNȰӀbZiHXCp4y,I8Q ڛ祩A' Xy ?Bkv{ץlIg҉TXŕVZ)zfZϢN f|xh L _c79Nsck$LǼϢWǝHDJ$IlPԲ亷)&pez1pT<sؠ8D :/-'%fɎ"eIZ#~V%)Vk/SE37E>RyB6LUd(%XΓ[t .k]pn~YTA$TrGta pG(y"􋐪&GKKe8/B]CbY_g gڕ'!_.ibqH0\v\}C )xņ,~jL՚ e9 i&EڕtI8-Љ}\h倍٭]isf2ygEыG[ <x-h❄";VaX` ,ݖ,NJZx bH**AD/k,wVO.86<225 -Hl/'%2=?\" C"Uo[C'6jlPSxFo Js!ME$ 7HژC]0V kDCZzi?\Y+sd,2.vCZ<^r9YjPqQLn!m7Z׾h첷\{,޲%;APYOŐNXi2zXed2qRւ  zNj:[g+MA|$߲(U9;k3x9غP` 3eiuK-/xT r,(F-llYz"hD=7r-R]4ĦNqƲ7,¥9sM‘9#`ѻl;#d0Iu$t/+C,Lb耷{! :Wzvyo7#i iFd!q.4v^]vYZ0fGE9Vqؤ/QW!.ms+5BPپD5&k/@y۩$x0z_+qF26J|*YHaF+x覼87sZ "R,2f k65k 2oDe`0bb#3XlEQ9Yf'x(,OҲYz^2E2KgKT9#s(R8l(cx%[ =/baE᥁{/KuJE'.бKo [D$Ks F8`,a} "N>>5Q!VDlgi]{~]sKsJ> j׬C Gy7bTxQ=+c5Ȥ}>d:fa2Dm6 I॔nN'k+x, *gم"IY6-["Ӽ@NKI.=]R%f1G?BtvH6x%B]uZ1,]5b:T늢z DVZƕ!dwECl93.!A@Q`: B8cWp 9<㰀 ZIŢ`rtWuРtHE49͍^AF_\4ЃaM+ϫPILq'Lbv'#Bfa {~MJ߲*K[cE ^hs_X^۫'ITrs\h0KMTns,+dIO/ө'mhk1CG5U.]Ċ1/ @6h$|N*Ov]yGi͑In+5Ty:[N5[ |P>[g5s _F6J!!-3, К Đ`v,i,>]X߾6!Wf\KRg[<쫝y3c k36JO6Ql(k9Dk'cpZx85fxT yi KJSfkxͦ0imqM%} =V(Sv;8%ˀΕAK*fr"?ݝL48 [o)4^7ٷAeY)8tyddUEy%-a =!&tA֊Y C>q)sS1dsUpNIJa-ĮHq=F*vǀ¾KЋjhxM J@[Cs,|S=J؉rD M!?X0c`a@Yϥ.j)HvMӄ,3vKid*QIյ`$&]}=`DBJv$@*= ')lu`zXneP3Be15Zҭ7}L=iY݈!F%1 $z:&| lnZ"5eEj1y;YXZGŴ2O q /2eݖHXQQP.oֶhjFE4JA-z Nte(+|U@!YZe#kX8AXm22`H~<n!_1> !Tޫk], 1+Xr6E d#RpQ Э,%-@z+WzRB Dy EPj,6e+"_#r45>TV$O,I NOrq>sF,Zȅ,sHY ֬} zESe l ,[uvŴˢYok ^S"0@|2[R5l, q >y(. R$|WԲHV$gQg{Zt-yYh1kXT/86C6p ̋BF-L@KT0gnWEɥ <+5}0q`8wG|DP wqvX(/g /&O麯!:Ds *6TAV9BܹiEe؉nSRumg)FdR^`VUI3IV/Xhș-0;|;j"sY1*Ե@LC#qmwZV2/@7sT&ʮxX]s ].14Ozu /2Zњh%Q8U^& pCq87X@k)r߶͹f-ȑ (DB79o\:8m&\2@ZOb(H`LHNdTr0϶b,N8v s5m΍FxG@,NB 5d6ge򙨅*f: Z'fi J-Y˺E11)JmG%yINk!VISwG~Ie1{TeC(s}^>L<ٖT$ ɿҰ M#F_[#9J+IuoLlOf[T~-Y*/|.zlZ_u[-yS,(>4_@`Zе.VM䖅0ki3LhzZ1hgf] ~Iy2iF91| {N H >p/\q(ĥ刃t' =iYu=,)e!JpΒ c p*]VI^Puja/̍H"5:d _&NݳLU *Q<EKEa8#3 my /ȫe ÖM.SCmJSgX`߿)xr[1,W,qb*tE9ef ۲5br͒ۗq wl 2`fސ1ve"8TCr!_ڥ "iIZT臲^LNyd*rv2٘7@?u0:+CQ>H g,HMYw&a7XGZP{%h, 0*Vֶ,F9dQ HAGq IKFx5F0#/A}a俱% -ii]#gH_V+zfX*bSr]x Yb9!36semֆX(5eyV a_:Oe MK *-lQ\KlTba,!LК5qI&|K4熛f<"׆Ϣdq|2 (f8MV2@ꈙ)69_c_#5kleXrHZR e^}$f/l1c!B<7 YT!L1yC]P dҫHJNX߂5X)И_lʪzQɈ$T%bvܯ xH4[hƌS H~ n,+n[ F ˄)"1$}#"%4ΈFFJ. J1*q=D%`)n$d3sSg o!8!UD.!axDLLܷ0CV>U&"a6#ٯ=[qGܪWtWAGh0̾ȵfŐ*'@i|C,]6F-Zp鐄fDE,TZo˧NV-w8cJPR&r5{[Mr8!Gy7 xjcV!mI'̵ <{ahZ-H5+ @ȲsU1IY7B}е-*$"iSp S+\h\@&p'cʠA⤠<F '#3.L\ 2V˚QaLPϥ 37"Vw!C GL^zi}* 2;5LcSEbv-t|F@+g94eH&k>!I#PvCdNbpT?4d.,Ic0eS9 .D/MpJ 2P)B N4rrh/*YH8KV@pv,ay 6' CW-8 ZV!"`2:, p!6]Cr(<[}K[rlSF(M/UU="lOqf|9H\dtZE}I_Fm.`sFlR?xV D9hL &kMtCy?[LE f6|O 7%qƐBEfLâvtF$E.k ?1K ƾ(zcLsuh6bq`2+D y"ER6QYiJKFSԊHjHmOIup(aXxѿȝcEn5|< dt00d&2ep" _pBX9%Cn/ͮZ4t=Ck4.x0?c$KS^QuWdַ@]y򬍹YFѩ0/kU)'{Rpþ:Hn'| mmv9`@vh[ҨEU_(V:gzXaѿ{-1mxXW@z.A2b5$(۪p9DiH 7\4)@-a^e˚uǚ, 활B4 -Q p "њ+@P.RR9KzU k5?_NXhYFRuBu[iZ E*4M(\X mKp;:2>b8:VQR%5+*ԜL<.Jx)o ]kh\dXLG0P͖dE4+u cTQ|jaU|X[FH)DI*$w"iM&`jR}>#HLZñZْk'!q l,Sx3T`Mݤ&1$Ԃ$FK#F"$Y1׿㹖;ؙG@B8N_w<\: `8fB-S#xhօ X @Al&pVbp)i $js Q5:^ z|Zb8a#ss_mϨ/!S/$ D0[_օ[چ߼#.!a`y ǖ.m3}77/ڣcÿ5ҁ*3sW,,V|誓}' Y{Z&ؼjO*ȇ1T뢥ZwI+:wQЉÖmofMͱz`E!˾I2(dvMajD:!Lv(}fbME+LtRkRGCTɲT4h1'^De?h]Iu+$ DSQREE@pS.-/FűI`S ,"9UNӘwp$3$ !3]iJ68ZҖ18POׯb  PjP*i|uo1C$fWc#@!moۓ>ɮ*]_#z5OE~uAlxBGrCFlF[Bis=1gl>(6eS3ꠢw $,P95]unX.v:mj#j+Q˓ )4zpGq^Ԭ"#-'* F_]7 aNް>y"z|6$_;i8uXcʐ HBZVO'!/M 3ڒLRmBMWl@QuE3E lRHBI2;]_#z!G! ]FZW3gb¹nRUVhԆE`n\J+V8"DwvxKV̚Sdg}'Sn|!x T eV+$MpMu*9m49HhwVg,^e̻-yhVօ)9L%ћF C/'l0iTԵ*;}0ƾǸWu.Rd$ z7uQK55/9 r7 VIlr:!N\8 Ye8kjM.FהJ`(sP VVL}@(&lb 2iG0gH2zAK?f?͛} =KVfW}m}?ʶAR6=$JJHh-]7ԉ(\.q _*0P*=5^jޫ$w'Cd@WYXGx`Vlԗ)3w#cp-H gΡԔU$H%@.Wf"V^7!Ynqjǹ\̑0sdy*܀Âm0e_ WwM% ]D c֎k\UFAR& w.tH;ku!,(E'x14@KiODRAyL YTU^ LC_Hn33hf9"rw ]H<2h !ԄX]&RiTy sŴ׿k5$Ѣ"M_hݑPS_y #J!/"79Y}M&T.0[4,8 -S#Jʬ0ϻa6Å3mKmK}V {5@zȋ?Q*$[n]zuW( -4N[ZEb1(-hCh'R{5+H"8@QW98ErݨDnj]sy9]fɷm 7CoB01 g_@J`;ގJ:1|ff-Qb8NBY5~e `ę ѿ on)ΆI2|P02C{#AXY&S%ȿ _ePȪ;6T7uPvtN_`ϳ($L˻RLa܁,6;?ƙ58&AޏvHs:/u䊦dm&pʦb6tPï02"YͯZd:2K ]´i$1>9-7G+\NMa~*Y=Eq4]+Ͽ >Q(*)u#M *L$͘ Ou(MB7 1-݄yn za5aMo-97SF дxg]XkHPn! OՂr(NeOv(7Pm_b]|uhDךu^݀4\\9c)mk^mC0Lc[B t_*oƗ`5 4 <ߣKF AH$榶pc1ݢ!;1 ʲr6 2͑ M̮ l- 44eJCxpxLl(m)fJs"D]i-j6OQDK^80ׯ,|5^%Ux{szO1Q%@psa,o˶oIf0v-i-)cp{ (K,QfaG{(-b/0s8Em3'-L!%M*m8sfz;ei,/MOP H(m,ɹ]:uTTaca0 PbQ5׸!+TV &w /9ޕ>Wf8RRTXrƕR>-yt7U'Yk@We2KBHQ#oeQ [#- MEf'0ʡˋR|}ߞK 7ID\wi, 7%k*V6^C;3%ƒ*+ڤtD/g.$b豳h`<rLekz5&bmVEDawdc8YraI]vsWڤd*`N%eIbUۖ^Nпk)ʔU z8 Yh!1aPWvEf ȃCxFoĆyTVf5IORk.~H:Dzvr"~ qVS1¤ƒbyY^pIC 59Do&_WZuy!H0fIG $IqaZ IO'FKxZSp&f-*7$>7J `jRZ3 ԙ|L0L-ocR:(xR02=q/Lv~3UTlGxRJ68\RNT$HYX,Mkhϒ!#l I^"1V[ԅ%N|55bZy,& FўTx+@Vq eaj#E[CJG̘;:FeOt- !5 N#<N\7Y%Y{)@6z4OŜDL!Q Y\L3o{N9靪aMF H .A1J2\f)X!UaIZiE?*rl͸_h%u,V"m;7nmg|r4E /D!tK&7ziF]d0Brs.PlRMDm1Ue&~%:6ʈE.!$7\X^i9K]?2`;Q#jM#?#O}w7*I2GfJ-|2 4rƕ+b]rnO SP.zB}av[q kY:@oJJ{ chO엡 u14mO*x&?Y~GKk^Ɇ*H   Г ~?5G@{èS)_D%Y7Fo jQ3ݨ-3HkL=x-zdR@VCSADrƕL97YL~~Q/+em;592'AGjs#xwIxkH멙*f|<,N AŘ 5̉Q44!TPzC *ID]zsq}[NfT͍(OxU^XLâO6CFnH(vj\86ag3Ui mZPޢ` YnxB<KFž& B~k&yGVp%@33xHUJhNN-*ז)f+'(O̠* M]{RXW٠.O6foLzUR8)jhݘ&:^cͺŽh SP'aF(K2VYq9-֠5זW09ڀܰ; {Ա}qelYN~ɑ=h YrOem2kb-k_J2_sqp1D_m/78/yCd*'&[$f$zU&^.'aʙ-lKTzGv:&AV`ƜG=0WtԀmYޮ|ҩ" XZH9)9V^u$/m-P ҁ i,:RU'FX$ G+ jz0PE\0«4'2"am&^+Ni@ZQNu+TpwaK8L^L !B*fޖ[RPn 6ɀ ҴC&Ħͻ 9XœOہT.Ȅ@Nj("Dl*C DQDݒlYl8(? ݚ 1 4_8KZ`. xh2˭ua6w-T7k25ev=NdP04cC/yajIF}Zd c 8Ƈn-6Ts\*:m4̓̚2sP=W <6VVFV)"@c"+|.*LΫ LW()pK-PL2"iri,b;fgD^DFbb>VƓVwxbbY2DNlrV jSKĚGHY?qJKLD9R']@Š5aG7w KdP]1|45kji fG& ܗ#Ņ'z7q &nh ,1xR >ѹ M~X tE|]-nk\N˨!ĤsJNЌ%PZ" /k+G3Wj lLg'~H7|rE^t]' a1go:EȹujFK#z]1;c(X̄x $~F]Ax'$0JX8bR 6dDq1 WER][R$h DT! ҏ Dk沸\S Xf',M7d1舖Kʗ˭Y?I`MQ蓫UbFɆ`h$$&>a[,71_UzZRE/쥯61L\Xv$D552n]J $7 83xBޤܸAi(5[,8P4!pRJ((z#i$ `"OׯQ89}2B(kw@򩱤,OP7?QHPFys u%l%bwW sƕ(cș0_O6+@>_HƕH8Uo!4c&܁7O mC}aNFoNJY0YB?g#ǩE9n10AY;UGX B(C)ϝzYDk< rXASlO;MauO4Ab/4Xߘ{KNJK8Eɽ:2myA^Pq-Fich!&Bm8%%z^'/,1xB%1:Z$.Xو+Y9Z0BdX N }K"uc^T1 Co&fˇruES`$` 6b Bz0 -RQF:b4~򱫛1E$ ~\IوLЃׯj(*XK g7l|u6@C&(Q^*B'+qRBZlpqf " 2 IU-2ba_+A5xU\IOZˤ Qj. "LX+S1'BToh hrj\hH1#쩝[q#V{:|01U')X+ 6Q޲,,D5QyV!KPbLKR]4a=t_6M~ Z$=ʢԋ2Eֳ݀3WSI&SoM. TnBKr"=A_.tD^4etV#TmyGڽC1QW, `@8DTrDP7=jyq4VJ @BIk3eNu.[W\A0V!KׄI3O؂,Sb7h&rN?-+Iv0Ou}{ɉ2_/,YE͐ꛃq|4P1>6 wز?@ ir Q| SP}) H8B ԻW:+\xY! Q$(7QאȺf3 lCK; ltB1jТ~u/kr@UfxVgY46$stE5i3C&!J/=;< JC.,!_4 r9Ǝ6-_*V_@7+])Yr] 7ԑAee MP,Ҝރ49 sw:sK}[N[uQ^$K G4oTߨaF!Oh;ж̣xK 7OLyĚEP6=j𵿻xإ"K@kuaG2atjlx N% H{ۜfq(UC3^N8$! f?(0Xke/eҀ|?\Y!6raHK$H,oU#HK9N闲$e ZpˉN"@:6+"7K kX S@WZ#5eFh$(Ral3XG^JѱS6s*BExЂռgIi/0r\xHo[WŪudzCa-GD:gop-Ͱv[GCA'F fM\TC-RءEJqE6JQj%CB|2|_n27 PQ$=74r7jjxdJW^n*`i0rJ3Q-LƵTQ 6 1"P$cr'~Qx oOAf!!0S)Id &'GX- Pª*hwaRn=[JFE'^mXYtMPoX`sҲ[uuԦ>cD !2;jA3'Qj- IUׯbVs[5`iYi-TW,1kW_b VWV*5:aqҸ)sw4SnfL!LoSѸ4ޥ߈d}s"] 9H X쁭k_@r 'AyaEnGu}[ JA@cqG9 {:iĸ@^%lr9W#Kmb< oT(/<ɪ+݂cu` KYJt)YL7}.?GdLG_Q%7#/3KwʑպvG+,W@B"RA }Ldu`K8h/Јǥ u@%a#-\(*6[ȰY@hWjfߙ 8OcxTaP.5y ,ӆID4m 3Cl[3`j4]%IY9"$BM>TV@_Hk*ԝ!G6,20\7hoDvf拎UOҀl戸}dC Ґ/p$uNCR 0pCSKK cԼ3bI},Bam+)[ɯwb2=xEaR-kFԂ(j"2=zaP#lh%GI_uu ^`# C$nN,r8S8lZ57o΀xl&WL̆V* A?n ? sB, -ä֘buN Ӡ W&ZJBǽ@-ނ %sHD9Tfh~9*RPI"Tx۰g w O1vQ xӑxpHM፷EG[jn ro#RN0PQ NV.k\.LеA\%$#s?gRJ8c&=N r^A#fN/oz=rnhmKU6Ql s;R͟~MϜFYa ѲY{iDŒza&."ҩ1 UYK)t9\ {vђV}5ɲYϦ-~emUmR  5RESP$E^6?A@r ٪0pKAxBPFj.;PiD&)`M^i}Aiü0 #aK| pG}W~7dUX(hZ0Q0Ts}LB` eiتbfy/n]Q@G0VP?T b@UZqҩ`5r((67_kͫ l)({}ʇf5PV J_fjFB `t#- WC]tKD|j\l˨9ymEoA ^2IJKJLm`&1O5-ө*:]_ۉs~ֲ~kɀs8~i(`xO;B/]XCGuB'(iQK)͚Uه to* TĖ!^=yw;m+ZZMxð#A Ȥx|0^, Cbyn(>gW]Š4#/s$NoH]@Ʈ"UKɼ;Ax,sQ\'C@rl6@JrL$k1=6d)$2v!Y$P7<# :NC|ۿpӼ1a8]48 hX68BR`f[bZ";7zGYH#³vGK b: gIrtbkIqUFpXoBrⵯ̈́\Y<(暻/aN] SUѻqOwY+`SC[@z|v}M`f]~X^fP dN_ָiyt1=`^}KǷ5<Ww&滯 *L *'ƨ8>txmhR^7~=1HB;[E"*۸ze޵f$H/]vK?4.R&@H0v G;et4~5"&0]X7 xSkh虶&L/X+n,ej?"Ix?ke\n-MYdf, ;a1%hH8&m(VV4Fdo;C!g:=c 89-Z QP Ix)aTAK)z[1Do,k2 ҷ5} S3bb+K! 6L=<%)LnI}>ޝ7u|Bz!r𒦬=X|b }T-O(IVodldH9VV/'*׆Nca,b(ҬMx N:[L(<8u< $!9[rp޽ J?aqpTrgs=7^G *hc2Ht\!aa7 T$]0 " _wY.ve4-ߐ!yw,8\( Q6 dpo<5Wѕ-ԂHc̅9֙ [8Mr=͐DI{n OΨx fm3sBcFj/p$-oT/z6VN㝃}cr-UFXdžyt/K [PC@Ĉb X-"ŐS(0z/Jh YeM( NHn7+P*WHDv@n.0OIOF!#0gdt~l|x7bæ$fiێd^h$qswom>sʹaɊjC~Op|pabJ$ߣ*Vzԅ<vrTHk*=ծ_<ٔDTEiWh\y9i. *eT)a#g-bnT\C]Q߬sOTϓb okCz2:D!L~}ϞۘϦWb@2_q @k\zza/mU܇ZwG>7ȇ)g$ki0 yv)ӺLA[ivcZ駪(l=ҌHp8+`ʩl4_ ?:N1r77g"(U )W AK1A1A{D4:WXI<7l%buvO92FHAecLE,6X]d 3uPyBr3 4 H > n,HuyWo"m0ozg26XKRXj_*gܻ&qlf0ZȲT>>UUvSfM5Oj3:.$Tk +T+9\6%JHon*%mU_!>vj)Crh=W Qte?a`tDCk/k ~ʤܷ4j{%/p~JN4d(yxX2!0G1ѽ buE@cN]#l\`Xt,ݶ.8ܥnrowPNMFŒˬT%8hkZ,AK!J(Iйe`g X1]w.?ԋ( `/]e$']2ӇX/d^.s&WDkNHZXh_# o2ɲ1^p,Nɱ[pbL0V!W>"xgoE@Z;@ry̓LQ#Wa 2IG6ٵ~buhʀ:ͦ`xͦC[䵂I gX2I(pF߼#'g!ܙ"h'A\Y!ǫ*X]C}䫣CWǽU`G!ԩ(,H[2(]*fzX!W ?Cl4CeX.oK)z X-br>#qO,y6H !BYy{yN•k$)KO4_uvH3C+# $ 2Za˩<2*.n,^ Bi~?/S7KDe!&Z '`FR\L*F`ؿ?\ 7"V% ؀7@HX5<_3^%= Qax.8Th==vQK&mWr+ i 7h)NddT.ܘ8[SRlgsgm ;$rү.wE3PL7I5!*rl7ZMx.Go5 ʤPnF3m˦ڒP ix9:bG*u 3=蔶z? oy{fЦbئL4Eȉ\i9 !*A{dH!@xض|ڀsuI3!2jDH5)2U7w9}j~aP;vXlhlץs}׎B799-"j4q9OE,P*!}spPca">)?r؉/ƻjAX[rZ݉JiLT2esdtخAQ[9 hG $l[#%6.`gJ|GS'ƽµ񝂔:`i6:0 DVE.AS# H/PGXP]⟱+| c4(I#$* ZHϡKń7:i|/h]VdHt7"|w4<5@yO#k߬QL4 <5 `SQ/ G'sç4T kI&dhF/.\B37x5 F `CV dUۍ{ dk ͖B*(pKBiŰ J]78{ |%.x "JaF'5BBӔxհzh3%#B*ъKsU&tki$g r&2oBdc\VbFl?SrXwͣn,,"F1最P]ISݖ.WDo<资z0I;ߙ?MXuɆLBw(wkkDI@HV5=$@XH]/q5AcFBWV{qZ~2ER_6TI=rg 69iA4o볆cٷg_*3ðT7-<Ԛ{$emrǁ²4 `d҉[ja L-Lu `ĤR5zUyƓP^1!% IBj|EI g3N,l,n#e f2|C4v-DrAB~œYet]_$y\1*ru0,NJM^AN6敎aH=Q@l_ZS ƈe!eԘ>`$@_DtCНp^Eɳ%Hu7<XrLcEvyuQٓO]R@ `Z^E qOegi'I-%k_-K7C7fÒ2f0*QA_fDv-U&4)}Eg+ߒmPkS, O0F t7-<ަ>)) DjbZ3ѡ4 x+Oaa+Q!VS?t?w.tm,)IIBs-#|* QgŠVq$4TFdnN"Hv&͜- Z ܼjr+ޠQ~,[j<6;\Vk uaݱ@勃 lH,`XuCktOZ{elum$b"Frc1㍻A;^O*d ^~5f8qCpÏ4fO/0\ $ޚ })(;FLxfN9*\3f|&=E4z4S!D]w3bOnt,w7uT|R`\q<70w c׽7\FEr3C;1a2TӍeŵ\ڔtEJlHiJr[iH7~`5S8'PX,M\N&ԈZ)d{_S雩\_z %8)GEeuqqݰz9.XkcV/W_;7e9V:jo1HX|_όJj hY9T3a&/$߰z P] Ր#QsU$̸х2$z!S(0H4lF9 `d8J֢5tG6zFph5%2nz[XKZTS姲ԩ暆H1I .~ݧC e^sӖkYc3g!hDFF88F`j-HsYUM!9"C'* Q @fӴt<\@oLP {eF<cɕ/j]_hMq ;APl۔N}=FN0N\bHoRDxkA`@! c!e+ jM=PF?.h9R2iV"zJ$67xѐdYÂuM~ iuM71:-{fXNrLH`{8lhQ7L/~M*+M~`Nu^$P*^ar̤dfsz)!rլ mXTO_tN-ȃJ: 6L6ZpA-Y Zr2%α<ne1?_=A 3ђ:`R1赦ZV/ @drad}^9CI]HЂ֏ByGX!}>BHIgFgѾwnV,-lt&d:ycԒ;w/Q-/E\=, S&ا=_ZS"/H+ahÏl8H"SozC;./DSU|J4*S_0Ξɯ3^,a36JԤy$ϒnlݡM%Hl vHɑ3ކ[,ځ>ajŠ]DZ >`mCpQځhΖ/JT2ѿ࡛8rnL uX;mB0|2ԃ<5jP g-H0Z6M'f_7ucHF<4t&)mX(AE@Ďy:j‰7`*Hx3;cL0gVh,~]>zLi10d6+.|EFH d0._EtZ4J,CeQT^/6hejJ| lV=ORJR*a]YFf-${2ӧ~R@u\]٪DcPLg*m,UyebȦ@ BoFr攱;.nJWK8) PRSSoÒ'~A67Tt"< ^aUܘM^rֲ޵PXAN*j=Ǡ{W"8 ,؟Œ# g#r 3H~# sD0I= c%YiYnP,N?%N E#*@HN~!|6H$Ե=8uDžjG({zYR[Yd8B`kǸ *rI>f`*)ָV=εOEx P(j% ((|RQq/z&BEVoj!Kɨk?!ef;U 8fW٠xh|3NTZopƓWL]h: EUϑR^SдVZWƘ혘+Drutb=tqJq[+KA~ (7TZ* gN=Q-o\cՌgcOu7]F fԈ xZg&zt2-xH`q0vEs̹u SL0ڒO)VW[_XK]2sDalŪ(X7AT`}X1lb+}h,%cW#I:F5.#or)rYa/&t+uddFT60,U~;ߒY]!7ؔ5[2uU%$f vbGmͺ\h J0b1Ɣm%ԃ (Io r TK)F9xw++djҦ ,$ؚA`Vҽd.ex#rq06 p1]+9Q"Uʁ.,RDG]\ݔX2}]-;5̨LCz4/jWÒ K)o G47S!Q-=BpiPGoBѸd4A]!Hx_lRˤ(bX5ЊR=r jVIuONaEŴGQ x8 F Q?F2n !h*U^ɡDnjRt0/* }.!9$x_$x ?֟gZ0`DVRyoRFM9 4Wev\uԫ K kܼQnr{/՛>K4HM5Eʽ O-H#$𫢤snPuw ?3+łɑA칷jC @iYNKVݕT͋Y(<[2ÄQ[pb.h@VkK@{n;ك{?C?$٧uVr ߠ,&2~v@0hm L484.-ܧyڌsmtmB]-hݐ؞q I2ﮑ|/YLSSSd+000&tg+\\k|d(i,pOEc@ LtD$C@ ) rFQ~;)ӭ103<ͅDӲC@6ނ1t/tQiYD(H*.xC3^2eKE0/̔>P)ЬGcPAU<6o21~IZNbQ:*`t`XXQm+4Mœ°ip;Idѝ¨ZܔbK=C`@TdodelEɌTU:i l]@kZ lt]^@W h|I'~Njܓ8dT{k^sCȣ%k8ZezF,ogil_2XrᘠBHU։jLR9ts)Y0ڐ#珏B)aS_^E ۍQf [Y߬TGV:C Īa^c.0;CCx*۴Q}_Ӕ}3bf ~=qIiVu#׆]Bo}PӎşTYg g 0&Ue9i[0r##cyVc:pG@0Ki-)Z7CK](l 8I!4ir2Ӑ2~.*b*P>̧" 5P)J(ZЀ9 ں;Pk\Kˑ&(j^0{͠fS4pXDX:^Ogà Pˊ{׈*;ENa;jjֲ">1 C(! #IEf9SKXs toHj7k&+\B/P3ۍW)eTNL.s=DSsJ>cH@W:`Ʊae켸adRf7t 'S#x1rR-Uin:gEE:(sBWI4C}>ơPT2R01V[Z;M;vp+d~y OZ 2Cfl t]Xr9y 04`Q)MgeZՄ ~?ԈkJ{H/iDT;  suק1PouwXuۊ)(n7&b~Pd.ldP8$d]QD D:B4pp)l1Mi$6 DfVo$VL%3elI h<˒͊KK tJzΘA+B@K3X#lbKkD;Nr'$]{ aF ^!xz2(';|FPEEk~澕gzd%A&ʩ !ƨ !f;MOB9}re={Q>BTVZ> ptqHRW }H]%> W؀ sE<F`27hȀT"{@cpϪNlDo 02]?Ke~zu0ɷcم"EؾEa`%XZEҾ$g܀H9W͋@I86 1U4̯d0N Z]({VaC$]ʽffPl+e#; >mRxPh츁>ĆhƠ#$ҊZ?f umKbWƣJuG#68/ U9!a%.LM>L\ymL^ڀԂ*|Y 1SM/O T Q`С{=T;8q5zOHd buЋkoEIv1dVC59ӾBPG]@EK9ϡn.iWj#Ft\;Z빊^i3RmGK/PJzfa^zz5: '͞#ULMf͉ ;&(牓a_ǰ*@vgt!BR]SAoGU&ri$UIT%PQTjo ָ3KL Ap]Bm)4O!g2 RVE9&flmrs G g}YK']:H̆@eCGhP*B;q+ҕz|;gz-\E\T(?mͲ ,'='/m6tJ0("7 wM<֠,g2d 5LV f 4@zLSfv^=Ĺ7rK1T9 I!NP=p-DqoDs9fʼhg\Zɓ@4nFz&-SpVЙHSy)PTj: ŅVX0J@Mԫ'08tϣ#q\),c ,4 K[j SP}y'ziF,ƭ^,9a'728H)A Φ }vĵu@ pȿdЀ\zWܔ[ [ 4i1nhX2=KozUKcEfjNOQoK!pP2e:N"[Aq[HG.o{fgDNȫ\[B1l!l&6W^e\a]CAC'5eTT7wk,6w+D|Z=!ni &(ST, k2ހu|r(I2%EI.Fj089}[nr5K ^I,1Szialh14FnŅOq`tE>5 Nq-| J7M']SXCpĀ\KΙ`.쥒;k!2?WvlU M;KCOWJkiXb޻ Ʈ0Wid4(A2/o BNXg@.^K\F [`5HB˧AGl$NP}13hmA"Β ֫Դ8< [`D[&#  !c,ؘL]7_cQuQn,DZ|<'3Did$-^ 7C=뛌+dr "u>Y9,TQcUҢFyR~WEQyK|\ `kJ !Bւf /tZT4,;m WC`ZW풊VNETIٕn޼Ӈc\,^$ֈKzqJ{0؀lPmNa$-d;T`u]y41ؐF+H)+QcUn_hFW,r:y= Foњb '8!P7)5b&oO[͞uHK.!W=P}p!2< F6THG\*,(Crj^G /'/V ڡ3}`eAWـ\ރǖ%1?Ra{,t#d rO-w 1KTG1- )R[JO+WDr(ҽ0C+Y A.P"RD]&x&Z ͦ:d$Bzra*~s9=V+ jò꘷9wv /`,J▒IޮB^BKYekF.tOzyVK8D2`jre\Rs )n)?7A`r-Rh5-!]i4r1`vpO}؉+Unת ;ŽA(rT=et%Hm2F+kԓ3ڣoX\@ Z,} 4 ՗Q/˙-2;D+1Iuua.) rTIKڼORnQ|0mj:}ѭΟ;aK(˄; 矽TLgg0j}?nѭ(+X\Ř2_|FWYg5vL3}^~$P(BBL* aZF"\i|R+86)^'_;=Ȣ TUA^_ar6!]*r+Muyy(AfDy Y .%.ZU:r҂!QhJ/Ǯ q])*R/ٖmJ%z4\>AAоBۂePU٥ [- ku!EZ_34/R- dB f(-z+UVzq҉zs 3ŋEC2%*53-ahTmY6es7;Hg.9ikT:5"U`X&iʼ4*Io#5jr.fQ3v[6#MAG#EmWo & ׫CXkQ`7jrwLtfCt郆sMv(1MHZD~cC#6z_mO{`S1,`84ǜPvE~cwo9'7E ^ĵ-ƾee uǵ @ԥƊSmy &4 ʸNBwGd/j>+E7\,/긵Q2Ky1\(13hbRΝ^1xȝ{f-՞EP= lJ6 ؜ʢjVz9p:.=:OyjfT)@MPM"LMtC:A"9 b\6 źIqwGX/9aҴ(& aǷԔ6](x@2ob0GL_X7j_];,f|("yy*#/m1eB{NDKi !&5(њ18 ~hQP8G: tvjsJ:9.zuhimX6/^Ac sQrlt#K/ɂ-)@.>ޝʎJ~,1#ܩAg`z9ӫp#h_!B.H ڻq!o>` dP~Q)Y-WiMM'4P7嵄AaFW/#"̬ua14#|L+/nCp$ѢV7!t+ wSvӠdowi+OH*,bRZ"Q&(*Fv M>̈́ 4 alϨO-)댴J5n^0)qlM!ee-Lh%"~hoZGh i.^^:6́2$*W4ɡDP^ :P[䙥ud(t* e:tpr^"d6B;ZI.j^jt܂D)rRZh"^3]vO8 x$꘏fz&fxU`5Em5fCR k Cz3?k. ~Fe`^ԫq + ymo?K DR퉏U=I.HEQ;? ƴfz.nT DB6Q/DIlVlm Qw`ֺfѤB[}u&~@K`|k |1m׼F9d2!i&ڏfgyuEW]l2T~ZaE]koYֱXN̝V5{]_7?7pt$RRsmgmi A/Gs! ;ctj:[_+Cwho#|wKw>qB}ĔᬻѱBJk8hGdQFBpB_–q [hՖgˡ)gF' ݽ k $Teۯ*"mF.;=HFZm s:: D!HȬWYvM&TKkO-{[He9¥㮸%m:+V4ziJ5*ϧM;q^& 1Gg xӨ !/k U'/>n@oY;_,ol}UVPBd#N4SRhNYw-6l:?^25VF{5z98R[Z2k2h e5wTr%~%GeD7VɃHGM0㧐i!zljJ`U70' ٓnn:1|Bq`rU#T Mbс.jV{0M(:W8[jjs&sblSgܵ͞[}m':)A\XNLkfn6z{ Ÿ1B{K_җo ..4fpmA%BEqf=FKE(@: *s-Y@6I+rYr3Cwf頙 &%8vnʼnteqW}W=ЅF+Iql8YW9R~j#mz#* N/ 9*T*iOfIDATtN=e+ 4,s7{M¼eAw׊,)Z&h@(c-!phh1] ˡ!`F[/y.&da1OQua^ߙ J5KP/9T8 uXO3i-_ )+bh+16 йbĖ^3Fт︆qWFY<{cu^#熃]KYbtr ?s,``5(P- #~\2;mVfkx1*Oϒ:ez7t9 y+_fukvv^Sf @tք"ܶn ؗ-Ul7I32qIHojìO"=Ot0x2)'=/eGFCJ+(,%A)rD)AGs)YF((BEմ64Jg Qm8ԽƺB T=l03,h93\/Y*hdudHљaV%eZʢ,P/eB`BcQ֮ʞ)m9 "򂓮D"2<9ɄHwmZF)r,fa&kN9^eʐa֨?Z2$[<{*e<ֺ$_X2+6,AUi"#?(ۅE8%0Qu"c*AΖF.OKI{QG&-FQftūh (t4с֥}zL-`3_Gە+[w ~N~S]TƯW_1d)/,K@{i#赲:dIAҪx7^/,zdepځW2ѳR"pif@_8;SO$ /<6 ! e 0 vwƤ6H= ܅sWUf pAJ}G.a.d4\fF TzT f qt4=n3d!O ICPm% a=J`^y@mO6I֦VnLRAAF78410[%2vp m%P vm:&[4pG@iQۆ"/Wim4xE {0h.PJ)dZUǭv4SD zxX ޱs}5z&$MBu `htYmvSh♼it@` cQ,4ZGt[TL V Z0o^'Pǩ D:?1+9@<)h@{-1 ~UkU߮}5jC86*[K/r\72{qjs= deIQ0X!^zYь+7ݢFP8vLYzC5qm8Nr燽 p@ Ĩ搁CnٌN=XǠl3165\D(W&*E- 7½J oo q^`.)E ) A/bh/oCKP0=sb-:*3B*4]c*7.d- 1#5*W-Fvb(o*.n%HMގ`\B+4g*إЋ0A=vK 79yୌ4.*dTNɺ%F9~.mR*`)m;-L .9o#',t)Vه`1-].6!4I\ 0Ugrd(|4jvbaf ОO !0Up-0xwh\!! aUms2wtΒdB "Kᐦ()>Ce1tn;& DHD#%NeUCاgyFsҞ 4m&{&{R"EH(KĎt4e,z\g8 y TRzk“ Ow]uKW'W/ʨCdBjl-@&<'o`E塕HuAX2b@Qοc|T1a>ф {h|-L.@1"$+s zEDťL{\a{lk>Q 4+R< [ꖁ30 &eE'<9l+4COl]0 ԗ(&[`T*:lUgU8sbEelI7bѰBO>F]ꁦ%3`YB2$q^Hk L5D`RBKO[=KXj@0MagU CodYRj7U@Q(1j>n~)i)MGezB&=X=+&B.쾛jנ)Gjv+46nQ@MDZ*^QQI9DtS6>Nӗhl$?4xo:wR-pBpg]]*ηYwvQҤ1XczjKfиgר.{{,u4"T'GLݭA9e4O]ůR%zY;mYw6ֆ6Ğ% 4QAҞ%FL]7-O00:jov1S5 &g`?&4A #Z[iB+Gjg!ݗ: 2Mi_ Mnhg]G o9ߺR)+` lS&1o uLepx}Lħ=ˠBȞ{9aI"!'(} )1\Zf(n?uD@,Tn5 !QN[,yA`ZԷwZ$"^$1vy4 8 t)d[!o(>)YBa5eGANۉd9*(=*¤*xkY#lna-҆ꀶ.y !w\-8Atm =&sp2{!iaSgv0;@&a^!p(HՒS"Npoi 2@E:A+JbA{T6/@Lw.6CL$-?ڸhZń[@B =t@/c$^&]?J;dN-XV~mYhA؊MQSWmJxR@*ToKCJ},; p2ՠqœp+М/KI TOhI{p >O5 2eS 쨋`#DRT::ςb~R(rvJfOS\* n:| ڹHr"{j'r,$g=*m^ljΣ.).om(`ÕySB(--"T]j4o:(y!=P`J}c.i ‡. Wea,}ή s/XZ8x@6XTogRVVuW,eR Xmzt 5$9u)qJchƗz2?̜=jE b0;̜,l<5M엩Syszov"BW! Us,̓1";givsm/hFH(8dzSQ F4Q^-zhnՅVU)gL]/f@A-7:hg-;HC2?SVp2*Lf bŬ%mTq P %kQzt&9P-nڸr}ڟLZ;ˑ(q*{W5Ӎ4)MC@t۳4NvܳIW E*PI zH{h+,jVFIzacB},#mv࢒sG Ph:^Q_Gz'-ѥ,P0/PqV dޘ-㡣T38 r\;.Eka2hӖZ"KlfrX5Fz9ޗ97;sKrgD{1R,`5+GpC< (p긿1L-M,[&A)W[<:ꍁ'V-H۠9v zNKbQ[uϽ. .úJ}ik7k͞yXIX[0Y=mcA[c?6;(&Kex"4nlx=%]ҀRW%niOmt0{ݒyģX?s)#:ѫffI˨V@vOp= F9e:&ī:VVO~ M}5{.Թ>DdK-ƖVXG-P X@nV%/@}  C$=^oq^~S"eRv9@X*wDsE7t Q/HZ@ Q60qQBs5Dof.ćmiҎ(Nw3oI+$2zFЃfRK;%y-#><1Fsi`@ Mw<; zZ\y',k-^PEFw*}:kfF`7K8$X#3#3A̝긾yŽӷm#/@ܛ+҉_tnr -nѼ=3tL_+c]ZuW-V8҈ko1]6WShc!v%He6X #h[6LMѷX:B2Qu'$hJ˰%\$S6=GRXMp*^ZOG\V"j([2/y(YO D BlJ"W]mDf\7=I-g0WG9Z-dԫ#z`~4Sb2D0dLMc˄%KKls&~B[խ MX0ؔZ+<)G+`3i^Kr22 ^xRwhJ uI`;ʄ 㮎C 1ceZzHt] ZXf]psmvȗZުf!;"=Po{ 183om SN0 > 2KhtȆ>QLyu͛&PZx+ay0b#0oj ò#-}fyö=Z+n7f+.@r \T\8;!$Ph[Kn%oL]@ר fE9D'b VIdxt,Pw T&3hI2FZJAk`BOfQ6lU.? af(#z>YtD"(&Mҫ|3J`$QJ q0!@@l:v@"42'v&O4)L%a jɺç2 vAփrY*8ih80sJHZfM f Mpz&+AVXqUTf"qWsIDt .) qa6{LvK,FerW9 C[I sp/[.X.T'sUSR(bFR fuWRxnszF2]W{ gd5y2ΐ*g2U 6[Q3ul##yEy5-ֺCr27HDs-5IҏYDt1zUJ^jfcMYp Z[wz& >*OPP5AR[|gx3}S'PڗcjiCPU}..Mwo*&!9C-hdKAb0{& E@˧?i,$(P*C>݌;GߟӐ1Yt`/ptgQzF]iBtrؕ.umhm 82 YN! g8\^pfЧ~Z=pukN2d9z᩾m` yzthtBkhPbKY/tLQ u2 `9`A^iL[8kToh5h~砝cmqza4􊘠[:TG-mYc^ ܗ0 4'={R[wx"Q415І|žv%NK̂]`+|^1群dzVe\"/,mY9ZǺ uieiֱV+&uTh;gYϋ)>#69w|a2V;s># V&jB~V/t TG/=bȼ||uYPȵv1)>= ]*Yhnx1d\pjTZ뺯3M;Zw6jEs?}{{Y2z>P9׮$òF;RVhĶf iQH͒b_B.ӌI{-&Oa/8+Uܖ*G6TfdjPIi̥њ"MśNSHmv /lʑfQȉS6"gJ+ CѪ[-v4h.( g ~B^^9p* pTV9Hs(czS.b(hvZR6mA!g{,: 68z[RP@{=ȿ뿚P?z&165Epzhme$z߯!&VFVKu"fx he ݽ1m^!>9DcT}[gF6l kRY\ Y0EѼ ϵ]D5jdzUN 1#W{WY-η{WwWdbyc9IE` R5%ښ-ʮExN)+ 10l5 0?(o9Dpj27YߗK!= dT(duzQ^[A׈JtdfZ>. K de euh@7ue9wI=ʩ2eMAVxz12o4s$ӋA{Ʀ樥JcKNB^Q(Xg~i ဧJϳJ" 3Ƣ$ђ)eK)8ԸqizR:(꘵sZ kʤͱ20cʞ,4NZ]*תs zhv(SH 0`^''B =pg1՘GRCp=CN^97ŚXǼ`>^Q©'|>x |hc-= G5f"%?D̏[ r BU3DmJҳ|Myx$9/0.7Yx-!vpnpcO4 KfQٴQyuYh[3G5d|3 5(2r-ͷ*\ 7[Zjz gldA)%\]HBZ'{ݛe3n4Ú"W^ $$0"~x;c}Qtb;}pХӉLELd8о`Jȥ s{ DŽ8$ۛvV-$)`YbH`[Mw"]SWa@rlJӡ(& FWi1toͮDÜ.'qK֔RvLoFjQn05=!n(F^6pFՆeV\ EWeqk2*;9Q/|Y+-QX/%yx<5/ǠVU(­ܦil(qVDxU0Wx@5<$e#E/gi0O߬4/R.O=mqp| [P$*{}\E䫏LǸ >3 Z"pFgpL+q)Y ŜElzR`[!?U ߪ`b,(w:QBɃj:.7C3+jhWDV Ms_l-|[zX8/OqlM5,=ARaO=Z+Hgf8+8 `z훅fg^־k}"|}ԹRX߷{(*AױQo?@XC*hR ,q@ڽO'ԁiG0.YߞmGT03uФN"{RiIh@ӁIajITP{_/aRo3o ʯJ$e]5]iDEg6tJh&+EireK"TG{Yhc+wT -V,ۥEEDo xyW赗1#߲+E| k|rdt ܵ,RrVpt[H)U(j۽<{bDpUPTk)3Z|5C 彋quSڨݵ#Pj|]f8AQ!:f=g2C{G@X{ Fz\Ǥ2W2T y5hil `U[k悀e_'s]j/+0_zx][۬plЀ(m+Qs,{*@NB;Tjg%Ry[xCr~LA-M'&Hd)v׌[O{]TU0N9 1nCYni 0=+E}i \h+R* |5(؊vJy{ySA/K<4KԷuRS..-f(m"@у=ӱvHt xthX\VeyY|qi746[ټKPYߘ>jhtWhæ׽Cd Vz}p pp?i7S.6Ũ0w r[v.!OQެ\ҘHljqtL ߫iC^md8<'@NTW(ukt6?Xi-oc 3':TZd$J&r6=8}[efʎb)K=Q|XIY%sbh)Ϥ1Te #;}'sxh'|c [vem;Uw[DUe=Ԧtq V] yRwL QA(=Zt[z8n?"ǷI2o齉E053]#߃:8DkRCd(bSS{A tzWR|Oz4B&3A/ Piwh:8T ~_qaI X?|3 c&PV(ki  he,VS?S>5ڗ2bqІR]X#7wDڸ Ύ!O HpjL5n m0r'ʍ"*6Ռigvm|%K深gR.+u&O$M;`-a5äPr+!hh](A+[dve3UmAiB]C~C46/G>G,K­By\DC,"*Ő#ZHIȘ;nqNc},5#5 # lq/L>†R(3݅On uh3_qy/3rjP IB(j#r]SDT⤢Rf-G,"*ANOcJ#̩H\LHMRA(ȭB 5ڗB]11]d !Jm3~I T^˸+~Gj'2J-o,rSLKqpQo-7er{k)4Y#KGbP/*i[6'V>SVygS{FAFی:j8 OwJe0zO>ckBaiL\{"HMaV,D2Ssy֫.pF /oV VdA{!1h lF`XPbx mc(|;4E+d]|bDCanϼY th G8o ~ۉ )--&%`LQ!ﰿtB$hk[gANR 6PE(V{y7ok%Z&d}0oVOgy0emmD R8P*p-IPO nz[[4iϷb@$F/g4Нȅn~R@ASeEʺtKw2=1Y%04(ֆ@^I݂|!QO;@e AuϺRd;+҈(.eJߕK/4w lt=3Y)ne_%h*f:n:P#8GhC7#|VZ 6xTc4)Q0T) PVF8@YEO;[TT2k姾/E tz0@kIiV2} -o|Ym,vfW С@eFAIA@6,*#cKenb[DC?cl<:pZ ? Ul`'9DqS\)U[' XE:|+9WjM'й'gÖp.3PxWZtƽ}hzQNLO ngm:v7 -HMΩVTN-:igx0@9=H .}iLW A qpyyg(,>3^'zC |יִfP*/ދ4`zTzGM]d"0dVNL Vi Ų5C>SLE2v )jHobk'o C1h猲P pI׼x.kCd!4x'@Qha]r6.4] RKj XKahIwM9󠀤YGWOP p.GoI5\{NSƁm N)eN@9 #u(5:a l8l T}gDP fS214uw#P 'y̺ĆUA{fY\b' iX22y^jTLS<^-PyV+n$΂Z2jwȟcKU԰#G.Gڷ ֒#4o3 =ub/HB !DraBA Qz85UK&+YM7mȹ$ZL4#<)w5z&.gٰ۟ C ]0.h@)qb,ZV^eM6Rc*iӡ狆ugƠU5)$.*6(09PfjvRWm56@VyqNΫ8{ޡK&qcNj)qb5/L`M&-z׻h,\eREm u7EiYn6 z$Q5 E'n=[5wZ̼]42{f>aCiߞ8jPR ڀfкhr#GMѹ!dBa򥚹^Ri^ jg@Э (#=_^z (ݦC7~T/fa9%:ml{&' 8p]\cȺ^%Jh9XL-wq K{m;} nHc62 L~f 3ɀs1 V{O-KK\e9٩d೏??/akWkXl0L)kBC 6z­qp6qe ][Ψ7a82i˫&6_ -w?alک 6Ae8 {ۤ0gahXJ%{I@>^פL7$rЈIw{ [ꍎD{@kMfrcpj9' QEX2ïvtQRiIctKBZ&[떎g얥jBrΠEQh3aH t1/77QfCq3V.jd3$  ph+O@ei@pk\2ȿ6-W\[\39/Ɂ>^LͮAI\E_)&#jCut/2&q%ƞkޤJAxTlg[8MhkFp|Ն-P%]RІ +MY\$p*ֆCJT蔜Hr9BzEft+l iҸ!y7Tcn!&b KޡBv:2=y F=U<ԍw;ψH-bD[V˕qi*0@GL*sGe''$5H UfWR>c<ƢI{lMwݣ;T&s֗AjQ}6=Z!C2F ۿm3!lCڐlZR`Գf zD^%^zT/FјKl~V$JAS c*L3})0}s]=T(+-ns 2ۙ[ V[T2RvKN1aF~ ȸH-r%֋Dob-Jcu_u2X0 a F K[;ITwq)aըl-v@vnxXz-P8-M}9\,M%A]( lp3L  X.3]Z( x1R֡??XXL =J,H.'WR@%ak=O["F4pEF>+NPQRzV-9A '8ȸgޡӋ1+d;~J5KRג5乨7+[%Tӧ|p:)OtX),P!e6(2wW!i E s{U?)֒%]TE KTB2S6d=NyD;rI!\([@(⍞dL6Ӟ=MUX9v@TDE!fI#TEp`-Cz;V\n^Jqj•MLGSW(*g}B ݡ9Cϲ4 `) -AF2!ޡX>ގ o2~%H, N0l|F@[ޡ|M?e!+Vx8Jy!*1`(W F3< g1"BFоORjVn83#jY$xq$%Qڣr`h/]ؤ V #Aw)a, k\K{/ t1h/Ch:x{RkԛNԛQX(FEfgٓsmM#wSR(w4GZ&wKB֯^td {jO GD-Z% a] ?ުBudwAKlhrt,3s.9H! w |vQ(Y^v | p(5_(iTnt5Dh kNW~C胼Q6 ,AˬbYD|X)IHU7גQt`q*Bk/,pp4uzej*5ХX6 ٕXTgM ra 6v76{(Pz*j*D+s=磇q8 n0f@6!P jRz,p 6Cԃi(~v(j ?w2ùP/sgB`nhnI}phĨVD yL+3fG1CK YDb]D=ɊNµ-:pkPjkS#zEyWrjp+aNjvv;ObqtmL!gku{To5s23qTlɭ'5:ȺM4JӸw +cM'UJ6ZBt5bRd騦}D6<d0\5'!j^~RmQH/,-;W4/]pJJ7}Bxv,qW()吙l92KxHnA>M=OHTŖÖ >>%M'][d.ŚrИr!Rj}H0l. eah[M$6p֫b#=&ƟKˆ.t=F5/={G"EtVGoxg: ^'4#J,iozɴ͓qu>q_-Ѱh, |aFy|\Ȁ'Ŭ^Q6qV@^{&>%m9$]}zs`bvC M*OxH%0Q.e]Dj?AXkc^l27AH7e90+DQFWPX8[NB\ՓvtS=Th8;JM.)p_exs)AfʵO&ΕaHh]B Aˆc:$gU.F;zUovoIuBLcL6uDXڙR@No2VcȨT`U<6Q{}ױJAԌ{)yW-dd2x¾"\,<'X/| 8FI9j׾0)[0d@оҭ yiF5Ÿ+&OS#e !mrǺ ffFco6C|G| 95O mi3ÒZzР쀲f+5Yg)o;%c53@@2K 8 &XVǒf?jR r $ &>{$%;9AniY!] ] 0q.X3Bwi>n3?,B@߶Z\q`_dJiuK+/cߤK>k zc˜10hU=)%s&Rs3mׇk\K D80ؗ1`P 68zezi(1uNԫr mY =QInwhг*$/(>luj6tzSA fIlhEhߡnm~tAttP%WF Q@Yz 2- T^|)!yD|B;(ۮkK3"ccwåg/&&br>v>ZNuϜiH'AApC^li8q [`ّLx.Nޘs,߫?K(V]!\I=Nb,w-h~:u[0Cǣ(e'>qQ5zu~֨ibF@yuZ?W2h.? W,l9&ׂ3C&/;ӂ*1m*p5L,1k`{&: KFRyZejEm0ѢE9fqGbf{"(ܥ\P R"r1"BuF0+MLFp/ՄZG[3Z5`}r~sPLS3á Z:(k~Av_Ʊtp2 Gӕ#evl:x&waXl.Yís rblpcN0[g"~>ЀON=x]齣KЖ+f2ONe1n[-1wA -23T*ģL/=f\ FR$Ҷ}0Ť@%y`#m(d 7/~k^St%39LA0Q`yuZKhk@A StX&_} @Um\lC*n8kY9\ Ҡж0ڤwYΐ̺[}Ӊ4 K潾<'g$β٩7x.Z&H GlC4/mZ3R .]mA`[D(o`f)bW(Z2P*Pk^3 XnE-k$ mEhdq*yL;Ja C&uJbSEYQQZy"f?ܤTB 7?,Y/Ӄ,{xx'xnh[h prvg6ۭ `qQwO. ڍÎ6)y~&ƥV$: u/!l!S4u\0#:dR/5PSF݈FQ\4JJs<eiL^TA'nԲ%{Ml ;z4mJo#7FQ{d:[ ??*\v D7M.||61W3B"fxtv7_PsJY.3WSW4f*3 !!O&ί@SFt>K(5P@3!v'8 a lF7Ƣ[>z|;C= 5Nc\p˫H?c/~kn׾;m֥}C bo;c+؈p;E?}{ Pd#у trWsE UI;4AgzD)|^Jp CST[ڷѦdc$囱!9))ѓ%t!$S:wݟ4P:ii- ư*K˹ak{ R7"t){/}RNRMw)ssDLV\k?PԭhX(frCM35Ԭh-YJ4fʳ|*ۏQWs/n# 7ݸD>ԉn_Ct5: Ԁ/qoJBl0"xWJH4<9(T±Ol!pzoB[LI@lI-܌W|O'ZK܌/'0,NH̶vO  ֎e拫_E/Zɩ*-E{l&`X.ԸUvZ)O_Zfh@|<ee؀=m ol e5KP(zbZ s8Pܝv hO?cisIU ^Gs[GByKSQ,=Lr n@T4]rTe}{ 0聧o⥑LJ&/D}rM-7mʼńD)Ļ!bIQ3 z׿ۿE֢ 6w-"uVȻ;e c͓7=2 J Aߩ^8-+ѕØwp>1->9+}=0i(fit}F<@#@w,9"Xsu:9r.0NBd.f Ty_"|hsTtq;;^#d,.HC! jIS%4.U Lz+(ݥS4,ěb"Em3VC~igW:YQa%{kdRѲlm[ի]zlʮg&.iCnrm=i? U罘j ]D* f`2,@$Ik UGT0 ѷ7NlFud] Sg01tHQl~8s]25ꅘe Aa+AZf4ǥ%jīeb`T5fLAO|{27Bd} aغ:Q/L?pay'"4M DZp/%kN-R KLbr. `Jl) bKfG\b谾uI'6/R>BdB>!b %~t%HkpnIr:Nī=gW+nʗG2 ][t5AkS̑}ZW18* PjI;U9~73DGZL㶔xڗ)2,‘r%? dnٮ!RmnBK z54 j ]q4   JꘁD#tI#C,O"O(,S*AԀ$ѭ Z08:B QF[VjF*A5!o5.P5+j'1#90zofNwE$BeSC3S^ֱ#BhX>( VfVOu+'qfOIbw!F /A ڛ\aq_a A)ndzmJ/8!yzy=O_= hZAeMe I |5v9R4N: 4.'jd?a V& kշqT^ ΥmB2TѦw;,L>lz5M! _\ 2SS)mC&r44UZ3wd,c, h [VJ)_D;/bIot Y,4&ܔ_oSd#oO@2sEGgƨ b}uiE+0Q.Qp 3Y-u,X0 ẕH|BU#bLhv,[̓..G @?ئ M4`=$n,+n1LUPiT V4樻f `X) kP {~'*oh#a>W9fDSF^Ci'"奌/~f[얉0cHMe e^P5RpػØFY$\4$4G@\e ]~0 l398eiGLQvF^|EV𜉜idz46?ŎX\ &`\BJ˳Ѕ>󣍖/+ W F&įpi5!X3wUm6U6)OClwh^.m#Kmsv:,kڗVU6pP/4Kj,pAF}I pN,mFv6#"Adɮ6ҘF,ZQ4/սMǞW􂛉/cgܠڀhzB x@s-RXY0[ a4 +(F Od,465كޏGq*MOc?7^4ͥѵSv?zf{j♷m ;PlZ;p d||5W0u.B/:[Nh O jjґ'݂!J> 0C4~FԔ@bu*Z [;Ö0jG]B2:g:Hf35c`K&N{ 5T>'{(Y(HUȓF%\9mi48{?yݡ3_2GOS`o{bCp\^ѸG߇dz.-aĚmZB$ i{eS ν/u,ײ/VC4(ӝMF`qu dE@C=R@Pv bs3 1g\M,|W{Nб̘AuxJ=ጀxtVK<,% M"ͱN췱 δGt7Φլru,QxQ}Z^rYSp`zym'*/b tisc%`t)*'65+颣r]ڄγ %i:U(eDν-.ڕ6Л xby%?YV+U`Qf地Dy{E] ]_CdS 'Dm}7-}p5I_t(dYtL)#Bކ ʡ!}"ߥ.[YG"ԌU%f^>e 4CjU3P"EbRPyv,Cem`s_s8 o\  LжoG A!@LoZAc}X[,REZ[!/ L/&i!] '[Ar8}9ܯފc4F5OJ3,J]7G-:Xk K#!l_pJЙ Ji>KfD *%QԠCB5 v4f.z׻5Mݡ45mLxg#Rqif =ĘKn h b6}IM1׶5eMHv87:@fD厔ИJo6NnY& rr7Xx 9Sj.H(yX 4,вTj .{еQ^Na=Q"`%_giM|5&f-P*{G Xi.[P'njV | 疉YڏKw<2zivZ%ZXTUb6kKOp2q)h_Z+e/Y:Dcu54k[ſkV&vL+&&} ÑZVCǯjkoPd)w(&2&Y{2 ]ʦVmGZdE7)P5YZۭK4\] iѷb|VQdJ%oBYT@Tȟ(2[Sz[*ݕjLFp?M-(P@{p/(/] i%bD!^ .a K;W / R($Ts>)&TVZۈHZ2e2m;|rb ,4!(2-ӆZZ'㖴#LAwn ir {?bQoNj5mu.2^!Xh{{OeGO{Z+of" rvBG @.Yگ}fV}˷| -р^y猅`[ mN@.McukQֽ<<24/ܒ=0-bnPJfM?)\1rr.#R(*0Lrgσ8|V Œ~&ndz㕋^{קM["HD*Aڞq1Ps~/VֱVp8c#қDuB8K c2Zg'mJN:p8JWjNKp]Ha\S'x\r0 Մ΃$92$u4Bۢ~J{bfܬHGy0@ : V~4Du)I.s> pM8%Hj-sQ>kO)aa5@( Ơ"AK3| 5d/E5N$Ccp auJF]e>_ &?&pCނprZJԛyAXY}s+.0e!`{Z^6MLujsr,_cEINy4&ƂXA0]8͈֫(tAfR7(&-8 cͤKy8~f |aNw[| aQ=ʞYty<.UʺdFQL()b]'I uQ6(BY_ X(dKcv7|b/l&F`!92 > h(A<G3--Ihu h=n!Xpn}I;=Z"`D:@z ls\`C K&LW̹[IB?Gi[o|2N,cx\Ţ^/Ɣ yĎEU& Ju'ɚuŭ@C$EZiF)F"ɸ_KzuҌEf(M (et'G!Br v^K-6J~{5Ԙ1a@v,m-"S.a!ls@\x4t !U(? ]k)d8"1>2daMS@eM!ϸtU.ӽsR?,Yµ\:c `lD3E3gh@(+ʅ^8G=,.Tв>j,Vt .`x1MF-1^jߺ+LcGjq&Y8U3M,46ai.K07Y3B8$򒮐)2 !CsȬs믖+R3'Ls V 3e-\+ӰNr xpLf˩N'+C+8B53< p;եY{s@"׌Jʴ{r__A)wÚ])A]jc<z]BIےofWD1*;cz(kM/w1\~ +-\˚*(bBQFmgL5-=nI iijNAҾ|i"/i7,IT⚣-R ԙXHR4TWkov bW{[Yx~=+cA;kd/yZ iXt,[3!  aXYLBy\dhD-MdSh?q} zh^2fP{Ϋ9oWI:aD>o>kq 40{L -vi ͩ57}ǶYI"O)E%l1J@P(,3K3&;}/kb+l 5ӻ\M+g[u˝Yz$@Gl,[~J^9|J Lb8!W}1sL4mǑ]ctS Cľ(+8W-^R]4H[kP&Md׽ˡV Ldo|v34g צd; me:G>E9͘8%`bAL36 a(5@af8ڥ]4G{˂\N]ʅ-3H[2#h⨸Ȅ/9x5 qN ؔ] ִFG"w6Y€])_~eU,O h$P=C0yq>)YzBO;AS.i 6@w)˂fEzG&p}O Җ-g :LěZEԦu颳xt 50 iRӳFK_+)zP˺k>ޑ+?3iFa2##r&g0L-7W+3#'=<@f4ck0kb5@x/9qJekZoYu dP,(zAGV*47'&BBcE0)*8ȵ76.16(re\`!a8v0g摸ZptZnL/f S>cG(5Đ3<>`t}V]jtvd,/mn5hVT q3 V2ϭp͔B2F/ ڼAM2-4W[k4oo(CΊYZ޿|'ӻVe1V <4oR|zy%XB.AsÑv\ېۘlolS.pW捌1$=oP͞S`Geq5#DMMc@s80P"υ"=g~iLt+1PL+Zo(j$kfnֺJ>V2ND"< K0o_MD!/XˤR2ڑ_S+w4m&Xسv  TtP+w$4ܵAUUy+Ykm4ւ0ktw'/FsAtL|MJ/Gܗ|@r7#czUjg>$s°D&R\(\>DxR08]xGAѭyH~v-&kj੻:ǸU^lY *͟,AD,:[Υ0ؗ9 ئ3k)Cۇ&=cVDƃ 9>i?Z-LXMdz tYZk"ir6[ƝX9a9`tp$+RI ڏtX&OzALAn{Gi>O9I0r}QF:mE4(;Y4QIu2'nXfѳ4 ]AcԠ|KP$5+ŬzU{C BH=D򙔵Oih1-}P-̓b\pȭ)To2  A6ru>fv"RZY޸>84L&-AǗT&qBN!GݘXO4 s~"Y ]J&ko;mvʽB0%''e^c?ceAKd,PZ%L@BTKwP+M3YvкLU  I:Dyc]{z}OX>6!qd8%Rʹ @alLj4wOL\0Ԧ#W=ˮ <|??bku-4 ,ݶm<{ Hy`o^BĠ}ruOœ)J8P6O/wY1.5Λ=҆me&D%S 9@bӎag40:7lN=y)ӕ;;2A^/ CpNO`'a;Ս]l.(]os7[ a偳42zt4r2lHMq*PЊgiσqKVCm`vHV+5OЧK34 ׀oTj@!R3`]:@w6)$~Ofm*8l-y1{TLyra>laɱ&.%{94ȚBc"df 4gl~6fZs}4Gm<\J^ Ȣ98tP@<Xd r։^,KXzD_}ҵ^{z}OX>9 ?:µ9h nӫL7ېZfXϥpI#Vh6]@cVmTgEooXm  -"fODY\r vh 1gt!CH]>,]tHCRcXL<&%ڧ]p.ޝ7ޤHj4 4 BuR¸tS#jW@4zrIKYLQmrD\}21<)t ,ή E*J/pvS(o^JБfv/F(YZCNcLkP膼gzA3}@+Y U3K @D%&ioQl&Cj tM{RϸΕu߈ ?Hu*[ܣbr<ˋMt!T~UB&G.។Ioh1BmK y@J;y'ێd KG7"a~˫PXi x](FxrQO;[v7r|;{=yqG&/ja V[e86Ŭx# lKj_}B 1kF' ^d'39pt3YCdxk4cHMnC::q+6aF/RgL0rVDکtPP"{ů܍U`dRy0 stT$2x@Va´RƂJhPFL1ˇb:C.DK Z[+@@'3zZ'"00.i-`aOGP,2Pe-"oXE쫖mp>k-6#8! 2jp+(@Ѣ.̚NoJ)Ek{;oj1ƒU*gےa'KqylL^\qE,}m#Ok =?=5]`w ț,s c{s(+^\`0g#іVK[Z`"WI(bdstZƌ 䪖*py717nǽ/;&HLsyNdKBp+a"]]?Y L惆KY/[N '͞ZsOĸ-k}( b})rQձEQVPK,N#hxDz0C'�BUϪ__xE1`͒m4 daPfmjd5I#&&Bq Q>.<⯡.)_i*$0J]`5JmXU(U p#CX%A$":І' SZ-CP,*Xq|Agj 5wGZ6M(Nʣ9dx-0nA^̢&1.%_A(jt>fs"[袣ف'P9 ~4K:j+tdf zLі(Y]9}C(kf,-ȔmA8OqNH΅sSgG"2&׾VA__HKs5 俲Ц0+ZJƂ]K2).r1AEWUBg;G̼%rO.BxRMAg9[ֹD21(6KEܭ#ɓ(4oijLӝyNB~g ׫bRpLC u*s!Oee<|oy:$TOqaŽ(]CAg,#`_ROo(?MG=cvض4:TPs|  oo)N)넖8)5rLcw<0b3-4Ѫ$g2ly〣^gOwHǂaGc4!;4Ήn+>+ׅe <̥!%`~Q1P Ry23n*!V OjSj}bh qGkvSm9{hPĹe4 ڪE^Z,m9x'ʥլD"]3E^C9OH5;0Wiy?߶Q樱7sYtrΨ^PpmA!Ym/z*7/ AKHB pzIFC3&Q0vrgv `֨Gʹ6Yw {5efMe^ E4we8#Qkm UKL>:=Vtvh*"JmӋJ pU[Mma5aRK8EEACK E*z;nX̃'J g>#R >HB1zdC!ۇT^X/;:اAY# q"%ckٮR""3>(9hBaejb xffTؗ Q@+Wʝ5Jv*)g JeuW(jѽ& ϑ/7 )Gx-y {iehKEly cX:+ދt腒%M>CR~ݭ :nszW@|h#Zi4Re1jY'hܾ8_FU5 >hgQo,Zc2!#pny+[mDzw Ξ{lρp*xrztӳ ^rO}1dl{+Ow9@RV Y`T6B 4XFBM* +h{jFڣ@ >f׮O~)Aӆ.Wt%4 ZJV3ͅwkK[νŚA=RX +#FJ&s+1J  %H;4oL2bȅf*}Ǚ0jR(R@lDA$l󄊐&,} Bm=[[M@ZJ\~KUZ bֺD s.!Idߡ6!߼סc5ig(qEsEoF4:܄ o8}ϸ֔(d,4LíZe2.Bн(\sWwZHpyMT ʊ/k+eg֙J7iDS6aGRzΊ(PDأ-zn "gPMwa?M@;7ڈsyKP7,3/Ҷ9aZ TD 2{Bx@=ªAqd\v\ pݹFzCzmQYc+Qbo(P 0kKG3af\Ky,%Nz'wR.jT152J{|5YVM3d ¢"!aq?"o yWi[hX?# jDW~eS>N`ڣ s5"lwiFv%p(eC4% d|\#}5ͅ2}|.є)9Flp]ts JYD 퇿1Rh{޽2Mh2݅vqgVDTf Z4)F _ApatJΕr鉗f+ktWt `i!]LXafN?D >-JY,GqB(Y*Lnej\9,<8dРA3l(Xau G֩(kd]\ r7Xޅg\Xjx}[##*4 TjR4}X  E"t쌧F1u\Ecten4ßdzw٪GQNFaz)JTRRtzkI;##kX ;TVK kJ^BE<KIk8 $HoyٙɭDI-4DMPF9k:@%DqQ d]֠OWAI0==keToqĹcȩ0-G@<=3"tE9KAX,GsL*V0=b2RA[y-ꭍU(L](ma./7oyFlS s2DRJcg]Kצ@Oee1L@@ӹ0"-5xLCN,a>S܁}*8p8Zv}!`ыzAw{m׾=exn?ONY}r~ͷssˠL"(vW.}{9L~vZ43j-Jm\7ەXv 8t S߹L[k| ,#4P^f6n>Epz5P-ܢfm8w+<%ꉱp'lDK(hdGbA,e+&Å=GN.*V ]D]<:, m p`)hV)Z閐 (dDͮ%QقrRA mS[1MQNyQ?nf"0G=hV7㑞7p40\Ids;HR7@7얳0; >#t$Åg6If-U[K/O:„.Q^R( w jb-*@A%RZ},P0J $՗4rZ- O2&~smx&*K03B tlo5mSVѪ (f=ӢWy C[3!,Md7+X]ML˩RA9ij,99x_LsٔqHcyBUҪrY23\'2:3YhQwJ1??\ c/n]q[b+2 ÐdV՗l eP SyXu,L ŌK=XӠ=H) ;$!Rp@ n@覦(>( ,̥HM`U65}jqS蠐_z[fArAXΎYum3Jڤ7t7$.w b,\9cYͫ'N/5R[% TMcI~UNb!ێZ(5 .d܉y0U Lj#m@V%0H֩xsD& r 9ѭ)p~K!0"Ie&ʿ]pk8{ddKUT8 SqGϾ'1K3&<Ҍ"B&`j@:dANڌzu/]0 %w$;܀2뮆)qgSPOt V KU%y6-y.gQC pj1=T'Pp~Q߱/?J-;vŗ!M3*;\ Ϋֹ6KqsR9I ;׈"W7J^96mA=UX?P8d͜:E^ ;B@AEWI0 M[w8&K]ULܚjPI^[OtE",\ꈯg'/Z>tr 6_/hZS&_0,7y@ZC[6~<4lig;pic[*[> d 3E e_CohЭʶo[w.&hi%*]#j`b21ShP0,k LZ/ *jGpl֥qB8)p-Q2v{tڜL@zRah7Cc){҆SLZ@H;ԝ4)A[Ѷ(] |jY/`sR$r0( (+[ i0`BV*re_ ?M7*1p%Rj[yW)b*evYV5κ+iu\EZfWzM[ȸdM)Xg;۸-1D9aXƜoqG71jZ^3tyz6Ic\j m@fdbTja;jcE*nhj u+BX}kJpYK* uᾁxڸ:[ˇ * :ZdNU:[^ݳ^kRVb*S^ϥ;2\ @z)T/õȈ&;fBdj5F@c5 dV|2W䑷pIw(l* pf<t4E -;:*l z vҬVTxW!u/E@oE}U~܊ױ8h|Vt~K"KYtJaVPZjԃL2UƈZyI%Q3Ha̧<>GtI,VK9zʝSdu\cei $P(T50x:)37}A"QU0XNF޴2jO _e#f l*+hޱ7v @gB65Z9 `8J*5{*a㶜 J6E1Iei_\ z)MZڧKVW4&ѳwڀ+*䥑;S52DD/6 CU3 aV6hl#k\CZlٳUo0YKvf^(o:}O4Eґ:T@@DA5ڛf׼[нLvA{Wܮ{3Mo}k9^ 1sWih$A/P9OMGi<ħN0SvKx 7 ū~iTߦ0珶e jԹ .^ڤWݾվ6w~HmbahB^ZM}9R#&Nj@aYESj朂 'ĩ^KrK"m8jb}//3*dތ۸mI! +̀Z?f$ҋ(R${tJ X;$1̰%ڔp.ykE5S1FQ5%W,g%ŔQ[}d (Et#uymmf,!9[*zn&-7d7WtcN4 MAhfdm|5h?! 7"U~`ޓh֢.|TWKY2F2lTAUdRh%YZ2-yE$U HB2W̿Ή BL%u.+ ѐ]镔Nݱw i4PB?+"@ql۝W򣶊_oQoFuk(dHEer L M=o\ ^ih|5)綅uS4w&Q'eg#G\v`g.rN,Y5*6iBT_~8֨[AG$bۀm,W&Z ؂uذL &4"cgܫu=2E`R9If8 dI7cptbZ8KKK0TyN\nWxXC *ox<`&)REM7lliNA>ϸQkT|+p&$A dx$2ɉfM_6oTD!wY  C$Ao:!#ܠ5XAsƓbFn@,JnL3MZd>h{ movm!P • FJ,<2+ N HKSfl˺l\=n(%] &7\Š[* Q[v9wr4z>uL\vVs(T Az md,G,;O;R҅T$@sMEwcѸ bir1e3z"UapzJ)LL,!씠Gž:Nw01A`I4r֛[ў<=xP>恤N)耜2Yz^zXIH@=Sh Q3+dcPjYQ^)Ri9297 ΧYXym| 6@lVb5 yAU9M) 4&}CGT v[Uc٢@_WpOsa [NHaV )Ң  @.L:5PXf氄Jjv9s:fNs4Vao3[Y!d$|B'IՓha|#IɬC(gBO?09*C\{uA~0 $"!S+EVio;]dwabSŶY}i^/}ߞ+"́"(]L:~)DAL%-+B~뷅\ƱZ2EL.TWxrҧ۬z_(Β&CeBl:CyE.})=FN+_fQ^4,G2dA솜]J@q-SȌY\ DicTSax+ V -"?CopSv-7jVQHan~/zJ{@PS^HY2,\j{bhѣ,LἮ`_ Y.x2nIFM iYm/z"c#)] 2R oOvG s2WP-ooSʬ%JVCNv652F ] ը)bP.o`< MW\+b&H1T\%6@K~pfL*詭{vrsEESKl5F{6Z,<Us-ɺʛ!5tGI@]ɣּQt9E1%I;u#GZQ["ќx( K1VůWzԮ+cMe%d$ao`Ior#t*^ƿ_2Y+EG.8-ȧ'P6$1mޥm|(Vn 錔2Rdz-3lQsT=S(jgMP-ATW,2(/~ɖ@ğ" m07kU%0E.Í~agx2nk=EYE*҇X +Yׁ$ :)]N+^ /f3V"G/줱H*ַ%6964I0_z5WZa8rN).0]#Fx"=WQuEz?{any ȍ}t0j -(hQ]U wfIGA񕏀ڥGd pPݎ¶tIC#N)Pdr,1@#(X۫h5Q[X9z(o]@5րh{)fېiZ1§H뀩2Ш#QԊFd1|4"F 5Žg_gUT{ CBOhU\Wu%K_??9`7FR(JRmi7U[ȌkD&brQx8%W c+>ⶖ_ҵ@]o᳖߃)eF$ MX9ydxf>(I ljËeJٷ(:A нɵJ<Bn*h"-([WE6 D..o'(fNTAnOi029Ylkf_7k1l(|rR)b !\x\f{!݄2u2~J wJmvdDyƜʺ7mb^Ba<K.p֕kmUlGoo;UM> Q'%+sJ7!ء-tRqq965VyĆs&ʥ&Mx?jh/yK˿˨|+KWU*p>EWn&s:._B 'c-a>Vm8)_ Sr:; [Ҏ%}~0?i3w O0',n>e{ί}kfٝ=j^#QVB6I<:~Q/ao<3Y*$qZ!֊|%'I5̗E6)LԼyX!tWT='(p&R~2j5U|:#aM])ֺuFZ6p]+-юT npNWe$o|[@4.h"BIj(5},᱁2]j2%ceo&4@41f& PTӓ%=)xI5aMb8fb;JZ 5ʧr{WZGj5=2蠼2yr\Oݢ0][mk_9TlܰȈl5 yk,: eGrwVo欴JC& 86)2)ԶkrL*ģ_Vϛ)tFu!Fz'^uѾ lX!sL@Um@ |ӛdƗGH߶}'q)ghR͓AZYR!%6&))bvp g?Y\ ߏzBJmxn@_ wœ(ӄmHO7AZybP\X1V_!JY sv.4Wn2ԧX0L{J3S.u-LLY1T!TWE1U%B>iS:. *xEP_H>##֢ZJvd SY"e=*^^k9kHќV._UTk#,"W̳i} N:O=0,ŸHtr</5-{S+%#݇C5)M$l3 Y]Hb`ZRB~N+?s0 &(ZzQ. ȷ$/6F7`s%ܲ>?Ժ!l֐W;d>hQ/>_%sǑH]a,J_?x$f}B! h`I?t)Dȝ{&s'|k.e!+125=a.CSlIbP""rQ5GV:+uh(C򵈌&Eq3 0h:_@n^-S_`?LTQXBP5)PrzR:\+Ơ@IBCF63B @٤m,0qNy_W߳x$@hiܔz4lS^*cL=D+">1MZc-s(@zС9/~kE!Ӈ zGJ3м#>b2AG2kzEw-oc[lV-ONb+%o኶R.[x:+дѣh!6γ*0o!iynPFۍǣ m5:+eI|L̤-R%t[&X"H\@^bɡ!}$*2#&1-@p̑@cmn2>ORGU][M9)QVν©( qZ7LuͦFY> 3&~(FPN>W0ak+&QhH'Ru'GisBLW&Kh{827ML!*z-1`!ٔMWCR[;E\㇢#3r!;Pa!eE*v*MS06Ѳb [>2alRHg}U8z_L{ * \CP\:6CCe)%aPpPAרi] oo\߽J&ńydȊl{+BOb*'2') CJ)݃It.u2r9M\vezI$ ybXVjk~`g=]HJ>'x9zR^ذ%,p.>3=0= ,DN]ƲfuL98, wffDb[@~IdncGQI(靄h^:9Q qH'6qfcԶ2I+ɥS׼5to.;gd/Cm0y bBh᯺+5DݥR,iƌ6(q/  jRbFD$<<* Y~s.0.mSf+iXh!I:"o/xU87XBX1d;Ytpȿۣ[J[K0! Lw8f)SA>l{T_x)=ex2d2S5VH 90izd"/-I]^kjP^XAz-7Q@U{072*jn'Ea1fM1?Ku+hbN6WRt\q5W_Z7"EQl ,ș'a2"ݶ+FHlXHze+VZ$̕DUӄmVMO: U~C.mgcrL{ ͿgBXA9jޡP껾񂱣zlE~ԃj)"H7%CEzX!rLH:RXΣ_WК4p}wFt.y ]oV*/d-ӸaVnUʯ[ ) FF5H ?<̢\JƔƂ^W\vI P>Kߞ:mtJG(R4ǝvvxs(fg+H=d\5"-iBٝ 5IyljzK!zh6&"sީmi@G$[pAxCJJ̱nS+Gć)lXT-Y-M^Ҙ-G>cbxt!  0om8kM+UIb !~KΦϠB~L+ somRԺ e[-jאFG"j=ub\ !B{GF|darT$A} 0(UTRvڪc]i>QB& 2_'/@yt0GA4S=MR8"E@؍& PŎ)Al2׿ b}-*l`BɿS:r$4\C4Z.4:y1*cL (C"d"v ˘VP7Ǣ??O N'd{BTWa"ufhB@w8k[VJ ilUg~=G{lYW+fmb-sP>( ρgUw tt#{aSL{uDҰ+cM$Gh)pȑ\Ď⶧-V+:-4M +ç }& Eg9hKf4̘n f#[Ih$WXg X(3`#~&rB0)9C7Oj39}؝9C0Lm(]ҢL|(S Tc3T5杊բZ+iڒ_8W~KԘŨFAL ?h(PĄEH~%{Mۺc&Ҵ-K{ #\'I} d4ȣw*TeN)S*X"]rJ&իnB#Q="P8a cӢH@U7yoL]Q}h}s%Wm]}J SoKzo(үk:.Hz]EHHJ1PJ)KFŞwkqa %: ćqLk̗.`e|.*}*,S&hBC=V #$1lY$o~YVt=1S'ׄW0U@4aUEfZ3 QdZ{?h(TCi"ŇR~u<2E;Y9~#vtL!s"5hzsY-g8nz@GAy`oG[>57ȒLQYDd!2:,3Qhwl0Z7/t 4LgSnL8y4VAIu}~~Jj\0jlAr"EdU2=5xY})@}zX.OP8XQC0A(lߣnDێ /v8NC.B\ ybu[͙k+GelXF8H7F7 l|Nn0O(df^1ځ|y #VZ +`[7nd%8CD@%M. #c&"DOH.#kNyoᬛ4MTIfϡI< Q8GHj &b m1|q }%1z-'1xA Ά?B'xu9B\SsK]lTQAqOLFPVұ\者)gqٲJLٌ!NBCVʣ']iVx*TWQ1\ʐM 3ƵKddYi bKVcYʙ4?5%W#D!*b+CB)D^ʤ|LJJ*>)&piRE5j1R$f :Z`MxrF h^uBZj[5%6%X)EUڃgpkпgZ,,@2-ЊKg2 C̓Dua*2T̲EЗOJPiڒca=MŠNTCɕ {yݩޅ^2́D0h a smSfGdi|*{ĮY̘-N.{+]uk4,j[4'%&B_e`;uwA+lݰQ{[k%ilCVr deF E7iDLN{!%՞Wc4dWbzMz6̓oN>eA>' ~~͆D}(TQyx|/M -YYº5__?*Ĉt9M=m7y(Qs0j-/GIˡ!c'L^5?P:2 ֵ _f/2X91=bO@dݵ.? gJUzG4oB-@3PZ]9F`!a X4jlANX1,?JO&U}xǫ=ej1:G75חLai8'S,f]0H#4c77KJj3+:ORI+dBqoWpdFېWAmfG+en`Z;Y.LPL?߇ tT' at;3' [`79|lG3PS A>ڻ oZ(,?]kz [P49:D 苬yޚ+$1;tT4p tf]DkWΨGsW-vCnZ0j4WMGza C#Q\|i`=p$sqrH.>= , I^)\WD̴rPUW[<98pVKU9a+/]"@V|;e@D7:r#l5k"VSRjQqVt?nGQ禆N2򳟌' |VyCP]NndTQ[E(KJ=v><9̋pT&BG ZSI5Z~:n33]xL?od AH\<3h0#H&*M[IS:!2f{_T)fz1'l|&M:̠B@..GIm4|S];~$[%-K?ХI_uŴ eH1=` + @9DK:qM&VJ{1i2f6R__ЮnCM[&7 t_ЪrVʤS3㩨L1S*l>22 dEy hcL "|̙sG)_F +y 6O[OJ]Υ9AГdT^ d-t]\o$4jMèKFQn`ʃlCx|Sf\[A^K+`>䩙i'i ܌-,c(/twX֒[wh5$5$oe3\/5C<& j7PA64@.sŝMU#ۨ׵:@ss=k8_]#m[7 2+MVFC/na۠ӎ8TKIDAT98ӖI̗ަгJHk~p!DtА*AtvU8J Dg}O,67Mܰ/VKUP-0FMyp+B0@));j@P&Zm2sżr/Ȋ0d*b;Za+|RҸ4"VaQ ³! C*:ҚHnXP0s=];Hkna9-ns^r ̠LOO2g95'Nwz3=93JB^=ٱuc5oU@#rW8g ]®&Iatakzn!e|/`AWP~7]KX0ijآ7dB+6axr\ih4$et_ɗ2յ֋22{Ss-2BX>)EF[M` i%^:4 ަz.LSq^-q[AwCrGd~FL iexn¡szz0L|. .F^rLCX+9j TXԕV-ik9h5n,ЭF|&c|qNj&imqחv DRyied"~e!U Ny  +HBFҚ %toA&A>׿ịlAC2EǷadId+"'WCS2Oa2'|(% ()}A"R&C@% kCm!LC4-uoV䡹m@QI` )I=UA\{Na>*2D-&'m8$ xYW2tW/EqLwLݬ1GCsu!;UDNFYnWQ~Y=r ӻf|iUN/onMsRt1;hv,@_NfnUK"I[%I&Q,HtzE1xK z:;FrQ3V%g "F&l`%DGH7hVG)IU&]7ۀ#Gb³9F~ '"4!O+RV= ҅b>,Z}T#>1xfZul& [y- R#f[׋u٘hzTg5 "Z1w7npGfs`XeBcKC^V,Ǫ $dϜ;tv#[Pxi Zp+mQ b,ڨ tvR:/%2[2ɇ2ԡZF*`vrPftbFRk iA[l.i)Gt̼X#[AIy؂b*ߍXLqsr܃(THyˆ )"& : :hJ$ It҆G9kCdɿD[1Pz'O.L@apLB_*M'xi,-,M|߸fO"\!fےɅBaZ)&us55Pg{Vy+=en϶E7:K#m_F Fq`??s9:.>i IxǶdqQ!S zW76 5O&K+OFhNf _pEI*ӭK.S,ؔ) YH#*aB$"#,sM(0[-ĀX e @( hG:7"ha-x(2lr+87A&gĀM! gP ,-j&Dݶ7[5њd(y(-jS2)0-JTq#TPRO X_m`OߔhNstbRE 88eTiG4 )|Us;S %] DxI&M¼0͍`QAIǯWn HFu" C^_R-ٸӵ m)q|{7M }&]"ж:b5@k^x`ȑJ;F9b Fe]48/Z봚SwKLqi6TL^i-hyQQL <<-sF[ 6*R Kr+I::Ao~%$`&&0.WQ 9Q]>DQ/#˸>Q*aQEfM8T7d`AVbQ [ǖ9^s˿RhN*Ju߰< ^Ιy1d0bPL@[^[TpSBB0|ǒw5/`@`+Y/ 6k3M )FJB(A%Nuo.Voڔnȯ y"1WQ[LQd,J.CدpnuY{x{"Hm ~g ~QC]Ԁ?>GVZ59n0jR8Ϳit>}BI @x–Ԗ@MXˇNisg*1ALEА͑!z})BiSM9ciXz@b.D@1X6JٗWP7YE A*_Y@i3'z~N;j< } SPOt fɼtñ,?')J{18⥹l96%/<1%yeSF O4bo* 䚫qQ؄kd2rKp@4vOO7o;f3." ]~=_̧, E SnA bRȠxk^g%e$rsfhKͱ]Seb(K^Hb4"ǪP{T0O}KRVΌ&29Yml-1b.WIid4^,ammk鐧ÜnŜV& o ~!Hw~Lgh_Q, )$(ڶ&K,Y ]h&$N+:>)T% {AIUE-ixe 7LD|tI;_Q TP hEBsjA'EQ3T8%Hf]ҝ}ci\ 8뾞ϲ ݺ0{_`o>K}j'Z:MAa-V}N%C]֮e [ʐ/R/R@YŌL.43 Fh9Z[ niP  T|.^Z{ds6K#~|=joۂsJS`# erZr uA5!)Wouf{Fάƻu$ Dk7f$Do04SQF}NM-즭]fWp&@1B%Q*-VQPSNC^!1$4慷dBpqTbE&,jhYiv!@G(HjZ-hRԝ.4 ft 2~l,9VԈ&A4AW[p.dA +,DSА?YԹ*po(Q ĔDŠIt8AvjYW[ C# )S^E rtPjZ:73jkcӫت[G!|St:DY++aS3WښEYԤ놁zAT{la=̉?>hکDɾS%iA S^EY9 ClA|+޶a*| ׸k[%yGnCM[.be]밟̓Kyizr%vuoAf 0HxRgcD1 ( R$f2YMڿ- fG>#eIqv@Huш˱jb,˷f <')CTbE266 =F@qxKbzRCPDr2@4@PVF3T Wq/eP޴je%/ykBt&`S?"D<<>- |_5D}yd (vFEODZQE9"zuHM` B25EŢ8YJk_h8hˡ[x|7z3`~"2K@Lld"F*ܒ[;9К.čtM< .эcu9r]ZeV`~.Ҥ3EO󐰓>5sps!gǁ,lfm9;l^ݏKCG`D@9dHtؚ V!Lgnr G&J̓'g!w+66^/OUa['jz+_sgӻ:vϳ0IYoכ Z-I1,$W{[ Шt<ڶWJ栧ef(VDVȉ[OI|z3%blp3nb o% @gCGa-_t:&ƫzQxdZ)sdѮ-Dt x uǠx 2y皳Σ^&2:OL,kf;_V2|]30Ij)?snc# z+B_XI9//}tՖ&GI\Z;Mf ~#֭0uB_ElAAfO CyJMvEŠUxýWeq˻K 8>1uN:(W&߂lp.Z`(pShbJehrMni\r<7iv 'CJ܅1IǤ_OfTaB1qRF4)OH\xw|:.\|2PJj+Mbl's[AΒDlTWu}$QRT5HgLnw̥ऄ ~! ^љX]K=U9( P>ȸ]uյ^ |_TS OGrzĈ?hmA4wphPP 0YmR()mZm=OBvh)L5/1V ,pp[(i4&8o1 y qQy#M{UU0 ţIC eT2ńuVD"e:Q$eHm˴+^m;v)nc _j~|s; SP 1,v,%-ae̒Gh 6Af8:B%oAE>)o~3B3ı[ۼ D.7[EDH'b%'Bgi+Ɛ60?Oi\DZ$ $6&=$جK 2)Z-22T ޿>b<o#W¨vI͟6iEGNKYf(= t~OnbJ#)y~M ܗlgIѠXp]C4DxOAy]ºbq}\߉GjϤ>9|#(!MkQ 8#k@=R@:߿f1F`-h!?W-N|Pou `zJy\LamTXTm +D㜂DhbVf'dž, D@:)p|xgV& R 6U:o2|$YCI2 SlL3Y .72Tϱ6Uϰ d#QƘriYvM.y9S(]_#P&ʛ|[ÿ\GILj: vu报72k~B膤8݂7L:Mi٢k"Df2$ͤ9B\ {EgւL(v +O}o;i@ Ǹ̶S@C+˵eqӵ ":¨d@ZҾfk1CT"ӆ[L2Sڜ9-R]v6R lДaѴx˻ قL]dcRhǿ25ƔK2 ^؅r8AevF`3m"I>A]LBnL_ B L™m&MXԶaj&r E PVXMn>1DBI;/ȥ h(-ץZ QPG$M.8P¿lLU0C; _e@]֖Wf7Eauto,[yjU_24,ab+ Lsë4Y<Cɜ9Y:mĿJf=_2lۥ[P n ZlHŦSΦNPګxT3%; BP6f \wH;///*wۍЋ-%wZUQ=a`no^o[n:3d*?)\ӝL<QR4 PRRab)Hs؉+6Ԗwyz?<:dㅘ$opk~1bTPʘ6fdu21قc I/GUZD<ьk#޲" 1!%o9diOqb)Jߚkv]~{ԒV&FB]s<尚0Z-d)Ũn U< ,(״A==D9+JkMqXg;\V~K ji I* .d%b3%x:j#O4"i 1z@6ҩbſYIG8>׃-d@*3bFt=ӪV In\L:oCUZuF*M@XG>+2d\4\76#⥝|T  4*AmOK ڍJI@B\VdA+`]fǷ@6еn7yĐ2GNp˪W_VST-mZ I$a2{.m_)B9Ç:0`h#!X)9?E2 Wj ,z}4Q9)G^wH lI&ZQS[ӷ7mKrzے5<[nᖜzPLЙکۤJf`V/|FU ;Z,G.yn>k>[߃y 444)!1jRL+*Y3eWU(&PE:'%%0@8FہUC_ YctjJ{GkVȲ471hhu_0ܒB3`B8ʱ"nW{Gq dm--t ! )IIc>[: AqB㑚1(J H (^NEC7Hdxm@@1~ @ Rb:R8E|*K"hLACy@/komΞXsŘ:d=%67\hl˜u);CrJ֐’?Iwr߯#͛%TH<]#Ūրy !lkOciҼuHAvx%Uw~f%Sӂ^iRxթS]"EkuYCr%}"X>W/u=}ozZ0SZ'8&k9|SIڢGv42NEk%X/5T*H)¹~ B) ~ʀ- ۜp L)G١b\b淄a9"Ǚ/ϓG3\RÂL ᆀ-@!B^K6FX M:hЃLāzGN[JGxENz% 94'Qae @Cؿ-4UMC(Z >GX 9~1JeyZEqZ6VYDaa@t-K%{E企Ybyk\ƨA)9D4# m -ڐ%/hMqnbzo S!`4m49.6][Iq+V4%{2#OI̴6YTQѣ:+ 8L͠i($$M+U,'ԿE F؂ >SLO:˲ kC" ӺŒŲk%g(-*\ htO Z#O)J3 3B,MT]ѯ⋩mfI6F3t$%[z&4U=ꖣhogxNpȘ`\0W0N=+=ʓ}ÕK m}) wjZC23l♥r΅Y?%P4O ~ 0FҤU1IGmt!"/\pt A;*=gFyÄڝ=%$|D"/,k F+)o3bSEb9i19"ZN/LbЖql'6MGpNgRMorTeBh(SRu4st͛ YN%zB@-HV-BL öd%P ~rGڀGvZz1\QCS<,pڿ Te`lRުijmYC ;2q0k%N(  eb^"Zﴮ\[17hq O/ =@ќD;Ѡ#*ʇ^QPuv'=z^.B>M[, ڐe lgyrIH&M漉_1C1]~P*=jq:сRQ.v0E"ca5 @}^ҶApU*F:PpiC4&Pp**X9ԩx %;S{ O;vmd{-cH7[v6S<|vN!x1 @u˯hiRH_Z)"c#`͠LwJC m˪FA4ҵZ+Epa퐍? +b|it֜.qZl奠ڳywYqpZYIYӉR761jkkugmEӞzWDL6 g[jXƵiQ s5MUl7=@Њ~[4{=-;Yb70߅.Ֆ$loED_T\1+ӎzBfd {x`VkiII _ 8>0[򝈴8M<.0&TKvE[# CU.rRQK Rhο Aa{$DU=7jrZ7%tXϺ7Mj#SIbX"*;jeyk!0O_-0ՔֳWD[ME_!~uMӿb d5?ZMm33XtL(Wvt6364)Kյp m$BVTPzVmR cL1E,m{r0"bZ!$y2qU&Hq,`SWsD f$o:Iǫ+Wt;1ѪwOenFl= a+U[-{2k>V%&>D Jgj]Vxv2w[.b5 3^Y%JՄj=&+90r2QsPZUBT/R+:l|*Q7JlO5D*mBp.u-Ҭ-Wzs59(=D'#"F~ÚI)^'#ZزDJRIymSKBպ#( NP৊d=sP It'09}x)w^u& J)ڔ8}xi)-RnznATLy=^.xf_|**yj_ 怴lG38P+ը*- =1+6:ȴd}0X7+;uζ %sgVo9x5yHI]R׍vp&k*jNɂW{`j[Z,MZ͵ך(cv )ކ_ޒaP`~ ;ECι>NHͷU"tڤGz+]%ڊ܊c"E-j4, ۗC=TnwxoaȂaN2D0!:$ʐ-LGB.+ߊD

4/ ĢmbhQEQoQ__LAb@gi2AeEwJdFUcV7dx3hwxIBʊ)S ~}A m ǜ*ek+-!Au] c9Ba3M;a03̃G|er®ÖguB3m;YU|,"M\${ɴlX4=_Nj \_Є,G2₤5u9Ϡ}L61_T"rZ[bl?F3RΟbpZ-}!>)聀!+تaYz-.#I75qK)KPQEmp5x:hs\Xgz k"?L]55Ҁ4AWc h+8ۖHU$pn!Wa9s-™.һnZ `-FPC!c([l̖.,vkjz !(/-0=Y*pioP" |0}y:Kn#>9vs0-.? ls-{k/F8}*>>X@IwTlG´~plػvu-o#`;i:0:z]gaPR40bƦًcce~H 4ښ0~Ɉq^ bGR3)!0񨉊  )!o|+[ŲM'hh@_#dY׽ TZ AMj MBӻ YʀLLʸC#v%Ų&ZV3ZxToEx'ԌQ.(e "Bvhhح׸)d-oc<$8Ks;>Ij +h~-a(^+sz2Za nnc|nrswE;Ӹi5~sDK&Hs"Qb oUmQx[imP&#r 8*k δӃt!$Np!hjZmy ф 6\Nۅ(4#nijVOUGXwpS-B;KKs5uqI}Sw_\QqTftP WY!* =@:P >]!i)oMHi޷ e* 0.[aWTP<]6z7f0[1 08r*Zmͽ-*歊ԔTYmMmirܑ+Vf3}?]&r Ih:ur-7KQ6$ZQ *uTu+bV&U;ejU 1)Xh GQWƼ倢?Ⳅޮ寥Vk MiI.iEӢ[]/>`u@OR6% '$y_X~:GX zJj}u,xaIa)1mv鵒N#>UTӭaZ7_ǂf=mkh3dQyO.c3|@:ޘh^>sĨiP*zz,]T290G^Tҫ6jfD2a\25*gTo"p~! d{ыLXjv?Uű7rXD¬]s; )$jew.Ad9aڕIӬrt2o3 Rw5r/쓪S^hB~jX51kɐ?6k薕]A鄠G2O bӌ#´JQo%R9m'< 5>iM 2/~Z2SRdP0x]AK5Ω5FFJCs|E.̶SY*Ӗu+PNZ!DO_i ԓFH!~YA1[O*p7Ni޲8ramGp^m*k7hX*A]vj X:!M5fuFX=@릙1:eTTg̢}Yk#z&J2.c]|J+Mz@Z)UWoE^|֞oPdAbOݵ V4Ex$ [YAb |Tlǁ26{Bj*oU{H,o4mѬu %a#K1:C O%~63?3\13%C,ܦt219#W XYöGyifG-)ւBR~I􊸜4++ZMh.uNQFޏT.#SA,W}$۱S]E|R4yW|U]1V4VЦQQ]Gm;1ZZPL- c6x4SCb<a6gt&15Nd[@!Qb Zl|9՝uHjAOAe,=M@ L4q(0 6mӑ3j+puDGeUK.Sy (IX3SbtmPVdhoCT{[)|u ս{3TVs``څFC3fޭ!;~l)x5h\,Sq!O2 U:`m;jΧf4G/VSO񈕽 1ckLumHi, e1cBHP6vx%:[qIu XTJ:dgsh=#? W 1Ip}*lټߩnCn1Al,AK=;D*C)".)04 h%[[`,xϮ=}gҠ i lMDh~E@CWj­d|OρYP8??ǓFB:8)T\(vr43_:0_jR4]weT:v$h N3=@쓲A]TʡteX(Q]:C M4k( -G1LJ7ankit܉AI0HáC%9Z F(8J.AD~6Ym.=>iՋXv"!D쭰bSTjC,SZb]1ņA% g1&(rwc\7K؞c&O!Kw~9 sm* Y|Oq&ųԊaEdc4\1 $5?@ﭩBgH]Q#}qL9L [ #ѝU]p ]0IY fy0pܳ^B3%}du{?oxtP,Ƿ['d}'ʕ'8,A@Z)]pHO4>mklv'\8o+ho 2vK+Kxy:7lm@]V%-XXAf,j 5͜iȮ bAHg2}2Yx#ӡl,XiN[B6:MF4)`3옓y*Ddnv ()&2Y6*m|WT6q2Q;r & TQ C\d=--#)a3#IH;WB1sZƔhY[& JgK1 (sƬVc'Ě_+ꅽT25ðʹo3ĺF!!ˏ+NL/`$#K׿N3Zq]e>;ie0,NMIȠW`#h VѼ1m=  G9MdC@̈́yTC8_^TÙa IJ uii< fH V:i!`D 2wD(1ҵA dR T's 2P Fp2>Hl͗h4a ÓVf2vř35zg__"g V {ʯeE@Tf~,|\eb4ǚl$^pUWLʁ)Bމ^=hpĐ~[nvյ>ʝ MEѡ[PeٸJ(ŀaS2wp{~g%tIDIA}R$Cr,EVأ*i7KBG:62;tu3Aai.jVGX͂-G](_9 C$N-B5g9wpXe>[>V$5ֽ{?>s)[F=\쩋)LvPXD[9HW'j~XcPIx@l8QOL|Aū& DmVZOO~]3g Y/jSV+=!4I6&έϚ?fJM\ڙI[ɠ! O8 .ChnuPEЖsZZ '%97% -εŔS K^͎9.>kLѥ}\16+}րsVp@ upS&-Id:#nCez 8P-7tR;}7Dqmcu51)NjU)pZ -;Uk5e4ʴ&X`M{Zānv,GcPKt*Dsc(j@{ґY*Zl۱#ȴ 71h&ĭ:}^ʡ/B΂dqx[g/;WhفXyx[|UZso U,*C+I*6 Y4 hk7H-N 1|ItQ.T5,?"۩4%30q~2s1Fs,\unjob4qRC^a|t e7MBVK}mCܑ0iz§]*ЧZU7$7GM`qtF"?ޕߞs7[&gnt|V\۫Uz۫ q^+NU[a`Rqyc @ %M/~?}`lQOhzP-74nUj0rK:r{ARQmc@[EnN ! @Q%M%q)^Ah;UDmARc)+T^p96h|ҖX[ylk.QD5(B.Gd(0F'89T5[Ƈ tv0Y88Z.jFe cpFcs0(3x8:>8mQAH<`>2 {S E=JN*3i5‘7e2bX }*&pS \&__>y#  JoB`f KއՃ"zi,SIXYKU J]Ξb 6"ԦM`DyARNAP- E:|DRU%ZI*NX< 5 P IXӝX(/It#hUdVv UKg,q @uNm5bW] /~.tL/I`6Ji<V˱՛4D&tIZT3 P_kmk)+-6n`;S_:X+@iL=)+E5*P@{@0`.D!'yvL|nvމ^7jy+0j. ǨP 0 dt0份-8HxF@~uNUlZfO=~~tƃȅC X shϭn}D<ҙL7ZQзEfa0k7xV}TK!vtS¤)— R+eOXK(@@aN7 Tnk} N vU = X 56eIͭ5?04XDL #m;bZBGfEε2&'?V[i! 2+3; 姏-jkc `XDIi@KsJY/> oLT{ýǛՠ+¥]l$_Z+d_iVy]*;!|?N"WKCp5p nl`+hP3zP(I_Z)bM v@0jt$Buvb 5R5ER?-RNKZ+"pyްZdB@.4Cns%: "SN)BJS,57 IkO3DФ+*ر=E`,9X鈉:uo>\xCDen@ P+;Lpi`ｕ6d\;v{czo' ޲㔳kF⺤9fXN&.}&Yk"Y2H; /@nA&V,[|(E oS`MRNR3TBVTQ F+9aR[m^RZ4_Z?m6?[tg~ޏEi]3V@u)P˰REtwz-TѳF=zvXZG"5UT~뷢p[Qv)ͅjGt0Uw'37Ws]WlV ocϝEʫL[jfέuunuc|_kcƖR>>_GG[Hek^Yi-$_[czR%[b4'w&8yB 1mI<IعԒ[ҊtB|rʿmdKLLݷ G]Ι]+!ٗHU_[ߢFX[}߂Ca2DHg 9:a"myU(">?ޑ_U(bB mw, rRX"&k՚%UD] iNkۂBbnh:RTjYo*j%K7k/:-nGx(3^tWo_I (́b rR%I'6^,¸uZ>^+Oǖ#9{\Q=/ G k)Jd[v#ӸY7[DKwܓ#1VBN@u[ja+.ڇ>!?aEKywy4$0fV{ oY)j*!*@(I Ht^H:@۸R3*IbTN䍝 f:\⶛Lsş9U&*vf7ˏ+`"*9@S^)lm99:D6rykZCHUo$T,ά*jȯ0҆p+o}q㤖t2s:S=iRPA1RעH@(b(IdX`WAZ%i39("X(4X p9%G!pDž)::cJg3f!oY%Hyʻ/P0Emu BbS p2!K1XV\$2@ڂt9P1Jୁ z %vL˵;:_@QF=Ǿ_u&n󴩞nS/5Dwe9/Y3H^YuhLٽft{ @Nw~0m'D5Z/.^#MS|g-ڷLjQvJ]N3:?ӓyAߌKѼFtlB8VV>}4Ǯ-(  ;WmY!覭[ [\W];uRocW!YVʼEռ^BR"mRXI*JZm{E -)llExRu.>SSջ!m|ZJ(DJhgXSS78TA˽'ӻXhn_]'?P$$z*ʿ/D r4]F %8@OqLWtU& xMҋ9"Jr U*]aBie@ݙE~/9'nj %!G@ȯ 5U 9H՝x=kwkחN# hNOiT-Nu6Ϭk"./5#]eQ̿SN.c9?g><IK\]*ۃ+b;n-\Ŏ9; pYhzGDIuP:v@sXv1U=@ڴhfܨҎtͅNvıiR/r鳇;F{qτHi5eޛZ4k2#lR2囫S Rz 8fԪzӑI i@@73ӻY=ĨpO5WuSqgvUO@hXG6)#@*J֧5]Y!6fAe Jj]T_p'`;{qY[oS|CqnFIaҦk:+}=å=Gvz{׿X7Ld{ D[AZ*b ҾJ6 PEZȭ9Or 2m0@3FRKp۠>&,GF(ZNyp~$̌&d2L_9rK=tm :ry$֫TP@rU$#hna3ˑwwv"I~nDd>0WWHȱlgO_εs0Qu) nm}ȯJfkiZi[vs 6$X;Ot#u8h U>9Amk/m$&Bpr|h>jZeIGC*ք}kӐk`Dž$KIq}i bݮ6?îwV7O4 ^aݸ~}so5T6!qe)([b"!:gX<~ArP/!AZlwŷKoڢsvO|k@1mza(w[alEff)p<)_u0ulVZD԰bY 3ѳ,kF#,dnc_-;Y=\p5_N/2p/z[\鿖{_1=ʫi\ֹyisoՍ>ޯ.UoNEorqJ$mA^&s6}{z:("#)$I%`ef&Ré=7Gt}#CwL`8g(iVdfS} ?+0e飇6u喜|hR>w&M=dDj05f!} L( lA/uK\rTzw])̱s̭2x1ƣfB*!kW~o9(Hdr]-4 枦QHْR 8Z+, JW2Rƭe _M?CeY0 Jҝ/}K]LXQ}P&$N m1tjzտŇ{{Tj4ʂ%$2#CyHMw`Be(f]_G:1,"cZ1QG EGh\&f{^H#а`xxU<շCQo]F5 wW*a3WΠ[Ag#)%JL4Ԅl7Ä < rkdvs6P`g=؄7>4.%8|XS<-/{z4YL@47%XKbbM\uG:Xcvq+a$h*v#%kBɫi7]b]O?Z 2S2~S=LkPMinr-9m  n-#doIAH{L-RO\iNp V炊C^ S=J{J|'pŨImA>1dQVJ6ƥ5H*(|b %B$/G0иTXh6M&\LiXУ'Ujbf&")?/gStHP~U*mh\L|i[Fy ^+:u'+Ⱥ ɢA>]@ [Z+=W[|P{yeө0vAP<"Ojeק]֐w*`c# *<'-rCjP۴oQ4k=)3)OQ5KC>IhO jkEɌSeJNwm ڍ-M׊ZzR#=QPҷk.hѫbUMz\TvR oxc§h⨌8d**O]0XPE65Ыz4bҲQ˜gT#VΑ-NǰN89R).lPl6i!jVReLo/"tۥ51eG^0/RQ|¼($d|tMOʡߘPF}~qf<ΤnBy$~G] FObc7.wmVJǖ C[,˭r_<~'PdfCRN9œ16TX]>SQL'9YIGI:tC[Id>:[! 9 uT̽6ŽaL6[pq+3%zM*gĐkcۃT{Hy.q=pc. c{X'YnrJ^i#Sʜr1L6y$& #&tUJ/~lD-Z5GÓk힃Ὥ2[m(\zHcr4',\S}?d0p`24卹Ā[ Ab[}j<4PpRFeZCi;SCPXF7 t_Q}@6StӣH'cŰVju2P^qC`u$ĔQRȃYd}3y{ T* {W\ +Mh:V a/~~Y;(ڥ m^a[/?xʺ3 v7s!Β>c6uLVLr夒G j2ؤ\ A193hT 4TӺif*&^ зykC/ۙ*S%j;%W@>w`m!(@_ ?2I>.7+%F(d1f5BX q8x<<ΪbC&<}@G$Hpp2,@&숡mv* n K% K̂ YWQ3ѭH?e<}~TfH/fD(íb$+M& Ն/^B[1u ˔L3߇ʭh9U^:g8'J^z!q%5 +=1&I"|"1RS溨 oANmͥʆk̃ ا!&/ T_\X#b.wbQ@0u;-NZq B{c3:(p0,}R^D=g eU,P=/NL z"<Atg9Q D eT5ќCD"u55Ɣ?H^y^cHfP''AeeCvs'~V8kco߂yl[<׻ݵpAŃQ`Y(k[[Ul[1+ںnnL6hkZ,Ly |&l VԥLغKa(&\1광h'@as2,W5"dn#>Ğ^5 Mβv-آZbr.+>bo<_;]zK*$r@ݦ̪aŚ2&=W[}sB>aByu\+W,nJ-~^YD籱O иYP G[x;ڻEEMH|r1(Y bŚN+Db_I-^*> ϭ1vZee) k< ~, |dmXhA4 O7O8倀4tܨU1H.@Kݨ"Q°(`Sb:#y=3ݞeΏaF vB&a감蓙Fq8R28kU{D-N&Jee_W/|ppV2I錀Ӫ0nTVFox_|Kmukqh@IeT~:ˈq#( \;q \N=m[k]dvZgla#-N+y>Y8emx.b榌~15pQ>k_M0%at0仪[&G>DŽ!G =MsUX.p7JDehlcJAh\d}$a;a<0y~36GxJ )Hs5c^e}kXϸ.ZU[j73O"55xhpW^wUvJ_lizyk=TM-*'ՓמuO:g DQEn^pie@vzz;Efa'%a*0qyb贷T-%.vE5tU #؊]ʬO𴕩:۲k)/чKWPJh@A)mvtOc{C냂;/ jA5rJWhOʹT٘_,ܔb3mڟ &$-5$1AS`'߅:ޗ"Ϥti!'onHלMs nzU)w~z]u``ENX Vؿ-i׾c,^Rĉ:ЃL+9RU*-4W=q,$nq`mt XPp"l# KЬ%KprjVLگSaҾ6(վtnsvxbv3@;7=63[|[/"UfJc7󴀳\4Ŗu WS-K6rOue{*}sٯ1EuMzەOՇR-,VmU{׹>>-X^.E Xc<ۢYq޽"jZ /tvFb Up Yv0Ʊloܗ-sU+fu Ћ1e!Y 1=mCelXԽ8:Mx[5r1J0f&Qm0[]I6KSH,rv Yn\-w<ļ՛1i3g&[uEVU$ \ir zT$ [ZJ23+8Dz)Ȑ)x~W{4'^"}2>F*%aB-_b+u}PѼѴT$LAF2Q~O=;,W£F 6LIqg+ )@e a33w`:en[Z縋FJGLTo'[LŐ-sP|gR +tyF9JB@=B*$m>}[(0e烩؞8XLJ3jyCFmGtGHR 29j%dMU#a@ʛT]!k:CNto30i0(VjՑrKmJ #y|c"CovpHyźaC8]k;Ӏ͔{KbЪ)J٤rwJʙGb\V>-8*|+8eN9%E|7c<%XZ9VoCYsrF_NSalyQĿC 6O@K{G򬣷+.$u\*Ӟge61Pf8@Y[^5uMhSX{ 曶w6FРrۦyn,lwh픦ѭ[ٵ>=Ξ2֭{.z>yQ@(?}B+4Uaw=@찮?るf?84/{ܳZt4RB αKO@aC:]Y0B_ppXB랶y{sj+ӣ:\p/j7> Z2Ȩb;:#|"{E#{.u;P^-# *oԲ) c]*-xy-6GNHuvc]˯[,曵-uk(+?ٝ⿖W/_V5,Jm+{P ؎-Ġi:.D[1}@ĨϺwF[Iכ/vO訞oeXsg>9ݒ{ !Syi>&*Ϯ<&.=v2oYJu:W] $8.R n|tZCx09sLj9MҾsiiKsNymq=;x`bmJ:EMpjtpZ.)Ft/) 9K`-hP( OvUMg"F ˎҵ-+ ;ظ>I5ݑ3-PV`8;N)K|kԞ]{:x(I-Zs*3=:22 α/{yP_=j~kTEl-KeXI+dʱl-8kcڣzWd>Gv8R/}K}w {g!(`{МC,wjEF0GISDt,{E\өwv6q@aGiAO| _WE!(K~4!$LI S4Z`}*L+&4Wv\W@'~OC }s|骷5dOўSnYx<V꿊qՖ <;?WO;Itmcrly"p'JR%YADOR(lȵnr6n\c9sd!e%x2FBA,SHF^ik `>j Fբ%78hWf[˫;A)+QS+m23 %iJPu76̃z祑Yբ5Qp x$] / 1Rx|ֆ/K49|8wtiʨz~-)pjK^/^c ezX0:Sm3OW+1!(1j t qiY֒y^0\r=VDNm `v-[W}mmYG[*⹅Vv.cEm 3]H<=cSӟ4EښR DJ+DO{AB~߿j{ToK*)9Dɩn7l)9¾9eSl8/*L7ܢ nHaZޢdd[)<OUJ= ڣױ ʇt{1!)jҾÖښv%*>gğv-`l8#fz}_thgS ^ä&J?Α)\a.ZH'}m\q\imQ!@(8 NH7&-|UMϚʯʯxn0jEesα}9>~#!}' RʤW=, aEhIJT:%רL_Rz@9FPMK&7Z?x^>+';LTcwUɷN'e˻iN"lTЇ>$p6{tG.ss˛\eȱV=ZwˊϚuv>0n{=%wL7>|āKI } 3$Dޚi]ٓ 6y6!Gw g2Pr*khqW52/9qEas%$kdn bM X"Pꚅ)U9,ӿ) Sk 5b\8yY R>ށ[> i~:: 2@@&$ rGzgK3YiP:k=t&[ANϥ (B+F_@tyB3i1/6j$AӹIbP\o^:S1$ 9| s5J74ZIȤEjҾ@qS%_.eO32zwXkN]HWBbNyjs A[*r PoZ,wͲ[_g֠O}2/:*=!"~)]b'Cgkz5]@"n}-ܚ+([RiRnx (f+ UQJRhoAYt$:,kI Xb_9Ad{^7cs!ZI̿G><2= F@jʋ}; 2׾7fl[sTJ(qxe~2_q8&2 U6% VNXJ.Pie}!F N:υ뵢j`EнZ:CdJ6vL k;Β~ qgQܝ׾Fy/|ijh|UvOF|smLu$za=[k 3׊WVXcsvWW-D=7X*M_ԿF?Q҅R׿[S,70ҭ(y5)V"뮐aU ^[ /0ˆ"EƁN""G?*dg#F)CǸ6J@Q>qV AmXӦ%*G=PnGe8_2NuQE۷m]`@1ĜHp}ږI9C=I -R}ڏ'z8:K^spDA N L:enP۟!$Tbૡz•(̞wY!>Ke&CBk2\(~cBQ9ydcц"WAaM;D鳈 *Kevր:]ᩰV%g;ht~ى̢\9 ->2կ.5C2äqЗik e~mv+EdyЧBZ~XpsD95L,:2-0?Gn@ZYYҾ8V[K|H1*SdRi#ޥD9 d(&hP\٦PA I92iJ3 ^2(0)K'8t 6hcnD'-W+iU.`i%9`n4$[֍\p__K)nA̅z:GgFD9ƫ˜ JFRkXbʁFYx~W/Uv )NBKx۶d7 T#sR jn|!/?5F`JxTd ~]6|`"AōzgDYփO& ߭cZ/zCoVkmY[f?IeQrvoTyZ|,0 . T>iAކP\j$.&$ߚIEQڢ|[K ԆڎjKǽ?H.-H)= $sH,\t!%yA;ӭ(_sj0Jwz.ękK[ 8~'")'?'t9;#}7IPAt#Q<鳞kAV[H_&ek 6-XxW /t8)W1m=SHu t |? rE{]/W]u*mr ).W ܙ(F{XY3Kċ=a!/} TcvCn4j6Qx!dȅ-ܻ^Xh̋6W$\#uӥb2S{1^/ ACJԱԟF{{xa*v'f 3Ç=e\zw&LLKo%:]~´L}|FZqۣfDBٕpa|ǑF$oO=*KVii?@jo-Gy:O]WP0P󵖱@grE N0zC<0צ$go\Ɗ1;*͚F5{<CvE~9Öm I1!{8CW{hiFѪq%|6ډT n!dW^~ݥ4͇%v m 2.FfuOxa∿ '6݁l3dD~gb7)pǩJ::wLza]g=a1#j0eM;e&eI)Xν0z ~dߨH%Em׀Vberc劶}䐃`bA2/T3|ĀVoPQ>p2#*!#pRLW+_cxC/bx1b[* q\Ya}Qrdo}/gTiW`$]1dĦ+.6.Y#s'4(8!zJ^ަUiN5I.OR>ڥRid |To#Je61.[LYRE̥ *d'ger t'Frx i9 [z+ $rX=p^$]8!/3 -ҶUz;q]+mU.'9P3m>A'%65ZP۔%+F& w|fV0b6"%${;fZ0MhMH1=3w̭xw7¨F&N<%F#SpJ{Q&Gj IJIdkxVVpVLik!$<;KS笞9(8̏YyVy.pH4U3DZc].0Ġwmj n {,&+Gn#cw6=<LQ qMydt^WT4d7wxfdI#SMK{b`?:s[E#6 r>7M\ױ Ç:xuh|8nakzʽ~Gy+ӳU[Q]վ⢵\w4 4%YR9$K88i2]ݛu"jrG>@/y=Lס.b1w*GCv@>Yh8N}ER\G{f9PI 7^4`+ss)-'zVIX9%&F b30q]ΙY:ORMd4ׄ˯][ɁA9yRGæh덫>a_~eb(FZI^JW4 d k.XeYRQsrNu43zV %sŕ^D|p8;w|͒ʁM:D@:ۂ S){-|-y5%p3hv\ك $GW;]2/ -nGI'g\g"CQX85d/v@l64n0bo^js^]ZW-3`Ҙő1𹶳l:^]O-ˢ^H'Qo8)Lu}j[J֑T+Fr'~]kVX EINE*3Wuzh1OJv\1(ii:Is8.}O?0-#I q%lW̼Ga[ǴWwz/Xۖڶ4O˓m@olۗV'Y8yU:TG8=wӃV&!4=W:ɘu4  -E4 $ڻ&e,]2b%R5/_Jn/uл#U2&NNvaJaqJ 0J5y%$N @V84&j@li֡u~%x饗~'rhrϓ|ec%-XJW?s4K(6]jpFh:]4 uJ O;gΉsE(I=.$W(|Bql,M"ܫgA! J_(`Hy#{ '{oBc ]y啔 O>.7qrlWec"y]_QDvvguu9|ZQ.{[a}T{}eqngϗYǦ;νYrrX9y>^|xa}a(Ȧ䄟[oH GJ\j\nٱ?ǥ6#eFh[zn΍m'Y#:<۳ieG/!$xꩧZ+F%}g }PA sحsr$ AM- Ch _64̹iYP8JKo@8u`6D|?=Qy$]@(#Ēq¯He$Z+/g`G4Ԥ^֦aur:$fB8 # PnBDG."6ʶ#vv >63IJϺ&UU0EF p6#1gjZ"F,772vLj<.؃}7<]sse`<6JhqH?X> BE -Sz4PC+@DJf`) !7<0!# omp Y-Q1ɤ{N 㙌`C0X7 c'n$E &Ш}hmI#I" M. ׍O0ӞævBrYqc믿۞&fs=Yr[Rº$^#ވdĵ.RHm9&(%0QʉHlU `ɵ jى7ITt@ڀ& d]gk@lMWTZI| +6ROY7Pf),M=GtQ{p-!!Xaa+9/`Ç>QZ ԼpT.-))@-KO2E Ry}H Er }y.0ɃWUq"y4ɿ m׿ =$_ĮktNbx3f%NyZz{ lJL+WA/qv$v=&6~w7U=˾DG&qKd`T\G8eXzBGM=ShtzG9^ dcLsV GO'r#РB8LR\4#ܡ&8X*5H3~I2XEw4ZI,Q7]ti/^ |ePnatILqTSbV"ݍ*(wDfsR=HÖ́1+ӟ,n)Op a(7̄~e+1DdȻCּ6(wZ# vzw&v($Zn=AIC|$V}4~mBOk!tTäԔMW4qm{V"xWدe_EjvXRYUc\;A>+W=ĩ*m楴 FO Fd`oΊ }bs .^Mz_JmfQI#S MѹAyu6-n@ih|}}r FaJU6É[Sl L5tl)'>,$ ty9,!~JԬ'PP[um.6&י%yfv=͕ظf,'i֎ i"F gBT+>P :(2.J**UFi>,>S%H|R1@L _>$Gw!z D)o*Sȣ*g62wuSEz~LYIr74DꨊQyKvzw$yzǹ =Jq&b XaOY1FjrFV>F"Ft۵<`D^cu qȎF)4̕o "oѨǙ+NOAbTh~Grþ/wS^IyS^%"Ü6?8nbL08jsȦd|͒zO;'syKkCr5n"Q5^:29'ztIU D 6)` OZnN3'1?g[О&݄ w֤[]3W8;~02ktSЋ@6R=?A_0?Y|mVaQě%O)6#Sʣ"{|Y \='&حH]z6:ڦ)<{㭴=[ݞS=o̥T>u?htg.E@lqO\bv/*XaVU\yXyX!Vy#F$׶A"ZP2 ^Ox̖%r<G?P7?wu9ٺSqOLS$dRA6g:rD6Xʁ4uB˩#Ts`B~}ɁɁK4XA>KYD%K"Ch6q|pN+#%zk8iQ P{6 & ԙ =X6PrM~ҴVl=F6k=Om3RW>;GlKiXҾj:ƺ=X=dae>7{jM>{'Ko>Mm}#se_{z\8g Cj7褐(K+/=qn?mj,=6ҹ4fNw;90909EďR?!{(63"ٌ͂rK.W[$k66&v8I@Y%t$ԥK()o~9CL%wb9B öClu3 | j\yxZ $X3G݉C7&l9Eӫ'hJ:Ms @Rd-?ơ7F=`:>4Bm#eGtikk>,]GkWkڲ. vi CH:7j\$,ǽr$fzB6jdDGɗ'8`;Ӂ|T؃v6Ʋ;2F{9· e!$ɵ^:?_|q58->@SReQJC5SvhH瀔 %!NL]aQȹ#9P0<擥X. O`dzOɁɁɁ rԛ h)}wI}:㮻;^|ůjjϦ6fV\vL66PAP<o$x) HLdbԾ]w0eu5Gw^=Ҝ#4RI^陬5-Q"'|9{.^$/o-*(aٲ~4 E<;o[!6g>& >i< c'.TY%,br}zb2u87 r-9 #ŵbqޠJ9r/ֵ%GoM]4f́ gα?/A9W?wwh^p&Wm zy7ʷzT):v:߻9QSp~{a/^<3 I\cī7dن'~oۉѹᏹ:8|BfuN90 yɳѸ3H0:0,-KAoUnj{XFIENDB`$$If<!vh54#v4:V l06544a<a$$If!vh5:5:#v::V l4"65:4af4$$IfR!vh5 5P#v #vP:V l0$6,5 5P4aR$$IfR!vh5 5P#v #vP:V lS0$6,5 5P4aR$$IfR!vh5 5P#v #vP:V l0$6,5 5P4aR$$IfR!vh5 5P#v #vP:V lS0$6,5 5P4aR$$IfR!vh5 5P#v #vP:V l0$6,5 5P4aR$$IfR!vh5 5P#v #vP:V lS0$6,5 5P4aR$$IfR!vh5 5P#v #vP:V lS0$6,5 5P4aRDyK yK 8http://www.sts.org/doc/4502)Dd P  C ,Afigure20bbվ4@wY-WanYվ4@wY-WPNG  IHDR`OwygAMA|Q pHYs+IDATx^UW5]չ{rH,[d[N8`  ̆oaXvYdc18gg+ز%Yi4{s9՘_F=U޻s{*\o͐C f(d_zp8\<;-nx!ß<SQoۗ kٳsv݂vO 78-4˓yko?=:i7Ru*ܰ3y@&~va|gy HiP2 kD(|~`<_:Eb˸ ya/{z;'܌ N7uR Y8b? >u bc.q x)~د@ҡ<:Au;9l?ͺĿ^]xW4֞ ـbL@& ]Q녵FIj- DFM* 0"3č/4OАGt3,@p QAT"Ps66Șx X !uBqd;[gdv:zdZlx5 Wd.6HH@*4܈C};n 2d0nZ=~XoΩ `8ZpyC@<aaмH2QE! `So1@"%(CEY)#ͨuM$DITtΎP`"ͪ)'d!GV #[2I NaMm,O&dBt.5U< ]bvg4ZL* zl">`$e!(MÆ((@^RܡGbaPTb*ٷQ :D| E0#a42^MF1ٮTA@ITCv%>P|:ivne #]1 ;a9);a1@TyJ\#k[]Gi |d->ۤfp`|q]` X O`Çr!4F݀8"BCepfN, o?8ւ)O ʦ)SPfl "Q r2<4Ctj;Q )x: Hk.CWk6$dވ̊s3^H$J0Nj (ht#Al='b~M`Ԁx 2 :I#ڣ[!ƨ5U,mO<6svfM ?H6pǍV0x鋦%KeOA[ Gmj_>X<Ûp !PBʐ>TYwkc3pr,* g ʵ$GH:!9܍ҸJ]f[o^CNqëQ%adM2<͜Q ѝ Q#M"q܌ȅDzMnp!?hbr *_WT!#l!a=$]R@&P&uMlXK Xe݀h7o:\kAs.$qBoEμB'`@42J?G;)Жq]mdSO dčr+Y G^sw0f$E3e  oLٙM*zC(F]lAq]`<IE$FE fZ2}.DT=?-HI7eCL_Y[-Ƣw;0c3X'7Rd4>A+Du;EvƗ[4*BYe^ā(1-CMK/2)7O' ĉ(c|Qx( ='kfLLi)ZAD y9Lw2K0u]O 14/j S;FB7t >;꧔ Nʈ> Yci8R{)CaYꌮ8GNޝ15U Gu$\XIu[( ^nOA8B|cN%̋f-sq}klp"{~`R:;8D !A70M0~Sɳ (贻2^8N <Qx2q)z /4IQ:fE\s8҉(7 P:CRAô($RnESS3/V `ܛCeO?)`9/rl[gyD6t`1ªtOx(8^E]n8b]Esī*oh,a0R6cΕ'8ZK}SKu6\%i.qqU@<NE<wc#4aV&nKEGIJ0!z̐8WN7NuX^,ptWQKij;o }UլrTwr[m$&`X L.)j)Omt2+UѠذuXzP@'J #^7᤼,ZFRvuŽ֬*d,&3I-G 48|;bc('djVQXL Il`(?x#{ڌ$@f$طE(tNo|>SjO$3tԽ7"<" {ef*$PŚI@Ÿza2~ ⼏Ó<  aUБ$jCJr %u4%J]9-@eH7n&DHT#Gfɉ$7 #L\Ky+|Ŝ +yS.tl@Y"1_"E@?Si&JيYGq q9Z.,@h*U*&Y{vΦp)(@vF&{^8=.ZQLP`p1S(JEFa JTM6!BDbVaL4Nܚ𠁸h@sAUTB&+% f Y&M,q,]>od9m=8v1yN'5F_02o8EH.%La:`Q٤KZ}dK0t~^ cA:uM~ )ib )"(wN[+'LEz] A,; tE̴khڪAE&j4*,٧"0;%OY+ ߙ['!%O%A8_]ub:B1NԞD梙C8r9qvkVOKC+H@.Hj$)}$&',ʰ÷!njHgʜ=B1B@5Ŭ]x6*v,8;T;h 4^i!khVB!?) `]VIӁJX+lQ ;to9 ҒJiV&GE@6C5Fz"ONHd "x*)vEx@. Rf2&> B ?{L ߒ @"q45 ;&H6@"JQ: 2&xLT/IEPqJ0- Ɯ!q* `$$~%׸ӄBv f3+ ^Ñ4JILX@> ?8wQ朜A2)K%m dJ2:"p=i/eQ< 4cA~:Jnh qY5fTD'StQeHf#h G%SDDIҚW N.q/15T_dQha3õ:fv *oB5h[Be+)Z6(ggq7`XBD4̙&1EB*6޲۪ZXUkĚA5CTPlQ-RVGG˥zPE/pX44+E|#ǧԒz1+W'r6Mtk܁hwn2^G:d:T<ҬQF FKjHQ+q/_ųxn ƳD4^jDrqR0U8:DhJHl<%Z⛪ H]xD5VۦJhdLjY5LŵRIggS|-54SL|ϝCǛR%r*uԗ2&ʍt('D2坮5ZR3m^ G=F"tҬkz/'[X6idZMr>zR u"DZ h#XÊh*j} EVϷl,+BCnTs',QMs;SPrRXL5l9T(_ j^-ۢ_nf-I95-XD"2]^X9e[ ީhFr'WCҡ}-y7[SG(RM?X`j31Z|j,4 ۺE)!ߌ3iXBF?Ȋ&̘vJ`9F98{$H}h#t0&e9$S6t_(AbGhJR,@XEo 1c~N|]#Q^E,$QۀR#Z`QlEF Gb^C"WX"F.W{۵ TuMt18̓F؝C7Ѫ.Ɛ kVAѬbCqL̈́yS#w#<4?K$ɘ/ZR)ʕJ~FRպÀh~ŦBupvZrjV-WkvEVW(?^ϭ/eHx=ӆYP8 f[EOF; p!'A'Xߛm V. ;9brJ2z4JCtB(_P'vmk==#W.Y4-Rp3RuvE\2QG sΖ Fдp4@FGC \S0͌mi^45v% oһf 0v4fдeAYk;~so֙p:шD"1u@; e21rIE9eR!M7Te=u4, OvR< |hx.LҖ|_-Uu\i SPsJ\p@BXi Xw@zNY'&NGb#u{ .2DDC X7Ay#EP[x Wx3ْC|-6o{{UҲeG,ODF+ !>K1(ӐHpWHP d@0LwX>Xf K񤦃p9q,~4N\t YA : x!_anFQ d}~ru;)vnE󖋀K5 Nww%,hD-qvv?Bh`/gNONO?vwli &gÉ(2<\0rhN#v3D-qd_Ғ71ӟ G?2Ѯ3-G|Ok|x(~*Du dYۢ/XnիCAP;7pV1U=bĺ) yD:ʶuf%go'5s.;g][3O7RO>{W/mYFP"﾿1ОdWV:_K1ϊk0sJ |׼/}5<7/*+VUƆΩE-_ܹX(5~KocODRG7 F4Cq1 iTg]P`~r鲤uH"Dʘ1YVNr8{}$S*c^r]1lDGkO-o\8g⒥>6K)ۆJcumpSŮSǻ7?J=ʑ7͉|<;]xWE{;^`dɉoiÇ_ntDwBu"fW;q+3vR8l_VD:wT33~kQ yFVY0]VE{V!rEihą1"dX7}~ԋ&Sz6S><Ի5O׾V?6+$˛}es[԰h9;糛NpszxS~тk;hyk/MeV$"dɍխ5CɿU0ړ{& :`gGK׼kMUz8尭ʎ9HҼI3cXEZm^+L9hseԍ`K$5OѪ逼 lG#0]m-֝JS)Kkz8z|l?K;'f.?ӣzoxrڶ)׆Z[KXv*%V L&j~_~=yQ[bwph*#Yw  p&rϱ/ي~<ٺ-˔Su^k bH#+*U@!*r ȿx/}b[I %BJsC.Qj E⫖qܭgq#Ͱ*|bZ, PnX\7#5| . /\a"{uVI<a8܅a[HQn^ 臝gۮAHH18+t\#ɛjqvxV[lŧ`} uVLӼdY#I~o)D(|O ,vݑh1,`bt4B\=„ŜOl /Q-$`־᧾Mح7Žh$NU> ~/UJ!j(M8TYr[!m,J\H<X,YbeSZ\D/oKdZk(` S94uS]QۦJM3$cXBtU"DJl87JbSءoCγ6-t]Uy*5{Cl^$}EF={ȁ?\pU qӿ$ 62=G[ G.P9-BVCbس|H&lu75Z)ǭ%T"VFQsj25r&[#fKǥ{I"aFCxw#T9RQԁ5)4O~5Fy+f3Z"5#'HħFxj~-"1aR)ʉxW-,}jk.[=9Rt̸ S>5K?=\sfvX6pN)>TPwľVr{Ġ]P<w9xcq1_>G^]hIn;ck'8<,KqFgOwzԙ~y Hr]qW{C7==;D9L#(R:^Ԣ|G,2-xqcgv4^҈c9 v^@U.hBGGEi ;AYqBZ1WM wьQ4ۑtds7~&y=_bpd"i%xjuFn&Eptu䖇#=Gƾ%Z왩S'ޗvotoc+3~Iɨ#DTC|M PjxTCcTfr'A-kvU2ryxY&rO?4y$l^7O5`10YTGD?[.j /~u_WbTcӅ%ɣK'+T뜞y6v½,<Հ-+|l`K|{~ĽW_u弑}ܞěeu|ˊPоGJo;q(H/X5@Gkq3ҋGjX2䙌&Y}D B؆<7o,vloȏ9KyBz,ܷ=0Tg-vk;pd|N?ڵK~硹TuGP*] ӷ?yHd;W&]MhW`KBzJ;;^=k̘ %Sf+0$ 4fivE-_q"A9gl@!AA|gAJD"$jEltũ7uQoIMn_|P4F#tm[>:Q,؟.۶AU[jPs_7oyGzsV Όrn7.ۙKFZdZnN3ɊFcX˭-Svo\R80+Q&6V(2Kv'hl 15t2m]wE?ޜt}cOH=؉hjY͗_'g-).yՅ=ccgB56l9 իCBjB3'TuT\J%/|j~z]\ƞ*Un@&fV O?6O&3W~k'ߏ :18e$v/XǙʘ^@+Ɛ\m.ӵ Lژ>5팕OЫx[ћzud`-2'-=Zj K֎n6_[ȆI75謑R-R͛Sb#x -rX.``lf|VR.;O:mq6bo, N1wm@XxNؒ踋~?LTjX"MCR)C=ˉ?*+@PNpķ BBGݭI^B3۱0Cq%RE,e,Q4TFqxcUKam -S<)+Sڎءɉ g/Y]Uٵ`nnAF;@E]kꕊ<(ld2B"%N 1IU}O[( n1\|'+ѭNqs[c3\G^'B p؜4UK#xy8/Ԣs׺h: 0M{\@yZ(n5t˅RMѠp9l)Yl.e k76*x'(^6ݡ4QN1h 9#* ~G2Q.Ӥ\~{qmόգJ~&Z`r{ic.f2]5A8NH ԫU=]N?!c!ރpE(4- ꂊ;E#F_pnbE:]B=gyC_{8lh7?K:M}bsgd V.`h|,Ǣ*S`2!Ҩf8yC$mj5)%%1| Ax[%ػ?€FKӄ" Z#fˣ nXhQ،4 9?5:7V]KXʳ GӚE.wq+NA$5D@hX:a 8g"T7 Eh`QQ j-O%8alMjWT3WӬihU 2S;ݼ+Ӛà5Hf)x[VYVZuқN?ȕ-fv0'k/T)*.8-J( c 7Vt 2 n $Chr*XI9a]F;E ;(?ؘ[ĹHO5fK`FM"4GC|JztVdq&ezzd;4e^hzR*sNk"'EGk/_a#SOEV< Cdzж}‚.Lѡ"EN1` ;6M̞܏A9CM1v2ݗ n4,&>1JFFi)XufžŦ~&YeAbx@Wcc A? vňo.$+7Vnz `b0)0^K$L!hXM{SflE,h40NH4^Nq];OKqd4dM j;ypJ|D#-SeC~VOU^:zLU!rQ1 !:D펵[/k-^s,ZЭoVs @Հ1Tօ JKhs"b/(,;^ҿ\L45qtB'):j2M }fhPL)П>)M>fBDSX:~t8qKjU8.\G^?\x*VZ%4R?GP>3>(Xڦs)I3)#^B :!/ѳ7ܲ%<ǮTv϶=42=m;NwdJ{_]IቫfF,х;Ym%,KB`.;# BCh"aPYlriҹ!v܆uC JG2^˗ޫ/0u4.g BDs*ϺPO\smb37|@l|q%={BZ , F( J%TaG0(Α+ Ub K )7D@>T -ԪALjņVt8ayE2z$Otf}TϜ1Sn(o* u*o[X|yڙUg-wKy?Yy?t/ u oγ8 PtK?霣| V:U$[F%idn];Ko(t]R"0IEֶv&Pc&WΜL[`K 7FO $} 8W#/}Gi}{<ZO_^xuj_׈X*Ʌ ,XL~3]Iԁg%LVA`d7dO2z2$@trsim(j4Hȑvt*b3$<[a{٘cYel+cҀ˴EW RࢩBnE] }igny8 M$;oeCK֬L8E2SfbhۥlsV+@-AG0L_,41p;MS|"q xl<--*C_ !JH<ǣbun;oi)5-Rai SZ;񢚵,xz2Wu˦]MmM5g0y96_jPG$ZV#XV X k?O npwVÑgie%bP&]H. G<H$2T߸m /,U73c {m꼱6jO +KFt 3nY?-V.3 |Jk ](6z56h\ćƭx5)S;W%0gmw@Rv3‚(>To,/\ @<4ymãCCUMx,#ViYK~K/ D3w>(qxn_t9zT?9 v  ^""KFψj쓊 a4Ct)Od]jL0tqF.+@9zP &HNfB;C);T.q=XIO;Kn6Jd^<[O,5O%Bع'\=wOO^Y{@ڦ77OpTL< k[c'd"r `vؠZ7r' UMr.K 7x C9>4Q(czm_t6 )N"7qj8yR8?qg?hfq6yiXG+^/ih̰;PޝG̱h1Ue`Zl 1ذ !yfY"Z(³o],ww9!4GlYmcmzn)Vm~<+*"5Yf`щRp7^::26桟FQte sk&wp#(C™)|UmO-1:NVǡoڽU G쁘O;<  ei;Q3~Iօ!`\^CXnJ{č}\[;k?[ܶ d&6տmD4 ݝJ-؏e.qa5n`.SprX<keSd;{U{uA؈txL|?$p `Grr^qE&:951xM>K),a#gH@4!P+Z4cժ)2zfvvQfE%_zMRǕhR<Ȇ@Cxϳ–T~aO͘Iڵ]Z'!(? V4dZ\\_dX :8| &7BMȎ,S\L$TG|2'-cVv>0qu)3<)tR aóXNb0iXVip[):sۯ{m}| b[X:KEJ+D M4jW;sOG\>M$ZtRA4DyX,4#b6:h]7ه>6*c;~nۄ=7p|I(~nT Z9wxR hɴK+ܠ%oawӖ-~9%ۃ*0@毘fxIm`g-8D(0k>G5|&]AE:k6f$EMUlE%Z/yW?*AqD:n/(>ϟzpn CVC%Y9C\ ),8?gm D(|4l#vK1 `4dt$_戈هx[ P%*׊zC̀ (&݉xAy댇0TacemupC Q֌Z=ux&q73>y.2>wq7QT2jaͩ̄~ Xxē€Sb(WihaxH)1Ε?|J}{kՃ+|8C+F?HKχ2x6(WXRTZp,<ڿhOXSUR9D(Iը|p.}m<yzzy5\ϕǢmS)^1&q E&/.T]Ek~o?w&:h56 /m/X$jmIC]%YSکZ$&Vy)ŕg4ݔF@nR.LzE = M<`f_6} T;h_(tg^%N*7:ϮE6{6IBp}/_Rh%avԨǧ~Ç1+ "L= #v03DZ n@ P12 N QdB8@ شg iL뇞Jr+GQ 7ooؤ_Fb -FZ= TjR<ΜFKW~3CѸ@K=ಖWcPtX}m(HAUH9np7FtHC)d n(i|қ {~,`[ .{'IKc92yUb#D]\;uP6C-'CkDZ2T<@G+*k$.Se5_]U>ͭB8ǖwbUh+֞s- гf!Crv$ )p%L~T'| N%[?\{ePA;z9APd˻୳]mNKlSR -mK`-Rz9zA_PY0J#Kk5pϼ ZAܺF`c^-0$FZ֒ 0f-uӧbVAF)͈r"q+VHWƒ4v ̣}3Kː 9\WzG_(,r#€N% >2&TC b MX<-F0YхnDǘC+4q`a)y{yJQ/XpePA̩5z?ǫvIomM&^,WMaZ̨LV =lƱKl`.ט.M^rP7T1h'M.vOSx]xɔS1 {lkz%e")HdDTƀFC!*z kfHY`SЦ荈b9v%z!2ͅNĻz}{-˗PfZ$x{VTHkՂWHџlml!+#6v B) @g&#AL;C5-³: 316ڒp i4,Vd*?er(:',/`n::^ƛh63Z9dr;c=C|e?$$u}[mNd֒CvЬF*jbUl<#͉\ڄ=qìq+DdF1B $iR`?f]8J/qc |i0HR9N,qO4VDh6-wӞ%)ЖT#Rg%!NX+Be0a+   J֮$7pwߪ\zE'"BuycVԾ.$&(4 ь~uhY@ >ՂQCX3|3-A- Y58xvD2 Hڶ!p#C2,@hjK x܂FT/'௖$o_{+#?G5Q-$ІK[(D"A3p="| 9ۊQ#sېF]`auI8(xnrĭ'NiVrT &SőhҶWEBЙrz.OlNVS\کX<Ƅԣ|3_ğ30{,<~r/&Agٚ฀vf{( j0ϰ `W@5ٶП霍%`6\DꐙܱhFC{D L^GU5 Č9 G4=[kZq6hNW7O϶]E4t4Za(OѯF8~W8vCꜳph@ E۫ܤB.B",! -E\zI6?s2G` \ghia) yUۉ Z(纫Lv8u1'(lx^ ABǚ亂}Mݘ@ `Kۂᴛ3nFU 7ЬQ( qUWEYbY}XPI1X 5.4p.rѳS!D"mtFzɖI,{}x ۑ#jh"7(Cb;Wm=LF0e*|Ӻ\O׋1g3${>B C!|ʮ?ͅ# | l0ODO‘^R/0يZ<.CfABtbUzrMtSvU~|dCra!'>uB_ GåU:i#_ʧ@%_}׬mJ )F<Z!cN sg`YUYV %òs8V044ARJL9=Rn ~MW+zh<-6ixJ8nz#陮tKU^ty!$m%|焎Ev?(䑿0= ̾}RUڠ{:8Q؛ʇwߏ)#IQFXVⱵhxC3mSF-h5 Z>Ab~ c_0o}/'+PsRFY쉞UER]qKc؉MNBŅpŽ"Xor]d:-Jõ>M9 r@^KR6y/.xl{8v{֘yuOc>bp\[' w3;wVofXqsmoEȣVWdv-GD{?!Rڠʵ"<7BmX$1DDh" L\a VZٿ.aLBLiG&!}Cؑĥ+x1>ko}/Ư'mh2b쪤:J"푞+E*`{1fi9F 3L5Wtdž?Ƌms]KHs1›e S-HPc.}i<{KD8 /Ջv HgN7||^A?8nU[Orgt )G^LlcQpt1Lju}_:AS{ypW^?VCk=spceHl DGR`F {#vEjEvlh~؅CVF%3redgUC~]ZˬJuɈz^?0hSɢ;HtNnb .:MAl\WKd`ΪzW^|?O~/?dbZT͉xGo;}-r߻xfa$wTwP0'lCF.6cV Ɓ"J%8'o!&KYQ8dxq" >/dBk"Ӝ$[!Ճ > cv @Δu/_<) ^#X[~I716g/!YgKo}U&_]gGN4hԻEdd04s)mo;?E87:)П+5T*g*Pc,= "TP64-Fa8C0\/ݓOZhj9A]*2#A$ =`o>J'=Q'Dz~V9'i [9p.L2`ګDĎnXz1aJ^ESBXQqMJ#5:ʑM7׃( \ w؄ sJV9YB0PPh5 :}(dԖ[ ]xۢˀd_٤G9h .IH,q;7>ƥ뢡Hu?vjfWq!'^y )ڕ3U^c DnjU%~% caV&3ujz 73Sއ*nF9Hrӱ9gۺio2mVq\K!m&kzSKVVC6 gu?Ɖ&4U?‚9FSAILYF8u$\@E-]Ks>&Jm `);n?0wE$vDJ'KBINCܙrhnm]a`? kMxR{qOٖ&ȈVDChdyvJvҝ\ ~[:8co=^vS}A+WI)M;K:i͊IYPhAGW,M3N(?A͎PT̳cqM6$,ڲb٦ Cx]<-|`ߏ5#R?1c% f[DR4[(ѓ0B3ePPP߇U;}ڀgC%ʘ6bf,A|J.ZG%̔~Iz7Ek*`NEyBu\s&!u=HL[#d?wmU6!{ߕ= FrfcܪKUg8e & 2'>QG Aa CL>ʔFf֭RP z}H.JTuJ]\%-g`ԭ%P| Q2~ i]bخ53J+&t7xd YX$ %MN&RMX#Pn3 ]*NLHcX#FLYyhT+uV~O/a3Tt(UV1 (73l- ֣U4zL ̀G!Πe{[A(= Z"ˊ̃íiPy,6 m8^\ 5mp-}[cZ2Yʑ>z؞S,^r3җtF[qzNzhqYowRA6F],Bn 6wo0@ޤeD#;mD8)F%ŞR V;dzQMCȠIҔ cQTyb4K{i X9]כyW[?_}Mq^na$hW/EEs<b@Y4 ΏtD;8Cj#,("pҢe{ 923AUot3cT2_鉥,+"}9,Sl[\$"a\RA w߿?:q׾ُzMLf 6=Q7qݷ##PaH9surQ<(ȶ[A)|*dpؾˤlp5 @q-ACL 0ѼxJ9 .4T` YW DG^w$bVNFmuթB=[3͎sZ d.i7WYނ`¹19WC$oɂ08U ŵA=r Avf'Ij}co % ]}dF4~He^/,a͒8&xPFj576Z{p6h9V T?vj/y֡֫Ev]*PLG؛q{\Uq"ic,m4.QrG՜,gPD1V,W$\TE&b!s&BT"Jg3Ed@]^D3v [IV"[gTWF:υBio1)C0H]uӅٛ1ˡMM!öoFڢא`Іȑu, n8D0;EdJ/(;w AbC#~l--f!ggv>imٮN 8=8EoC`RHtەr)ħX 9>C#buT[gx*CjSHJoSx#x>6,CFt,KBKyu} iR3jy|82.>4672;~e"۞h[iMww]FC4`!âxIo<X醢7lU d{ڛVPX<4y6dsT\.JyYԊjezRN&a1<?m7.fq%L2.N%r9k8CEЁ# #,GІʝЊ{Rl7ir-UEڼmџQ@A!SB$\tDءz(*fb9r`p`?CIRk4[~t޷.˶gҟwys{Hz <)&~7 ) H=GhP6ZmcEd"F7Q/p)ݿlչ`c<Ȟ!3v8%r/0֚H2U> y ͑l:)mjȵR3"kB/݂XE۾V*K`]@ O Gq~)R{ i >Q{0a{)?Y6iMȐ?J@`@j =Qh@FO"Kإf5 H7vioh%`7\ e#G$hDLvͬ]EH~$T?3G,7͊]F-#.lT*E\񮓊L;s?2>O`d{Trת 42$DWo(vF cdqNR @(coy腽gojJ#[g FL1+SSU/wT$F^ШNsZLuyk5:k|Z)bl(mi$Ra.e!a1L N+g,(좀6[zDBb˭su g%M ʜZy' ioδzsnb[V\^stao.W'3 G^$O33:vꈽX[q7E3Sc4bM/)$ڿïs̥7%a( *F.øH͉ XE#1J prl-K(o{ξuG+ZRLm׎ 6XKY7#})/}j[bpsX9Wֈi̢C{e"=҅ u<>0~WQ\DIpRbB.aҐAILqޘP1WuV@Zk\O3a6KԹUUǕalqMT'zS*cŦLȬIhlSfqĢ肹wm"K:(ShjݖYBm:57{;j3ѴZ̤^{PlILcl/[vǝ{k6>֙_fXL'%~I-NJlutx=pvhDžSG|?;`=z'X8밗o'6,EjxeFيG]xFCd ߫W™tb~Gtj o)xGWW EC.@Q9ع?nfڜ/%X@]:|ZUҤGЕhA.Y0 ZcKa"Sq̈́@ f$UxG7_zil {أ݅d9.'##㶰c3tlw{6^˴b<㲃,'p!>xZ~f,j񌆲% :^: (1zU{/(bE'XIw\!)waK5)ZA}81*{"X)U\MB 뱢KKp&SV ]-m^v z=֒O =eq>Ǝ\J[PSf5M8pK*dմfP=Kš,^-(p̹m![Xj_7&#Y=ɍ|GWIl±Qg^nGmM#bψ8o&i5FKg2&U`C9ĪٙB(R˞>8?sɱD<ؙӹM|to,Xu UMNZ;bdk kF" Q.3 hE){)m{-rzkp ab \}Hd6E7H%%1]i9^}3Ðǥ׭GufpĖ|k7|ȇiEȷiXG ɡܫ}#OGß>_GmvkiWihOGm%*ɸ{o53_ rEO4Z]QX6X" fK6dgfos>FydG~ȉbyla2vS?ٲzt;n{P5fH5lE.R/tdIʋ@d֖FsO^,H]M#H$ٕ?tt&sQnKRkWTv%V"GǣB3ҿqJۙ:9sڦETY?d^;=wm#`I'xdOIˢ]j}EG,@B*rG*ٚ0ಿo' jW4 dXMV*֙Oןwwɇv^iy_ʯ=d³[F/l%'9 JSx^idZ,Or,˧殼XNƫq[4>H\h==vx}x9qIKׂ9C&~{g i*RhQltܝG rHT*7tP-!>X䈊#D~`ЦzO;94`%Z/X?wU;go۷{<=vzywn΢tRWڲ;m Yu}:7nlV/fq*#ՙȆed%& ,(6ul/4F+SP".rq(fr8۪w *XM7^AP rR}N7xNIeF@@+ #jQ@K59MXrsŢѶx"Nt'Fc?DY5-P [hPm_aHryfǢ.ή5±T̷j6odRĻUPpLb}-tT>f,jFt`oO7cLqLɐow<:\RmHQ$,7Dr Gi: ʅ+b}yFd̼%mq, BQ8 0 <[Q̎YТc$boZ4?};O_ص_9bGt9{` 0i/kj7Udڴ:es h4_UcZda^y*[5ѺmqR?udMÞhSm)k1^i2!Q֪rwWmz+QkzK崶5WX':{ _iiN4+x<62qfl2_ u$ ٰ-oڢRF[+ˌlc/ZC(ft||6B{otKhܕQ&dg"lD2zx{Y5Ɩ{w;ZԘ*RL*~O?]_wkp$kLo7m]Ỿ~0VoR [)֜\{_[rKt3 ^=Wo(VHwǣx&>u4߰g.ػeoO4cZ=.EEhLYZ&*Vr&5SFcӑD%>8]MLɎdW cJK+idxkGvf$#+[Y;:"{ApY uծ0̖\;O\4g/FFiJ}GSD3UU}֑ɘi>#='_:1̜uZSށ@bzb^K_RP+YN'jWTщ bjw}O;甲tk-KjXk`Dm}Ǣ8ll6i[ImV#W;:µR8<ߒ rsQ,ǀRz*+QEAU-œꙴnZʛߙ9yܳwnjj[2k quҖCtbz4jE+Ufq{R2k)U&xKK#]uFڱXڦPզ*=DGb¨j[Bk!r$n/C1+/|b鸕Q-xGAHtafʸ=j'sRfĪ8D3 ZL-~Y2WKYygn/{G?tukK0n&#<1w͗0f:\ U3ǧ5{Π32"6 ^86虓@U8}Z (Ld3߯|t3? !NǮZ\R3 cכrXídMTje-`[Ă'ϟ*T>X]4&‘loE3 }4^;OgYzLA.;zJJÕd SEz 3'_7ĩ4RO?=ЙͿb W竵O.^Ξr@'#$6J7kþo6Bk=^*צvt)֦wL\5-mF7_tn]'.7 -F\YVD@4 *=/Uǫ;xIo`}hWt22qɥM/=tGGfCW[fg*3^:zHWO:&|:j^.XcqPf=o\۝=^ڂn=[]339FP6KK^wK[Oϝ{->qp;9s@d@YX=Xc~TI#GԳSm+ݩM9uR9u-{Zi[?wINrt4m mk{ZM9Mч74zhÖArV5@ gz۲{r+ns~[oI,Dx˯nE-&K.Yb^m{zګG_oprd;V#ߙ̉( 1ke:~QTG[XK-dd0-9ke{L=kAk 1BWϚDAOZ7e.NgTw(KwZ<3\t )BܤgY"Œ.譀9`Ν^ywOp!]–NN澢򣛸3IDe 9Jrm>V*>{w.^-D]@b Ul?YKYcLe$!69.c\cgL;_M:!j-Rz<lcvR+ut;Fb 5ȓ9$ &^q 8udZyp .5D : beA^-&rZ  B^iVMt8!{6 š`;@8""F,/Ԭ{&~+u,6QZq>)ߠ!-eCQ@@Q ]=&ABIɼy0"2PpߺԦJ,E$Vzd/w171G lڍƠb+)ZLF1 }EZ!_91~B ٿ*5µw?_v,k>ԗꧡ'oJ[[b"*f[q%S/]޵Rщ)6[Ft!lM4'svyţz$Óww7'䖯Kc[綾^m.:}w#ӥrf`aT?pu((j^dz .$%0ktKI(zybb ܙ2XAP栲Ҩ09˾` сGY7cz_<\zKW]57l|}7ozfG`q"}>Մ= ɅɁ(> j;2 N‹_rA&1҃\ߵ`w[|wOm >}n^uU#ccOzibbpOLn_s_yfEcιqtf?Uyғ/7-Cfok#{_xjCm8w7loYK%OlԆߗ7ڃ5CHLkdIp=tTΉ5:3h$7 zGbi2iUyHƒ{Q3-fbPik-PSO]nvzbΥ{_bxчް_T˾qްwж'>?q=2^f/Ï>6=9_rG;{w=[zNמN<7|іWE^ڶ/=z9vny:RsyҜ3z򻎬p$ Sf/>'-pݏ,PDU 5j=U^,YN. Z*εwaQbיJ3D;^[].<;vf^Ti]=_\3qvrgoz*|9OLo{lӑ?~WT>.~m}VLl9Z?yӕ)j#:w67UcOs.~&/:59->V!t5+Eh] ܑ0 q߀-Cx 2-: IS:g%b]vd>v~s]?zb{=9ݹʞ;/ظisE~EC(z7{\w{_׶2Q~uxэצO/,NνgrsE5bܼc|/_ ?sټ>ys}vi5Cً^}yΕƳ)*W!l@qS ɑ)$i;Q89r)WnD!@U %J20|• iꀂkl OlaDg[q"9]4jJa6grhpbtөМ4#m=WپxFflAo9B>t>v,#gwFeNj#TO{t%Fof~D>@Y'qJi $25m+ RT/+<N qas 1J+ݖ7#*|iR围WcxdAV9{'ؘ}P&pWx@x*`!A-%SXU!+M!f6H2f""b'ei.aî+f]UGD(}P l:RIMhPTE܋[˂%N$< A@*dSdrVKpbߝ AV;WԸ$cwiZ@f 9c Tv vsꛅ`'/s=R`# QL vXİ);V0N ɖ~ Jԉ0c]$QiP$x[g$'}4OUpg"%R9g@-@ =q֩n [eB K[6;`Dymc1 @&/wϭ3]t&$h$C.| "E!-ZqqT HZvF-hF4+Wdq–Z.ENؼb HLrF#,f}byN@x_ٸ1-B!#Ce Afu>Tw|{>b0g D YM6 R'U7(88fu) kk[Q>F 7  3mb1\+UN@\ϯ1z >:2M(0*ޚf?}$)N98|v9S@ȕ7:՚:YwX r\XKV^$|i'ޔ) wgZj;u]J'tX'mKa ĭ{(N(sg(&0p">"br+ 1.c%iq ~!Zz+̾(@: v7 ͇IENDB`$$If!vh5$#v$:V l$0$6,5$4a$$If!vh5$#v$:V l0$6,5$4a$$If!vh5p55(5#vp#v#v(#v:V l0$6,5p55(5/ /  / / 4a$$If!vh5p555 #vp#v#v :V l0$65p55 /  / / 4a$$If!vh5#v:V l40$6X54af4$$If!vh5T555#vT#v#v:V l0$6X,,5T55/  / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/ / / / / 4a$$If!vh5T555#vT#v#v:V l0$6X,5T55/  / / / / 4a$$If!vh5 55 #v #v#v :V l)6,5 55 4$$If!vh5 55 #v #v#v :V l)6,5 55 4$$If!vh5 55 #v #v#v :V l)6,5 55 4$$If!vh5 55 #v #v#v :V l4)6+,5 55 4f4$$If!vh5 55 #v #v#v :V l4)6+,5 55 4f4$$If!vh5 55 #v #v#v :V l4)6+,5 55 4f4$$If!vh5 55 #v #v#v :V l)6,5 55 4$$If!vh5 55 #v #v#v :V l)6,5 55 4$$If!vh5 55 #v #v#v :V l)6,5 55 4$$If!vh5 55 #v #v#v :V l)6,5 55 4DdU(0\  3 S"U(((DdU(0\  3 S"U(((DdU(0\  3 S"U(((h$$If!vh55#v#v:V l6554Tn$$If!vh55#v#v:V lT6,554Tn$$If!vh55#v#v:V lT6,554Tn$$If!vh55#v#v:V lT6,554Tn$$If!vh55#v#v:V lT6,554Tn$$If!vh55#v#v:V lT6,554Tn$$If!vh55#v#v:V lT6,554Tn$$If!vh55#v#v:V lT6,554Tn$$If!vh55#v#v:V lT6,554Tn$$If!vh55#v#v:V lT6,554T$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If!vh5 55Y5Y5>#v #v#vY#v>:V l0655b55|4$$If<!vh5!#v!:V l40!65!4a<f4$$If<!vh55 5$ #v#v #v$ :V l0!655 5$ 4a<$$If<!vh55 5$ #v#v #v$ :V l0!655 5$ 4a<$$If<!vh55 5$ #v#v #v$ :V l0!655 5$ 4a<$$If<!vh55 5$ #v#v #v$ :V l0!655 5$ 4a<$$If<!vh55 5$ #v#v #v$ :V l0!655 5$ 4a<$$If<!vh55 5$ #v#v #v$ :V l0!655 5$ 4a<$$If<!vh55 5$ #v#v #v$ :V l0!655 5$ 4a<$$If<!vh55 5$ #v#v #v$ :V l0!655 5$ 4a<$$If<!vh55 5$ #v#v #v$ :V l0!655 5$ 4a<$$If<!vh55 5$ #v#v #v$ :V l0!655 5$ 4a<$$If!vh55[55{#v#v[#v#v{:V l0W5555/ /  / 4]DyK :http://www.acc.org/clinical/guidelines/bypass/bypass7.htmyK thttp://www.acc.org/clinical/guidelines/bypass/bypass7.htm$$If!vh55[55{#v#v[#v#v{:V l0W5555/ /  / 4DyK http://www.ahcpr.gov/yK ,http://www.ahcpr.gov/$$If!vh55[55{#v#v[#v#v{:V l0W5555/ / 4UDyK 8http://www.oshpd.cahnet.gov/hpp/ccmrp/ccmrp summary.pdfyK phttp://www.oshpd.cahnet.gov/hpp/ccmrp/ccmrp summary.pdf$$If!vh55[55{#v#v[#v#v{:V l0W5555/ / 4DyK Khttp://www.hcsc.gc.ca/ohihbsi/available/conference/presentations/guerriereyK http://www.hcsc.gc.ca/ohihbsi/available/conference/presentations/guerriere$$If!vh55[55{#v#v[#v#v{:V l0W5555/ / 4DyK !http://www.cochraneconsumer.com/yK Bhttp://www.cochraneconsumer.com/$$If!vh55[55{#v#v[#v#v{:V l*0W5555/ / 4DyK (http://www.dartmouthatlas.org/99US/chapyK Phttp://www.dartmouthatlas.org/99US/chap$$If!vh55[55{#v#v[#v#v{:V l@0W5555/ / 4EDyK 4http://www.healthcarechoices.org/cardiacsurgery.htmyK hhttp://www.healthcarechoices.org/cardiacsurgery.htm$$If!vh55[55{#v#v[#v#v{:V l0W5555/ / 4DyK (http://www.healthfinder.gov/healthcare/yK Phttp://www.healthfinder.gov/healthcare/$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4DyK www.healthoutcomes.comyK >http://www.healthoutcomes.com/$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4DyK (http://www.leapfroggroup.org/index.htmlyK Phttp://www.leapfroggroup.org/index.html$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4DyK #http://www.medscape.com/px/urlinfoyK Fhttp://www.medscape.com/px/urlinfo$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4DyK http://www.qualityforum.orgyK :http://www.qualityforum.org/$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4DyK Dhttp://www.health.state.ny.us/nysdoh/consumer/heart/1996-98cabg.pdgyK http://www.health.state.ny.us/nysdoh/consumer/heart/1996-98cabg.pdg$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4%DyK ,http://www.phc4.org/reports/cardiaccare.htmyK Xhttp://www.phc4.org/reports/cardiaccare.htm$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4aDyK ;http://www.rand.org/publications/MR/MR1255/MR1255.app4.pdfyK vhttp://www.rand.org/publications/MR/MR1255/MR1255.app4.pdf$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4DyK (http://www.ctsnet.org/section/outcomes/yK Phttp://www.ctsnet.org/section/outcomes/$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4DyK (http://www.ctsnet.org/section/outcomes/yK Phttp://www.ctsnet.org/section/outcomes/$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4mDyK >http://100tophospitals.com/Media/releases/nr010702 cardio.htmyK |http://100tophospitals.com/Media/releases/nr010702 cardio.htm$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4DyK http://www.medifocus.com/yK 4http://www.medifocus.com/$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4DyK $http://my.webmd.com/content/dmk/dmkyK Hhttp://my.webmd.com/content/dmk/dmk$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  /  4DyK Xhttp://www.womensheartfoundation.org/content/HeartSurgery/state report cards on ohs.aspyK http://www.womensheartfoundation.org/content/HeartSurgery/state report cards on ohs.asp$$If!vh55{5m5 #v#v{#vm#v :V l0(5655 /  / /  4$$If!vh5*#v*:V l t065`9aDyK www.usnews.comyK .http://www.usnews.com/DyK www.checkbook.orgyK 4http://www.checkbook.org/DyK www.healthgrades.orgyK :http://www.healthgrades.org/DyK www.jcaho.orgyK ,http://www.jcaho.org/q$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kdL$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kdb$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kdx$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kdа$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd($$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd>$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kdT$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kdj$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd0$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kdF$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd\$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kdr$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd $$Ifl8 B ba #c!#&>mYEEEk20m688884 laq$$If!vh5555555#55 @5 h5 5 @5 @5 P#v#v#v#v#v##v#v @#v h#v #v @#v P:V l0m65>5m5Y5E55k5 5 25 5 5 4kd$$Ifl8 B ba #c!#&>mYEEEk20m688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kdP$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd "$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd%$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd)$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd-$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd`1$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd05$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd9$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd<$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd@$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kdpD$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kd@H$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kdL$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la+$$If!vh5H5m5555555 5 5 5 5 5 #vH#vm#v#v #v #v :V l0H65$575V5 X5 Y5 h4kdO$$Ifl8I Qau'!#&$7VVXXXXXYYYYh0H688884 la]DyK :http://www.nwlink.com/donclark/hrd/history/hawthorne.htmlyK thttp://www.nwlink.com/donclark/hrd/history/hawthorne.html1CDdXGHJ  C &AfigureRBWuA%?{oBQUFgBWuA%?{JFIF>ExifII* ACD Systems Digital ImagingACD Systems Digital Imaging $(C   ("&#/#&)*---!141+4(,-+i !1A"Qaq#2BR$br34C%&STs'U? E(4)i2E`L1KU.7ku9~>,FSKi2@|YireymEb6yo .3|C_: p>?qx) ,p:UvΞr0u⤇V ~^NkQ N7NT ▗PZQKGjLEu c.ؤ"mMQ[KM eKR@~mZc=<)qh||?Lm!m;U'>о $&9HvJ?AH#Z:lÃa)Wշ.4i֒ ޹. 3q1\SLגsdAZmG< 6R:?ouL}'C6|X[DhR ~ Luu7{i8^4y8} >P+jϾB^&[.Y 9Zy0V̔jzӳE)4 u! SE!(KM'ZNTDžo̐vR2\ua)vDLHF~6r OYG;54n..=r:9)@'(J~@V N@bGjJS@w+ qc*\sV'z(ڌ|*tfG`rG++ꛝV9<0j{Gzb`B0 ԶrB~x}[nE/iE)Z3PPFw4w$dgAXs/j-6Q6KgK*se'4&Rf\]`:ʰG٣s;}:F4ڌ);J:QFísh+Jf3GWy+'z @=yє'`y~mT[ܢeD[PB;nM߆0"l;fS[B@pcԭk. /PP1'tdUAQJ)hiKt9aE)q Jֵԟoʹo.²({`bAt6 EDh!}sՂv'GqGd?R + ܸSE$'"O77;$ xuyCpu}#/K25!$%?pG2o­(lRRt插UcdJ:JrsP:Uq7+)p75w ߂ !n/8;=A;T ؞E\Zv*Ad(4QUNҊPiĜPMXˑ%!ƥ(?*ąOXF>u6O4dSkoGJ▦=󛵡&.:PJTI+8ö;VHB""5B|JcVTx*/p]Z_쇤軨j[)GnNdg|wp$?.#\ X $'ڶl/sLfzamPjϞh}/^xqK뼩HXPY!)m]m`gj˿Xغ< 14pU غGF;F|3h:E xJ<! )X &4#PBX#ZUHǯtI7f f(#m6n ZJ3(u6t#zM 0{(;lisIn6lƝ#z=3|2hf)RĦT\bC{)׷j-ݶYNuv=N#* 8R7ȧb;R`\'nj|Vk!ΡZG> !S|R!%*:ԥdNOJ6Pd椙![9h:MS_a$S$8;⤁\UnH]jS௕˥1U0Ӎ6.Yj=^]7RnnSnwRw N}*_\[\a[ԷYjG\.)WbBna"Yu*J#8G96,e6ˌ;9l#SS:/6EuƚRY؝HV3ӡ2oΏj$d|p[(M2ҤJ~*)>ZsVt*䉜h=t$o}\ޠ pcҜyzu)lr;LL$"{l,w hϞެ9v\=B_3)V%R6V{g%Jt rթmҞ c Hz=k,~<8 8aޙm}ZdFi Β㼼F)oIAqnB)Zb#ejm\'8j bTSAO9JHFqs\FvqG[ RswO_lECRC i@CKQy GqJpaשara ZΗSw5E\.f!y?x$-ȬYHqi@8Կ1UV>9(V!m/AM2q%-Ts*]wyOI@RӋBVuX6yc#tBle8;{k[ %Oh)Ign,Lّ)Jq6ث[]()sg)Hq{Gկ;mXSt'QF0 u3oKp\؜%!#KGTo*+Ry̸Hߵ2n-x2*D2Rt;|KR]Z>t]Z }ݾ4VËro8QH;s=iEuז) -Q} Lc;ԷGq[ Fk/1CU*:#$JGBI(j3cJRF#" Sޝ8!@ G;]"zRIQmF)ZHcgg[OOnPR0GihEC#Q=qR]- s )icu j;mq7ASL*bCKR> '#&:,=pNt%HwtQ)84Ĉt! TJZ͹)3ԍK }TM$zA 'VHޟEڂ6~xڡoB*5Z$0 je!%Y=;Qn62v?2iNFs:t=;IhRjߡI>3D%kOU?1ӵNEĶ*Ns-}yJԤ>;hN)OZQQL}b!Cl km/?q&lM 'jcViie9pYk| vU֯G h!t|l6IUD FB['U`+pgcߥQA5] 6\ZKm!Q 85Z{j+m\%l~Kevsgou-0"JөN$\W|{死k1Ĕ4BԤix|uy|r6wY 5ydGL#8 kfJy + H>H_${, o@¤HRFp%ac}~8zm֛,4ut&[&uKfuh!E (xv&"[L!+%Ni?jFߟ_zBu l K- `dRHY $_BmsFDNei%xK⹭;uuRI' c⡙cz"ÖmMH3l!ЀWjN@ ɘڤc9AzC޲o,54%\>cYB^8h'` \U3 UKu*-ZHF7sFNw~ +A-G1e:.u GCֽUt3=Zqۮ)Au8F(ǕT@M*)LTP\g֨p4?"-'=R5Qf6W]_%JxTVeLCv;pjtZӐs B )\2.Α%,gu!#$ݵx1/:]aRd`|[lv:"jC͆Q|)'5> prϚ`-Ӏr6PRG|ZEg׎\&-O !A@MLx u˖xo $c`?]E"U$gg Š{ mڮ1%*ZLB[lI$k7jDsT㥶hA$vϰz) !HH|4d< ky$R@w٪}m"lZ.-%Ej>H$Ele[%μʴ|I!#)Q_--0|e=7#ZU"- Rq)\9=ߍe/~pe§Jd4[o+I$Cέcb6iJe ྒj:AB?pq'ʹp)KK %#8V=܃l 2JS.%E.)q[RQ ZrwptOR7~SM"t iSӹm[NJdE#ZV7NA$uwފkԢ_mN2sHB8~u faX _R㨩.sv?uEΗ>g4*\Me};2{Tȥ]QE.֗Jx|0T'I,x9+t[9ˊB$*8;cx1(Ԗe8Jԧ:BOt u5 Di̮ܖXEI\ʤb-or\C.Pu5tU4HSi.*GF]uxBʉJn+ͭ[A(V +J==AVv(ֵ\!-˒p|dm` 0-L2YC%Zty:ai@MzQ-'ؓ"1eMiupduԯ]FmA% m.k9:l;&p:yQQ\Q &ן )_?]'j:~?F7z|IWGEQEIޗ#KIޛk:ox>ݱyьq7 LgQƒImrs(qR&Ia-o<0!qINGpwDN?L$%8y?䖀Rn'i[tB""B\YsP:(RJZ)OJN~>([}YO\\˭oʺH#ΊmUVڲqznM NsjJ!$}kEؼhBVzijdΊ9L+p5"T(iZU%NR'@S>&?a $dc h qjS6NZfI '|.)ʛ~,XB+Dq#y Gu *{;m9ʂ] m@USϣEopⴜ(l}u'jljS,_W"+ZHQrsFp+P^=Hl%7ϫ'@H 4?sbW 7Ϸc Vy(]N{-BxAeYpS]#'~s3xNe10$#B+pWHBZӮbmv')DqJ®_KFԕ$KRp1;T/s2d^ۡG@~LujmтAz`}]o$!syHtvYT:DiGԊ88'NEcV|u\>P⧍aD9n ỐIx3֞՚ݜZQ K|AN*ϱpU!/-0\w-D#Ps\OzԲu+̎}P$hҦp0: ;-E !ž :¡߭ /ҫ|2ҔT#qSplQ*\h|HJ7յ3wYp9#qe YHmA~{RNdPi)NZD'6(ܦA}^/nͭ*5a4h=U҄cYAt b"2lJPґԩA$tE&$G\8[C$)GNjuq1A):j۽,~#H ,h֥R4;Uw8ި~Ń! IVqa"6 &cN8jum!^-"olYR3< wkLfd+Rq- %Y*TV#>BmJFJ}q \GbJuR?^Rь(|{ukdGNc6ge%J^V).T #$@)]AJ #}R6 @dfX97NFC!Τe'E8) ^q(BzNm8)*IIiڶ\Ks R$%)O /K M*Eh=iH.TW#\ߵK2Lgy!ڐHUXW̻l$5hiP$zsDmC/6Et_jm#ȷDr_ij +lڭͺv_ybˑpu7!* ի,gYo׉O=% (']yQneʺ\֍I)i~ma]jZzL%`(?#=wR@-:uJӱg_ L㡴Rwmr3fKl4S!h#_dlU62ŲY[p[H_u+@Hu=3V]nTR߸]Ib,3P~bqu jyi 9JSq'J r{cjzY&zCo!56T&S3ӋF[VI0AZ3؛Ésda POȵۛ~4)b2r9wi<|ոq$Y +LvX-$HjBl,9s]4Gr-)jxu% Pyz:ap43\ՂFq?*^*Z֔2gV:tu|䝿04$qĔcQ@žq"%AƐ >>9 #RI43Ɣ kƖRBۨ-趘 Ä,4 *;{ե$Ϯw,Z_Vo08zcK +j:SNxbDKm]IF?TG!~1pa.'ߢu*0jX)Ke4(g JAr>uV|a*qM.\Y%J$u5Ila: j HR sϪ]yl i Cn# G*ܛwm vC)mJNa+@A~視R((^Z0HsҥV_?HHY$ߨ;vQ1a9H_1Kvk[RLw5 QL kXom` QjY Hp>$ ,˒[5@Vݷ"eJT{lr <簨jPY,FO+c8ڥԅ8O%Z7[rCR$) 7vn0~$iLoqRA+٭C:s9[Η. ,J,2O/:vH9Kt Lƙ D[+%(6HNvj4eZﾅʐ+VR=ƚ '4FC֤T0i=qV~UK7S7ܧSJnkq-KW#S%n*:U`'S&m<1KXZv W)}6f[F/O@HV)L֜2_R)I#ut>U=uD9Kmċ[ !d$}sa] ⛵-Ka}õ_Fv]k%&0'g6%-N1卿*p鹨47*ؗ:Lt>~Fگfǹ؝elIm.=CjK@KH@uA%G=juR;}+JJҫZُ $!a@% xs #Lx"s%(d`'jI>f/]o8jA5iy0 h+FwmK%6d9)ϩPz=* pe?܂*F4(g#HNw)|y<q+NS #ROE ϥhڠ$wqO/Гl=֢yeNm KY8 'bR̋쀰|ƐٴxpBv`. -M #jIm5QY\-%TWCj-+ӥJIUIS0F:!8y䷑  vof04  ;G.FRC C@RT4 n fnn߅SFAPmb!)A (#:c PҬFQw9&ca䠅J%'qLČŋY8m'1lxRqѡcQMn`ֶ*C\ "عsr\x; $JWd[!>gR5 a B0wY%=)v;nCƊBIg bI\{vjumw[%@ʋAp竦B1ѿ:H6娧F9[t'C&xreA W$lwi%;m'=)j>tB|-<> Ri7q}ɒn{)aq-HѨ%HЬg}s#_-)^>p=)#JK-ɐ̶ˈIjOZK}mrUvW ĶOov$i O 617Ȇ,R±'LqlS-m8U4l8bP)IϋnlBsm{.BÓf^i̺5G+A Г Tn\qt:^硟ڥ|+# k Rs2)d{Ԗk,Զb6)@8S*I^2u멎N# dNҭͮmKZKn]RЕ$+R:UKUnKP&2ޔˋZJBRU铵OpFT!GQ}+oyAn^yJ5TRwHs`H1zym:%y>l̨ȑii+B*}X=)e rrPܠ1s=H";(RRqqHKQN!7R'JQ 3MThi9NP<'RJJTI¢o8"C5|-_c'LZmh勜Z\NX Ү!!!)0jԩR- IMGLMV=6$ ˗W7Ɵ$cojE䦛ZqE+Ӏ 9{֝tŷ›&jЇpj7+" ,Ⱥ!SQ A)N@#Hߩp9m ΄*2թA!YlV Ο5Fq,j@Gt&P@q\KwCIsڙ$$ct0TIc~Y`QuF)h4gziqֹ-%-Qd=mk}PZԕAAJNN2|-7x%VI!\@Y#s* n҉9MH:U3ՋCXl82Ҽ #}UE*?4OCc im*@;9T8:5dlu2.Mu<טު3}|R_z@ʰ3%_YrENLgAoƸXyG8#zl姓 ,,[QO-dҜXRBAmE }>Uŀkg5M٭N\ƠDZK@(jϞ3QMDЙPmJR0i$n6W"$q6v<+dBYmev$?Fm"ah$ '9#Vmvĩ—nOR|?_랕z= ':JN>Y(lAhe! vb88PzS40(#jA IPIVM9Î_ԥu1Kl,e*.|?&B=XrAE2D{qCq3ٴ!Upy Bq?nqPNp,m@iI*C1TuAW,lu5h4CI*A#==iIy+" PZ*liKwN@5@*~Z%[hWJҍ(4g>^UqILṴ$Huz~5jǶDDh҄ԓպu6j!(KJ)%+H)#I J:_Ȅwr0G+|nG9W~zb˷iDEKBPegN=+-u < g| ֥ۥ302ZRӨ! 'ntzeP[n9(*.)Js.Cl<O>rT4eG8ε:ZyipF;pe"E`-*ԓzWa܍'9X|h@ j?~5wF)Zu!8sf̾ITJQGk`FF@OsVRuJ=ij@|sM6NY>vIyCR¼rh•jʻ֙u@=]+{:[!)$Ea02rMK'^b RS%NJ f_Hdi!:]CJ2~}(sV_  }ukUz8%I Ue\W1ƒ94rf6“4Rbdy[%lIAsYjU Ăz3=x6ImБ6SmKIӭ");SE-P)M!T&;2Z->\lJEejm|KiK$D{qV"]:aиOƒ}Cn+έOptepe2LMKotʥ] \NeIV)9{2w .-i+RVRvEE3^uWy֦N5FZ RXs+PW)pk~t>QMڂ;wLSlIQՕ÷%8͉to$S_oZem*c˛0y}թ_GE-(IS~XȢZ/QLU*vhbK|C0qH&($ufF\A\Rr /GT}< zeГG\=w?إ}E-sxHl uUo oBH s)p| 'ZΛk ) tEg8 t|_ޜdʞG%,՚J;09 QJE `qKEtڄޔBw4袍?RZ\R:y`+bìgEmS1N8T)V_#|=I=)#_.ug^Etb;Nh{Vྙx>窱'T^1Gu܊~})2;!.[BN߀V+E@K6y„8\J:Lx0^-i?Q Vp2 =iiE3(4$^vWJDR+/zT4@cҊZ1HէzTP ;QÊ+Xi:z֤:QޒIKڔPhQE/jjP)E1CDdXGHJ  C &AfigureRBWuA%?{oBFgBWuA%?{JFIF>ExifII* ACD Systems Digital ImagingACD Systems Digital Imaging $(C   ("&#/#&)*---!141+4(,-+i !1A"Qaq#2BR$br34C%&STs'U? E(4)i2E`L1KU.7ku9~>,FSKi2@|YireymEb6yo .3|C_: p>?qx) ,p:UvΞr0u⤇V ~^NkQ N7NT ▗PZQKGjLEu c.ؤ"mMQ[KM eKR@~mZc=<)qh||?Lm!m;U'>о $&9HvJ?AH#Z:lÃa)Wշ.4i֒ ޹. 3q1\SLגsdAZmG< 6R:?ouL}'C6|X[DhR ~ Luu7{i8^4y8} >P+jϾB^&[.Y 9Zy0V̔jzӳE)4 u! SE!(KM'ZNTDžo̐vR2\ua)vDLHF~6r OYG;54n..=r:9)@'(J~@V N@bGjJS@w+ qc*\sV'z(ڌ|*tfG`rG++ꛝV9<0j{Gzb`B0 ԶrB~x}[nE/iE)Z3PPFw4w$dgAXs/j-6Q6KgK*se'4&Rf\]`:ʰG٣s;}:F4ڌ);J:QFísh+Jf3GWy+'z @=yє'`y~mT[ܢeD[PB;nM߆0"l;fS[B@pcԭk. /PP1'tdUAQJ)hiKt9aE)q Jֵԟoʹo.²({`bAt6 EDh!}sՂv'GqGd?R + ܸSE$'"O77;$ xuyCpu}#/K25!$%?pG2o­(lRRt插UcdJ:JrsP:Uq7+)p75w ߂ !n/8;=A;T ؞E\Zv*Ad(4QUNҊPiĜPMXˑ%!ƥ(?*ąOXF>u6O4dSkoGJ▦=󛵡&.:PJTI+8ö;VHB""5B|JcVTx*/p]Z_쇤軨j[)GnNdg|wp$?.#\ X $'ڶl/sLfzamPjϞh}/^xqK뼩HXPY!)m]m`gj˿Xغ< 14pU غGF;F|3h:E xJ<! )X &4#PBX#ZUHǯtI7f f(#m6n ZJ3(u6t#zM 0{(;lisIn6lƝ#z=3|2hf)RĦT\bC{)׷j-ݶYNuv=N#* 8R7ȧb;R`\'nj|Vk!ΡZG> !S|R!%*:ԥdNOJ6Pd椙![9h:MS_a$S$8;⤁\UnH]jS௕˥1U0Ӎ6.Yj=^]7RnnSnwRw N}*_\[\a[ԷYjG\.)WbBna"Yu*J#8G96,e6ˌ;9l#SS:/6EuƚRY؝HV3ӡ2oΏj$d|p[(M2ҤJ~*)>ZsVt*䉜h=t$o}\ޠ pcҜyzu)lr;LL$"{l,w hϞެ9v\=B_3)V%R6V{g%Jt rթmҞ c Hz=k,~<8 8aޙm}ZdFi Β㼼F)oIAqnB)Zb#ejm\'8j bTSAO9JHFqs\FvqG[ RswO_lECRC i@CKQy GqJpaשara ZΗSw5E\.f!y?x$-ȬYHqi@8Կ1UV>9(V!m/AM2q%-Ts*]wyOI@RӋBVuX6yc#tBle8;{k[ %Oh)Ign,Lّ)Jq6ث[]()sg)Hq{Gկ;mXSt'QF0 u3oKp\؜%!#KGTo*+Ry̸Hߵ2n-x2*D2Rt;|KR]Z>t]Z }ݾ4VËro8QH;s=iEuז) -Q} Lc;ԷGq[ Fk/1CU*:#$JGBI(j3cJRF#" Sޝ8!@ G;]"zRIQmF)ZHcgg[OOnPR0GihEC#Q=qR]- s )icu j;mq7ASL*bCKR> '#&:,=pNt%HwtQ)84Ĉt! TJZ͹)3ԍK }TM$zA 'VHޟEڂ6~xڡoB*5Z$0 je!%Y=;Qn62v?2iNFs:t=;IhRjߡI>3D%kOU?1ӵNEĶ*Ns-}yJԤ>;hN)OZQQL}b!Cl km/?q&lM 'jcViie9pYk| vU֯G h!t|l6IUD FB['U`+pgcߥQA5] 6\ZKm!Q 85Z{j+m\%l~Kevsgou-0"JөN$\W|{死k1Ĕ4BԤix|uy|r6wY 5ydGL#8 kfJy + H>H_${, o@¤HRFp%ac}~8zm֛,4ut&[&uKfuh!E (xv&"[L!+%Ni?jFߟ_zBu l K- `dRHY $_BmsFDNei%xK⹭;uuRI' c⡙cz"ÖmMH3l!ЀWjN@ ɘڤc9AzC޲o,54%\>cYB^8h'` \U3 UKu*-ZHF7sFNw~ +A-G1e:.u GCֽUt3=Zqۮ)Au8F(ǕT@M*)LTP\g֨p4?"-'=R5Qf6W]_%JxTVeLCv;pjtZӐs B )\2.Α%,gu!#$ݵx1/:]aRd`|[lv:"jC͆Q|)'5> prϚ`-Ӏr6PRG|ZEg׎\&-O !A@MLx u˖xo $c`?]E"U$gg Š{ mڮ1%*ZLB[lI$k7jDsT㥶hA$vϰz) !HH|4d< ky$R@w٪}m"lZ.-%Ej>H$Ele[%μʴ|I!#)Q_--0|e=7#ZU"- Rq)\9=ߍe/~pe§Jd4[o+I$Cέcb6iJe ྒj:AB?pq'ʹp)KK %#8V=܃l 2JS.%E.)q[RQ ZrwptOR7~SM"t iSӹm[NJdE#ZV7NA$uwފkԢ_mN2sHB8~u faX _R㨩.sv?uEΗ>g4*\Me};2{Tȥ]QE.֗Jx|0T'I,x9+t[9ˊB$*8;cx1(Ԗe8Jԧ:BOt u5 Di̮ܖXEI\ʤb-or\C.Pu5tU4HSi.*GF]uxBʉJn+ͭ[A(V +J==AVv(ֵ\!-˒p|dm` 0-L2YC%Zty:ai@MzQ-'ؓ"1eMiupduԯ]FmA% m.k9:l;&p:yQQ\Q &ן )_?]'j:~?F7z|IWGEQEIޗ#KIޛk:ox>ݱyьq7 LgQƒImrs(qR&Ia-o<0!qINGpwDN?L$%8y?䖀Rn'i[tB""B\YsP:(RJZ)OJN~>([}YO\\˭oʺH#ΊmUVڲqznM NsjJ!$}kEؼhBVzijdΊ9L+p5"T(iZU%NR'@S>&?a $dc h qjS6NZfI '|.)ʛ~,XB+Dq#y Gu *{;m9ʂ] m@USϣEopⴜ(l}u'jljS,_W"+ZHQrsFp+P^=Hl%7ϫ'@H 4?sbW 7Ϸc Vy(]N{-BxAeYpS]#'~s3xNe10$#B+pWHBZӮbmv')DqJ®_KFԕ$KRp1;T/s2d^ۡG@~LujmтAz`}]o$!syHtvYT:DiGԊ88'NEcV|u\>P⧍aD9n ỐIx3֞՚ݜZQ K|AN*ϱpU!/-0\w-D#Ps\OzԲu+̎}P$hҦp0: ;-E !ž :¡߭ /ҫ|2ҔT#qSplQ*\h|HJ7յ3wYp9#qe YHmA~{RNdPi)NZD'6(ܦA}^/nͭ*5a4h=U҄cYAt b"2lJPґԩA$tE&$G\8[C$)GNjuq1A):j۽,~#H ,h֥R4;Uw8ި~Ń! IVqa"6 &cN8jum!^-"olYR3< wkLfd+Rq- %Y*TV#>BmJFJ}q \GbJuR?^Rь(|{ukdGNc6ge%J^V).T #$@)]AJ #}R6 @dfX97NFC!Τe'E8) ^q(BzNm8)*IIiڶ\Ks R$%)O /K M*Eh=iH.TW#\ߵK2Lgy!ڐHUXW̻l$5hiP$zsDmC/6Et_jm#ȷDr_ij +lڭͺv_ybˑpu7!* ի,gYo׉O=% (']yQneʺ\֍I)i~ma]jZzL%`(?#=wR@-:uJӱg_ L㡴Rwmr3fKl4S!h#_dlU62ŲY[p[H_u+@Hu=3V]nTR߸]Ib,3P~bqu jyi 9JSq'J r{cjzY&zCo!56T&S3ӋF[VI0AZ3؛Ésda POȵۛ~4)b2r9wi<|ոq$Y +LvX-$HjBl,9s]4Gr-)jxu% Pyz:ap43\ՂFq?*^*Z֔2gV:tu|䝿04$qĔcQ@žq"%AƐ >>9 #RI43Ɣ kƖRBۨ-趘 Ä,4 *;{ե$Ϯw,Z_Vo08zcK +j:SNxbDKm]IF?TG!~1pa.'ߢu*0jX)Ke4(g JAr>uV|a*qM.\Y%J$u5Ila: j HR sϪ]yl i Cn# G*ܛwm vC)mJNa+@A~視R((^Z0HsҥV_?HHY$ߨ;vQ1a9H_1Kvk[RLw5 QL kXom` QjY Hp>$ ,˒[5@Vݷ"eJT{lr <簨jPY,FO+c8ڥԅ8O%Z7[rCR$) 7vn0~$iLoqRA+٭C:s9[Η. ,J,2O/:vH9Kt Lƙ D[+%(6HNvj4eZﾅʐ+VR=ƚ '4FC֤T0i=qV~UK7S7ܧSJnkq-KW#S%n*:U`'S&m<1KXZv W)}6f[F/O@HV)L֜2_R)I#ut>U=uD9Kmċ[ !d$}sa] ⛵-Ka}õ_Fv]k%&0'g6%-N1卿*p鹨47*ؗ:Lt>~Fگfǹ؝elIm.=CjK@KH@uA%G=juR;}+JJҫZُ $!a@% xs #Lx"s%(d`'jI>f/]o8jA5iy0 h+FwmK%6d9)ϩPz=* pe?܂*F4(g#HNw)|y<q+NS #ROE ϥhڠ$wqO/Гl=֢yeNm KY8 'bR̋쀰|ƐٴxpBv`. -M #jIm5QY\-%TWCj-+ӥJIUIS0F:!8y䷑  vof04  ;G.FRC C@RT4 n fnn߅SFAPmb!)A (#:c PҬFQw9&ca䠅J%'qLČŋY8m'1lxRqѡcQMn`ֶ*C\ "عsr\x; $JWd[!>gR5 a B0wY%=)v;nCƊBIg bI\{vjumw[%@ʋAp竦B1ѿ:H6娧F9[t'C&xreA W$lwi%;m'=)j>tB|-<> Ri7q}ɒn{)aq-HѨ%HЬg}s#_-)^>p=)#JK-ɐ̶ˈIjOZK}mrUvW ĶOov$i O 617Ȇ,R±'LqlS-m8U4l8bP)IϋnlBsm{.BÓf^i̺5G+A Г Tn\qt:^硟ڥ|+# k Rs2)d{Ԗk,Զb6)@8S*I^2u멎N# dNҭͮmKZKn]RЕ$+R:UKUnKP&2ޔˋZJBRU铵OpFT!GQ}+oyAn^yJ5TRwHs`H1zym:%y>l̨ȑii+B*}X=)e rrPܠ1s=H";(RRqqHKQN!7R'JQ 3MThi9NP<'RJJTI¢o8"C5|-_c'LZmh勜Z\NX Ү!!!)0jԩR- IMGLMV=6$ ˗W7Ɵ$cojE䦛ZqE+Ӏ 9{֝tŷ›&jЇpj7+" ,Ⱥ!SQ A)N@#Hߩp9m ΄*2թA!YlV Ο5Fq,j@Gt&P@q\KwCIsڙ$$ct0TIc~Y`QuF)h4gziqֹ-%-Qd=mk}PZԕAAJNN2|-7x%VI!\@Y#s* n҉9MH:U3ՋCXl82Ҽ #}UE*?4OCc im*@;9T8:5dlu2.Mu<טު3}|R_z@ʰ3%_YrENLgAoƸXyG8#zl姓 ,,[QO-dҜXRBAmE }>Uŀkg5M٭N\ƠDZK@(jϞ3QMDЙPmJR0i$n6W"$q6v<+dBYmev$?Fm"ah$ '9#Vmvĩ—nOR|?_랕z= ':JN>Y(lAhe! vb88PzS40(#jA IPIVM9Î_ԥu1Kl,e*.|?&B=XrAE2D{qCq3ٴ!Upy Bq?nqPNp,m@iI*C1TuAW,lu5h4CI*A#==iIy+" PZ*liKwN@5@*~Z%[hWJҍ(4g>^UqILṴ$Huz~5jǶDDh҄ԓպu6j!(KJ)%+H)#I J:_Ȅwr0G+|nG9W~zb˷iDEKBPegN=+-u < g| ֥ۥ302ZRӨ! 'ntzeP[n9(*.)Js.Cl<O>rT4eG8ε:ZyipF;pe"E`-*ԓzWa܍'9X|h@ j?~5wF)Zu!8sf̾ITJQGk`FF@OsVRuJ=ij@|sM6NY>vIyCR¼rh•jʻ֙u@=]+{:[!)$Ea02rMK'^b RS%NJ f_Hdi!:]CJ2~}(sV_  }ukUz8%I Ue\W1ƒ94rf6“4Rbdy[%lIAsYjU Ăz3=x6ImБ6SmKIӭ");SE-P)M!T&;2Z->\lJEejm|KiK$D{qV"]:aиOƒ}Cn+έOptepe2LMKotʥ] \NeIV)9{2w .-i+RVRvEE3^uWy֦N5FZ RXs+PW)pk~t>QMڂ;wLSlIQՕ÷%8͉to$S_oZem*c˛0y}թ_GE-(IS~XȢZ/QLU*vhbK|C0qH&($ufF\A\Rr /GT}< zeГG\=w?إ}E-sxHl uUo oBH s)p| 'ZΛk ) tEg8 t|_ޜdʞG%,՚J;09 QJE `qKEtڄޔBw4袍?RZ\R:y`+bìgEmS1N8T)V_#|=I=)#_.ug^Etb;Nh{Vྙx>窱'T^1Gu܊~})2;!.[BN߀V+E@K6y„8\J:Lx0^-i?Q Vp2 =iiE3(4$^vWJDR+/zT4@cҊZ1HէzTP ;QÊ+Xi:z֤:QޒIKڔPhQE/jjP)E(:@: cke 7$8$H$_HmH sH tH ~@~ h 1B$$ ) hp@ P !h@&^ha$5>*CJOJQJ^JaJ@ h 2B$$ ) hp@ P !h@&^ha$+5>*B*CJOJQJ^JaJnHphtHX@X h 3$0 @&WD>`0 !5>*CJ\aJmH nHsH tHT@T h 4$@&WD`5>*CJOJQJ\^JaJJ@J h 5$$@&a$5CJOJQJ\^JaJ\@\ h 6$@&WD`%5>*CJOJQJ\^JaJnHtH@ h 7B$$ ) hp@ P !h@&^ha$>*CJOJQJ^JaJnHtHx@x h 8>$$ & F & h8 xH@&a$>*CJOJQJ^JaJ @ h 9 $ & h8 xH$d%d&d'd@&NOPQUDZ]6CJOJQJ\^JaJ$A@$ ؞k=W[SOFi@F nfh@2 h$a$ >*CJaJ:J@": oRhd5>*CJ\aJVO2V Short Return Address 7$8$H$CJaJ*U@A* c >*B*ph,@R, u w  !, @b, u  !2V@q2 ]vc >*B* phT@ e,gWWG & h8 xH8UD]^8`CJOJQJ\^JaJ4/@4 Rh8WD8^`8<2@< Rh 2d8VDWD8^d`8<3@< Rh 3d8VDWD8^d`8<4@< Rh 4d8VDXWD8^d`8<5@< Rh 5d8VD WD8^d`800@0 Rhyv&{S  & F46@4 Rhyv&{S 2  & F4D@4 Rhc~ xVD^(B@( ckee,g!x8C@"8 ckee,g)ۏ"xVD^&O2& Se.sL#R@B ckee,g)ۏ 2F$ ) hp@ P !hgVDWD^h`gCJOJQJ^JaJnHtHhS@Rh ckee,g)ۏ 3% 8\WDb^\`CJOJQJ\^JaJnHtH0@b0 le,g&G$CJaJ$&@q$ l_(uH*w x "6_8QT^r33T_" @I?>=)HGF(*+,567JKLV^r33T_b  !(Fj "7p?u&'yz{|     '(ATiXYZ[\]^_`abcdefghijklmnAau.Kmyz ""(())++U+V+++//L1M1r1s1~99;;EEGG:K;KYNpNNNNDOEOQQRRSSWWZZ__bb*b5bUbkbbbcc+e,egg j jumvm"p#pr rttTwUww|x|y||||&'KLlmfgwxߛ؜ٜ\]23;<PQ899:abb7@TetHP[ef67<=FG     C r   Z |     CWXYhivwx%&'CHIejkx !"/UyHI @RS'(78INO_m@=>Fae = ?uv{RLpq CDst$ / 0 i j     !!B!C!!!<"F"G"H"I"J"K"M"N"O"#-#.#T#U#######"$#$E$F$$$ %2%~%%%%%%%%%%%%-&e&&&&$'V'W''''0(U(V(((()))*)4)5)b)c)d)))*b*l*m*n*o*q*r*s* ----9----.\.t..../|///&0'0(00000000000000000000000000000(1)1*1516171N1O1f1{11111111111 222S2`2u222222222!323r334(4)414a4s4444Q5R5666607^78'8(8)8182888888809192949>9?9X9Y9Z9d9e9o9u9999999999999::::::}::;; ;H;j;k;;;;;<-<F<g<x<<<1=2=D=m====6>H>t>>>?]???6@@wAAAAAAAAeBfBxBICJCrCDDBD E EEEEEFFFFFFFFFFFFFFFFG;GOGZGlGGGGGGGGG HHLH[H\HrHHHHH*IIIBJsJJJJJJJJJJKQKRKcKdKoKpKKKKKKKNLOL}L~LLLLLMM.M/M?M@MMMMMKNNOO2O3O4OHOOOP&PSPPPPPQ9QJQxQQQcRRRSqSSSSS.TOTTTTT>UIUJUUUUUUUUU VV3VFVSV^VVVVVVVWGWHWIWJWNWOWWWNXOX^X_XXXXXXXX Y"Y?YSYoYYYYYYYZZ2Z~ZZZ [ [!["[#[1[2[3[5[6[7[]\l\\\\\\]0]M]N]X]b]j]u]}]]]]]]]]]]]]]^^^+^>^O^P^\^]^a^e^j^n^r^s^t^u^v^z^~^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^___ _______"_&_'_(_,_-_._/_3_4_5_6_V_W_c_m_q_x_|__________________________________________``` ``````!`%`&`)`-`2`6`7`:`>`C`H`I`L`P`U`Z`[`^`b`g`l`m`p`t`y`~````````````````````````aaa7aQaRaga{aaaaaaaaaaaaaabbbb#b6b7bEbFbWbXbhbibjbkbpbqbrbsbbbbbbbbbbc:cQc`cvccccc d/dFdeddddd e!eLeeeeeefff f f f f ffffffffffffffffgggggggg hh-h.h2hAhRhShmh~hhhhhhhhhhi"i3iFiGiXieisitiiiij2jNjjjjjjjjk6kAkBkvkkkkk7lnlollmrmmmmXnnnnnnn"oIoJooooooo/pppqppppq q;qIqqq(r)rrrssQsRsst tWtXtttttt&uTuVuuuu1vKvLv|vvvv9wtwwwwwwww5xpxxx'y(y3y4y>y?yDyOyWy_y`yaycydyeyyyz5z6z8z9z:zfzzzzz{{{{{/{E{[{}{{{{`|k|l|||||||||}}}.}8}9}P}i}j}|}}}}}}}}}}}}~~~ ~~}~~~, KLPQRSabcdfgÀŀƀҀӀԀր؀ـ')*+,-ABCEFG[\]^_`hjklmń́ρЁсҁyՂ(?@JQVWnvƒ̃Ӄރ߃ 5<IJZalms{DŽȄʄք,3EYopυ؅`+ˈ;23JKLMfĊ89NOPQ+tu|()6`at \]q eǒ^_z?@ӔԔ/ӕJ)*;!ŘfҙĚdЛ՜6Ν,-Mx2_+hijkvwxY^ä!@[pquݧ2"a٪ #&19=EMQU_`qyǬȬݬ   !#%')+,.0134678@BCEFHJKMNPRTUVY[]^_abdfgikmnouíŭǭɭ˭̭έϭЭѭӭԭխ֭׭  $&')*+-.0234567@BDEFHIJKLNOPRS`bceghjklmnopqrîŮǮȮɮʮˮ̮ͮήϮЮҮӮԮ߮ ')*,-./01234567>?ABCDEGHIJKLMNUWXYZ[]^_`abcdeqstuvwxyz|}~¯ïįůƯǯȯɯʯ˯̯ίϯ   /123456789:;<>?@CMOPQRSVWXYZ[\]^defghijkmnopqrsʰ̰ͰΰϰаѰҰӰ԰հְװذٰ    !"#$%345789:;<=>?@ABLMNPQRSTUVWXYZ[pqrtuvwxyz{|}~űƱDZȱɱʱ˱̱ͱαϱбѱӱԱ     (  M !зѷ=>޸߸]^޹߹LM<=VWݽ޽89}~56ij/034deklNODEZ[gh'(  !"klYZqrQRCef<ghTU"#CDxy  fg#$ YZItu]^34 ?@xyIJ}~LM45 lmLMdev w   r s     4 5    K w x 12./;HyCDzO|"Cm    ) * D E M N V W a b r }           !9!L!M!P!Q!]!^!h!i!t!u!!!!!!!!!!!!!!!!!!!"" "00000000000000000000000000000000000000000000y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y0y00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000$$$$$$$$$$$0000000000000000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0  0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0000y000000000000000000000000000 0y0000000000000000000000000000000 0y0 0 0 0 0 0 0000000000000000000000000000000000000000000000000000000000000000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 00 0 00 00 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 00 0 00 0 00 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00000000000%000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000000000000  0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0000000000000000000000000 0 0 0000 0 0 0  0 0  0 0  0 0  0 0  0 0  0 00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000000000000000000000000     00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000000000000000000000 0 0 0 0000000000000000000000000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 &0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0   0 0 0 ,0 0 0 0 ,0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000000000000 0 0 000000000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00000000000000000000 0000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0  0 0 0 0 0 0 0 0 0 0 0 0 0 0000000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000000000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0000000 0 0 0 0 00 0 00 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0000 0 0 0 0 0000 0 0 0 0 0 0 0 0 0 y0x00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 y0000000 0 00000000000000000000000000000000000000000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000000y0 0 000 0 0 000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000 00 00 00 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0000 00 00 00 00 00 00 00 000 00 00 00 00 00 0000 00 00 00 00 000000000 00 00 00 00 00 00 00 00 00 00 00 00 00000000000000000 00 00 0000000000000 00000 00 000000 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00000 0 0 0 00000000000000000000000000000000000000@&0@&0@&0@&0@&0@&@&000Q@0y00@0y00@0y00@0y00@0y00y000y0y07?0y0!?000y0 1?0y0 /?0y0 -?0y0#00y0 ?000y0 ?000y0 ?00y0#0y0#0y0#0y0 0y0 0y00y00y0)?000y0-?000y01?000y0#0y0y0  w L#5,4=FNRC\aimuYitl%_  !"'-.16]7 =>6CJKOL`MXZ\>a#kmqXsuFvxx{SњmvȪ˵5G&h`Gc im ST !#$&'()+-.01345679;=>?@ABCEGIJUXZ\^bdhlnqux{}~  %'4DGKMRWdfhl g L9O[k~\A3Rd$T "=$') ,*./11246@69==>>G,JLK6LUMrOQSTU[VJWXXXZ\]_a8fhBkKnZpqrrhs&uuv=v^vvvvvvvvvwww,w9wEwRw`wqw~wwwwwwwwx?@ABCEFHIJLNOPQSTUVXYcegkS'<FTGG___ȎHae=z ]UWWWم"\(IEpBvώďFnoĒ <9ЕƖpϙn͛@˝ƞٟiР(ա )QcȦ'KY" XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXNTX8SW@-V2(  HB  C D%H   #  * NB   S DNB  S DNB  S D NB @ S DHB  C D HB @ C D H  # + T ( C  (  T ) C ) H * # *   H + # + B ,    HB 0 C DHB 2@ C DHB 4 C DH 5 # 5 H 6 # 6 H 7 # 7 HB 9 C DHB : C DHB ; C DNB < S D&H = # =' H > # >( H ? # ?) H @ #  H F # F  B G   #  B H   $  B I   B J    B K   B L   NB M S D"NB N S D!NB O S DNB P S DNB Q S DNB S S DNB T@ S DNB U S DN V 3  B S  ?00000099:::}:FFFFFFFFFFFFF_eeeeeefffffXtDyay6z{-S"QptSt" t(@ o'tV6tT!~ tU$ H~ t #d#tUttl#ttPt,$t*t+ t)q  t4\ q t2 !q t044q t7$t; ! !t6t:44t5 t9\ \ t@.!tF?!tLdDX tKd X (tPxl tOxl tIx tJdX tNxXtMxdtGddX tHdxt*6!t<@ t=t>qt?%At  t  t _Hlt114738970 _Hlt114738971 _Hlt12252735 _Hlt12252736GG "@@@@HH "cM\ M M M< M M| MsMsMrM<MMM<M|MMM|M<MM!MT!M!MԨ!M!MT!M!Mԧ!M!MT!MlRM,RMQMQMlQMlXM,XM}MĘM,YM,δMD̴MUM䗵MXM M M MD[ MtJ M MTMԣM$M4M,(M4M CM\MJMM,RMWMXMMM$ MXMl M[ Mt!MD"M4Z#M$$M>%Ml%&M6'ML(Ml)M*MT+M,Mm-Ml.Ml/M\l0Ml1Mk2Mh3M/4M,.5Ml.6Mđ 7Mtx 8Mx 9Mx :M4y ;Mty M4z ?Mtz @Mz AM<{ BM|{ CM{ DM{ EM<| FM|| GM| HM\} IM~ JMT~ KM~ LM MM NM OM< PMT QM RMԃ SM TMT UM VMԄ WM XMT YM ZMԅ [M \MT ]M ^MԆ _M `MT aM bMԇ cM dMT eM fMԈ gM hMT iM jMԉ kM lMT mM nMԊ oM pMT qM rMԋ sM tMT uM vMԌ wM xMT yM zMԍ {M |MT }M ~MԎ M M\ M Mܓ M M\ M Mܔ M M\ M Mܕ M M\ M Mܖ M M\ M Mܗ M M\ M Mܘ M M\ M Mܙ M M\ M Mܚ M M\ M Mܛ M M\ M Mܜ M M\ M Mܝ M M\ M Mܞ M M\ M Mܟ M M\ M Mܠ M M\ M Mܡ M M\ M Mܢ M M\ M Mܣ M M\ M Mܤ M M\ M Mܥ M M\ M Mܦ M M\ M Mܧ M M\ M Mܨ M M\ M Mܩ M M\ M Mܪ M M\ M Mܫ M M\ M Mܬ M M\ M Mܭ M M\ M Mܮ M M\ M Mܯ M M\ M Mܰ M M\ M Mܱ M M\ M Mܲ M M\ M Mܳ M M\ M Mܴ M M\  M  Mܵ  M  M\  M Mܶ M M\ M Mܷ M M\ M Mܸ M M\ M M$ Md M M M$ Md  M !M "M$ #Md $M %M &M$ 'Md (M )M *M$ +Md ,M -M .M$ /Md 0M 1M 2M$ 3Md 4M 5M 6M 7M 8MD 9M :M ;M   ,,99  aaw ~~ "      !"#$%&(')*+,-./0123546789:<;=>?@ABCDFEGIHJKLNMOPQRSUTVWXYZ[\^]_`abcdefghijklmnopqrstuvxwyz{|}~     ! "#$&%')(*+,.-/012345768:9;<=>@?ADBCEFGHJIKMLNOPRQSUTVWXYZ\[]_^`abSS]ahhcc-U3!9??MMQbuuvv{{ ˒גג>>pp6      PPAA!!!\0\000 6 6 6$6$6hXhX+Y+YY [ [\!a!aAa3cdggknppppvv{{{ۀۀ88ԂԂBMMOO(..$$ddbbáʡӡӡ//88LLYdww!!44dppǽϽϽ̾̾¿%%N   99NRRiUU ;;p)//_ep||``@immII;;eoo(22nn~z    Z ^ e X<AA55<<v "  !"#$%&(')*+,-./0123546789:<;=>?@ABCDFEGIHJKLNMOPQRSUTVWXYZ[\^]_`abcdefghijklmnopqrstuvxwyz{|}~     ! "#$&%')(*+,.-/012345768:9;<=>@?ACDBEFGHJIKMLNOPRQSUTVWXYZ\[]_^`ab =:*urn:schemas-microsoft-com:office:smarttags PlaceName=;*urn:schemas-microsoft-com:office:smarttags PlaceType<X*urn:schemas-microsoft-com:office:smarttagschmetcnvBY*urn:schemas-microsoft-com:office:smarttagscountry-region>[*urn:schemas-microsoft-com:office:smarttags PostalCode:_*urn:schemas-microsoft-com:office:smarttagsStreet;`*urn:schemas-microsoft-com:office:smarttagsaddress9a*urn:schemas-microsoft-com:office:smarttagsState8b*urn:schemas-microsoft-com:office:smarttagsCity9c*urn:schemas-microsoft-com:office:smarttagsplace @r@}@@@ B%BEFHFMFZFcFFFFGGGGGGKK >'>5>Z>k>??????!@%@L@T@@@@@@@^AeABBGGNGOGYGGGMMMMMMMM-N3N5N9NTTTTVVVV&W/W1W@WWWWW?YJYYYYYZ#Z[[\\0]6]f]g]]]]]]]^ ^ ^ ^+^1^|__gaqa/d=d=eAeeeggiijj!j&j(j-jkkmmpppppprr s s\u_uRvUvbvevvvw"weyfyyyyyzz:z;zfzgzzzzzzzzz{{/{0{E{F{[{\{}{~{{{{{{{E|I|J|N|||||||||}}}}9}:}P}Q}j}k}|}}}}}}}}}}}ƀр4@GOҁT_hx)5#+yU^rԮٮϯׯدBK-8=Ax|1=>Jbg~  .4ܶ+;<DISW]BIHLbh¹6:QVACHN_juyHSptӿ\gw} \`PU]cio!Y_`jko$9>io;?&DH"%)&.pt#%*^g v} 8<V]ah GMNRjpv~<?COPTu{ Y_2=PU.2HO}9=FLMQ  +17< !);E  &0y| -7CGntILQ]^byciovEK %,05BQU\`ejz'+EM[` rxy}`d/6dhtx48RWsy:Dai|6<AIMRTXry!7>u0>joB P  * x            3 =         : A         K N ^ b }      7BJQ4<   !(-3=AGMT\`dDU]$6=    % &       !!!!" "[_tv@A!!4#7#1$3$%%W'^'//=1G14(577):,:;;==,?.?c?e?U@^@BB~FFGGHHIIJJFKIKKKNNVQaQUVW1XbbPgRghhooxrzrsstttt{{^`AM>Cԋًz}r}&)# ڶݶ޼˾ξjr]_Y\IN ),ah")  3<SVdgt   @G%0:(0!"####0(6((())**a,,(0y0"1$155(7/727]7a77Z>k>rAvAFFHHHHHHIIGJRJLL@MqMrMMMMQ8QT"UWX/\5\@\X\ccf_f$j&jkk9l>lllm!mtmwmmmZn_nnn$o'o1p9p/q6qssOtRtu u.u0uuuuuuv3v:v@vJvvvvvvw;w>wXwZw|wwwwwwwwxxxx{{{?|S|[|}~~ÂƂ(2Å+~Ċ7_qǒ]T\(ҙiЛg +gDGacţˤФdh%0DG_n"+^g6= aegͬϬu)Jgu/2-.  (LjEVY/25BSN?BAwIs DH&)"$`h  f p   Dtu-9<D|2* 3   !! "3333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333s33333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333333auP+T+RR__b*bjjgwCWxCIe">@<"K"*)4)c*o* --0000+141{11114'44449?9Z9e999wAAFFLH\HJJRKdKZ1Z~ZZ [[#[3[@\l\^^^__/_6_W_``ggww(y3y?yDy{{`|j|.}9},yʄքkx٪< "=DCM >03hvm"uD* C E L N U W ` b q r | }      9!K!Q!\!^!g!i!s!u!!!!!!!!!!!!!" "D "%Gt|=&M34  f!g!:#;#<#>#?#J#K#z#####$@$A$a$b$c$r$$$$ %L%Z%[%%%%%%&&@&W&X&&&&&:'''}(~(((((((((( )')()*)+),)-).)/)0)1)2)3)4)<)=)>)))))))))))****X*****+++B+t++++++, ,K,c,,,,,,,,,,,-->-?-n-o-----.*.+.d.e..... / /=/>///E0R0S0_0`0a0b00000000111\1]111>2?2@2A2B2O2P2v2w2222223333m334444*4+4,4E4F4G4_4k4|4}4~44444444455*5L5M5}5~55556(6I6Z666 7 77E7p7778 8L8g8q8859`9l9::O;P;\;];s;t;u;v;w;;;;;;<<(<=<K<X<h<s<<<<<<<=/=L=W=c===,>>>>>?? ? ?.?/?O?P?v?w?????@@/@>@^@@@@@@@AAAAvAAAA&B]BBBBB CCKCCC6DDDDDESE~EEEF"FFFFF G1G2GGGGGGGGGG HH2H?HJHlHHHHHHH3I4I5I6I:I;IIIUJVJgJhJJJJJJJJKK8KLKhKzKKKKKKK L/L0LELULVLdLeLLLLLLLLL MMM8MIMZMkM|M}MMMMMMMMMNN#N0N>N?NZNNNNNO5OQOnOOOOOPPP0P1P2PGPHP[P\PmPxPPPPPPPPPH. L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH. ^`hH. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h ^`hH.0^`0o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.h ^`hH.h ^`hH.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.^`5o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH. ^`CJaJo(. pp^p`hH. @ L@ ^@ `LhH. ^`hH. ^`hH. L^`LhH. ^`hH. PP^P`hH.  L ^ `LhH.0^`0o(. pp^p`hH. @ L@ ^@ `LhH. ^`hH. ^`hH. L^`LhH. ^`hH. PP^P`hH.  L ^ `LhH.@^`OJQJ^Jo(" ^`OJQJ^Jo(hHopp^p`OJQJo(hH@ @ ^@ `OJQJo(hH^`OJQJ^Jo(hHo^`#?fK=QF   VDWD8^ `OJQJo(l hhWD8^h`OJQJo(lOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac SurgeryreillygpcOJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hHHt$`h`^` hH.L ^Lh^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.h ^`hH.h   ^ `hH.h  L ^ `LhH.h xx^x`hH.h HH^H`hH.h L^`LhH.h ^`hH.h ^`hH.h L^`LhH.808^8`0o(. ^`hH. pLp^p`LhH. @ @ ^@ `hH. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.h^`OJQJo(hHh pp^p`OJQJo(oh @ @ ^@ `OJQJo(h ^`OJQJo(h ^`OJQJo(oh ^`OJQJo(h ^`OJQJo(h PP^P`OJQJo(oh   ^ `OJQJo(@ @ ^@ `o(. ^`hH. L^`LhH. ^`hH. ^`hH. PLP^P`LhH.   ^ `hH. ^`hH. !L!^!`LhH.hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.@^`.@^`.@^`.@^`()@^`()@^`()@^`)@^`)@^`)hh^h`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.pp^p`o(. 88^8`hH. L^`LhH.   ^ `hH.   ^ `hH. xLx^x`LhH. HH^H`hH. ^`hH. L^`LhH.88^8`o(. ^`hH.  L ^ `LhH.   ^ `hH. xx^x`hH. HLH^H`LhH. ^`hH. ^`hH. L^`LhH.@q^q`OJQJ^Jo(" ^`OJQJ^Jo(hHo^`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHoPP^P`OJQJo(hH  ^ `OJQJo(hH^`OJQJ^Jo(hHo!!^!`OJQJo(hHp0p^p`0o(.   ^ `hH.  L ^ `LhH. xx^x`hH. HH^H`hH. L^`LhH. ^`hH. ^`hH. L^`LhH.88^8`OJPJQJ^Jo(-^`OJQJ^Jo(hHo  ^ `OJQJo(hH  ^ `OJQJo(hHxx^x`OJQJ^Jo(hHoHH^H`OJQJo(hH^`OJQJo(hH^`OJQJ^Jo(hHo^`OJQJo(hHh ^`hH.^`o(.h pLp^p`LhH.h @ @ ^@ `hH.h ^`hH.h L^`LhH.h ^`hH.h ^`hH.h PLP^P`LhH.x^`o(. ^`hH. L^`LhH. PP^P`hH.   ^ `hH. L^`LhH. !!^!`hH. $$^$`hH. `'L`'^`'`LhH.lQlQ GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$lQ @ ^`OJQJo(2?2P244Ϧ֦Nr)*TΨ"#b&PQmݪԫիfڬ۬Tͭ+ϯܯ4aT l*_GHz%YZkQ׸ظֺ׺ tu۾+VWb2`azs>IR^hs{#)/5;AGHI^adgikmoqsuwz|}~  "#134689:;=>?ACDFGRTVXZ[]^_`bcdeghvxz{|}~    &'(*+,-/134568:;DFHJLMNOPQRSTUWXbdfghijklmnoqrtu      !"#$%&')*+,-/0FGIJKLNOPQRSTUWXprstuvwxyz{|}!"#$%&'(*+12345678:;<=>?ABPQRSTUVWXZ[\]^`afhijklmnopqrstvw !+,-/0123456789;<QRSUVWXYZ[\]^_abkmnopqrstuvwxy{|LYZ[\]^kmnprs'()+-.QRSTVWijkmop|~!"$%&'?@DEFGTUYZ[\Ej"""@AAl/A@@45N^N_DjP@P8Pt@PdP@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma?& Arial Black;[SOSimSun?5 z Courier New;Wingdings"1h#Fz dY? \  _$0dqh 3QHP&Complications in Adult Cardiac Surgeryreillygpc@ @ ^@ `o(.0.......^`o(........HXH^H`Xo(........ˍ0^`o(........ˍ0    ^ ` o(........ˍ0X X X ^X `o(........ˍ0X>0 $P$^$`Po(........ˍ0X>0  ((^(`o(........ˍ0X>0  ^`o(........hh^h`o(.H\H^H`\)\^`\.\^`\.4\4^4`\) \ ^ `\.| \| ^| `\. \ ^ `\)\^`\. d GlR.;WK&;87Z:FQ+q#,{X^oQh/bFSrX->K`#i"S )HvpJ2WF6a_$K=Q#?p @ ^`OJQJo(T @^`OJQJ^Jo(" !^`OJQJ^Jo(hHo "pp^p`OJQJo(hH#@ @ ^@ `OJQJo(hH$^`OJQJ^Jo(hHoh%^`OJQJo(hH&^`OJQJo(hH@'^`OJQJ^Jo(hHo(PP^P`OJQJo(hH;;:                 h        t~                  |                                  &         ~        bx        8                 h                 f        Z=        y&        „        (        bx        \        R&                d        j;RY WXYhivwx%&'CHIejkx.#%%%()))9-&0'0{1 222AAAAAeBfBxBICJCrCDDBD E EEEEEFFl\\\\\\]0]M]N]]^^^5_6_V_W_c_q_|_________________________________________``` ``````!`%`&`)`-`2`6`7`:`>`C`H`I`L`P`U`Z`[`^`b`g`l`m`p`t`y`~``````````````````````aa7aQaRaga{aaaaaaaaaaaabbbb#b6b7bEbFbWbXbhbibjbkbpbqbrbsbbbbb|||||||}}}.}8}9}P}i}j}|}}}}}}}}}}}}~~~ KLPQRSabcdfgÀŀƀҀӀԀր؀ـ')*+,-ABCEFG[\]^_`hjklmń́ρЁсҁ?@JQVWnvƒ̃Ӄރ߃ 5<IJZalms{,3EYopυ`+ˈ;23MfĊ89Q+tu|)6`at \]q eǒ^_z@ӔԔ/ӕJ)*;!ŘfҙĚdЛ՜6Ν,-Mx2_+hi #&19=EMQU_`qyǬȬݬ   !#%')+,.0134678@BCEFHJKMNPRTUVY[]^_abdfgikmnoíŭǭɭ˭̭έϭЭѭӭԭխ֭׭  $&')*+-.0234567@BDEFHIJKLNOPRS`bceghjklmnopqrîŮǮȮɮʮˮ̮ͮήϮЮҮӮԮ߮ ')*,-./01234567>?ABCDEGHIJKLMNUWXYZ[]^_`abcdeqstuvwxyz|}~¯ïįůƯǯȯɯʯ˯̯ίϯ   /123456789:;<>?CMOPQRSVWXYZ[\]^defghijkmnopqrsʰ̰ͰΰϰаѰҰӰ԰հְװذٰ    !"#$%345789:;<=>?@ABLMNPQRSTUVWXYZ[pqrtuvwxyz{|}~űƱDZȱɱʱ˱̱ͱαϱбѱӱԱ      "">">">@MN$$$$$&$'Q2Q36789UVWX\]^`a !" @ V @ @ @ 2 h@ @ @ F H J @ h @ l @ r t @ x @  @  @ h @   @UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma;SimSun[SO;Wingdings?5 z Courier New"1h*YFYFOO4d44 2QHP?j;2&Complications in Adult Cardiac SurgeryreillygXKHOSP%                           ! " # $ % & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9 : ; < = > ? @ A B C D E F G H I J K L M N O P Q R S T U V W X Y Z [ \ ] ^ _ ` a b c d e f g h i j k l m n o p q r s t u v w x y z { | } ~                                   ! " # $ Oh+'0 $0 P \ h t(Complications in Adult Cardiac SurgeryreillygNormalXKHOSP161Microsoft Office Word@p@ƒ\@f*@ V\O՜.+,D՜.+, X`lt|  4  8@ _PID_HLINKSAGqhttp://www.jcaho.org/\Fnhttp://www.healthgrades.org/ Jkhttp://www.checkbook.org/;)hhttp://www.usnews.com/`%eXhttp://www.womensheartfoundation.org/content/HeartSurgery/state report cards on ohs.aspx{b$http://my.webmd.com/content/dmk/dmkZ_http://www.medifocus.com/ \>http://100tophospitals.com/Media/releases/nr010702 cardio.htm0tY(http://www.ctsnet.org/section/outcomes/0tV(http://www.ctsnet.org/section/outcomes/utS;http://www.rand.org/publications/MR/MR1255/MR1255.app4.pdfp5P,http://www.phc4.org/reports/cardiaccare.htm=wMDhttp://www.health.state.ny.us/nysdoh/consumer/heart/1996-98cabg.pdgLBJhttp://www.qualityforum.org/n?G#http://www.medscape.com/px/urlinfou/D(http://www.leapfroggroup.org/index.html7)Ahttp://www.healthoutcomes.com/30>(http://www.healthfinder.gov/healthcare/3r;4http://www.healthcarechoices.org/cardiacsurgery.htm#c8(http://www.dartmouthatlas.org/99US/chap^D5!http://www.cochraneconsumer.com/e<2Khttp://www.hcsc.gc.ca/ohihbsi/available/conference/presentations/guerrierey8/8http://www.oshpd.cahnet.gov/hpp/ccmrp/ccmrp summary.pdf J,http://www.ahcpr.gov/P):http://www.acc.org/clinical/guidelines/bypass/bypass7.htm" &http://www.sts.org/doc/4502~:#'http://clevelandclinic.org/heartcenter R http://www.americanheart.org/KT=http://www.acc.org/clinical/guidelines/valvular/dirindex.htmA=http://www.acc.org/clinical/guidelines/bypass/ExecIndex.htm)umhttp://www.cochrane.org)./)~http://www.ebmny.org),/LP!http://www.clinicalevidence.org/&=&(http:/www.nap.edu/catalog/1005.html)M http://www.euroscore.org/\http://www.ctsnet.org/doc/319k:Khttp://www.knowledge-finder.com/philosophy/parsimony-fourth-substance.html#mailto:tpezzella@hotmail.comCK:http://www.nwlink.com/donclark/hrd/history/hawthorne.html  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnoqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~                           ! " # $ % & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9 : ; < = > ? @ A B C D E F G H I J K L M N O P Q R S T U V W X Y Z [ \ ] ^ _ ` a b c d e f g h i j k l m n o p q r s t u v w x y z { | } ~                            ! " # $ % & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9 : ; < = > ? @ A B C D E F G H I J K L M N O P Q R S T U V W X Y Z [ \ ] ^ _ ` a b c d e f g h i j k l m n o p q r s t u v w x y z { | } ~                            ! " # $ % & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9 : ; < = > ? @ A B C D E F G H I J K L M N O P Q R S T U V W X Y Z [ \ ] ^ _ ` a b c d e f g h i j k l m n o p q r s t u v w x y z { | } ~                            ! " # $ % & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9 : ; < = > ? @ A B C D E F G H I J K L M N O P Q R S T U V W X Y Z [ \ ] ^ _ ` a b c d e f g h i j k l m n o p q r s t u v w x y z { | } ~                            ! " # $ % & ' ( ) * + , - . / 0 1 2 3 4 5 6 7 8 9 : ; < = > ? @ A B C D E F G H I J K L M N O P Q R S T U V W X Y Z [ \ ] ^ _ ` a b c d e f g h i j k l m n o p q r s t u v w x y z { | } ~        !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789;<=>?@ACDEFGHIJKLMvRoot Entry FpUJxData po1TableŷWordDocumentSummaryInformation(:DocumentSummaryInformation8BCompObj  F MSWordDocWord.Document.89q2Microsoft Office Word ech