ŠĻą”±į>ž’ PRž’’’MNO’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’’ģ„Į` šæMRjbjb >˜|c|cKL’’’’’’ˆŖŖŖŖŖŖŖtŠ”””HZ£n£ÜŠīv¶V¤V¤V¤V¤V¤V¤V¤V¤evgvgvgvgvgvgv,¤wRöyŅ“vŖV¤V¤V¤V¤V¤“vF§ŖŖV¤V¤ØvF§F§F§V¤ˆŖV¤ŖV¤evF§ÄāØŖŖŖŖV¤evF§F§ŠŃiŖŖevJ¤ -{õ¾”Ž¤hķo¢ev¾v0īvpÖČzF§ČzDevF§ŖŠŠ¤P.XäHŠŠ.XChapter 7- Cardiovascular System Cardiovascular System Exam Part of a complete physical exam Complaints or Symptoms Risk factors Cardiovascular Disease CHD- leading cause of death in US > 1 million MI/yr ~ .25 deaths 158,448 strokes 1999 cost ~ $286.5 billion ~5000 cases of rheumatic fever/yr Bacterial endocarditis – significant Congenital disease ~ 1 in 100 live births Complaints or Symptoms Chest pain Palpitations Dyspnea Syncope Hemoptysis (cough) Cyanosis (pallor) Dependent Edema Nocturia Fatigue Cardiac Disease Risk Factors Gender (men>women, until postmenopausal) Hyperlipidemia Hypertension (treated or untreated) Smoking Diabetes Mellitus Obesity (excessive fatty diets) Sedentary life style Personality type (type A) Family Hx. of CHD, DM, HTN, hyperlipidemia *C-Reactive Protein is a marker for cardiac disease Hypertension In an adult 140/90 >50 million people (1 in 4 adults) in USA 2/3 of Americans > 65 years old m/c in African-American (1 in 2) >30% w/ HTN are unaware 26% are on medication/ not controlled 95% essential HTN??? Conditions Associated w/ HTN Heart Disease Stroke Atherosclerosis Aneurysm Kidney Failure Retinopathy- retinal damage occurs cause not enough oxygenated blood gets to tissue Dementia Chest Pain (table 6-1 pg 234) OPPQRST & Assoc Symptoms, Treatments Differential cardiovascular respiratory (pleural) gastrointestinal chest wall syndrome psychogenic *Fowler’s Position- classic for Pericarditis; patient is seated and leaned forward, in a slight ball *Levine’s Sign- classic for myocardial involvement; patient has a clenched fist and holds it over the heart *Angina- temporary *MI- prolonged Palpitations Uncomfortable sensations of heart beats associated with various arrhythmias onset, duration, # of episodes, quality Associated factors: exercise, chest pain, HA’s, sweating (dehydration), dizziness, heat/cold intolerance, alcohol or caffeine usage, medications Potential Etiology thyroid problems hypoglycemia- increased release of catecholamines, blocks alpha and beta receptors of heart severe anemia stress or anxiety bronchodilators, digitalis, anti-depressors heart blocks pre-excitation syndromes Cough & Hemoptysis (table 6-3 pg 238) onset (sudden, recurrent) descriptor (blood tinged, clots hx. of smoking, infections, meds, surgery (females- oral contraceptives) associated symptoms hemoptysis vs. hematemesis Dyspnea Onset (when, mode, progression) Palliative Provocative (exertional, positional) Pattern Assoc Symptoms Assoc. conditions Dyspnea on Exertion (DOE) grading 1-5 1- excessive activity 2- moderate activity 3- mild activity 4- minimal activity 5- rest Dyspnea of Rapid Onset Pneumonia Pneumothorax Pulmonary constriction Peanut (foreign) Pulmonary embolus Pericardial tamponade Pump failure (CHF) Peak seekers (high altitude) Psychogenic Poisons Positional Dyspnea paroxysmal nocturnal dyspnea (PND)- sudden onset occurring while sleeping, relieved by assuming upright position orthopnea- lying flat, requires multiple pillows trepopnea- more comfortable on side platypnea- problems sitting up, patient breaths easier in recumbent position Syncope (fainting) (LOC) (table 16-6 pg 604) Onset Has it happened before? pattern? Did they actually lose consciousness? Activity at the time Position before and after Preceding Symptoms or warning Medications- vasodepressant Dependent Edema Accumulation of excessive fluid in the interstitial tissues System Differential: cardiac, kidney, liver, Peripheral Vascular System Onset- U/L or B/L, timing, palliative, or provocative, assoc. symptoms, ulcers, discoloration, pain, SOB, meds Fatigue Cardiac (m/c CHF & Mitral Valve Prolapse) Infections Chronic Illnesses Anemia Depression Toxemia Medications *you cannot perform cardiac percussion on a female patient, due to the breast tissue CVS- Peripheral Signs Any signs of dyspnea: posture, use of accessory muscles of respiration, DOE, cyanosis, clubbing Signs of elevated lipid levels: corneal arcus (young individuals suggests the possibility of hyperlipidproteinemia), xanthomas Splinter hemorrhage of the nails Lichtstein’s Sign (was previously used to indicate cardiac disease, assoc. w/ the crease in the ear) KWB, Peripheral Edema Jugular Venous Pressure- dilated vessels in the neck Other Peripheral Signs Pulse rate, rhythm, amplitude contour symmetry condition of vessel wall Blood Pressure JVP versus Carotid Pulse Capillary Refill Pulse Characteristics Rate > 100: tachycardia increased blood req. by tissues: exercise, fever, thyrotoxicosis, severe anemia decrease stroke volume CHF, severe anemia, pericardial effusion meds that increase sympathetic nervous system stimulates Rate < 60/min: bradycardia decrease blood req. by tissues: hypothermia, myxedema increase stroke volume: well conditioned athlete heart blocks or altered conduction parasympathetic stimulation: CNS depressants, increase in intracranial pressure Rhythm (table 3-9) Regular vs. Irregular regular- consistent interval between pulsations irregular- regular or irregular pattern irregular regular: predictable pattern such as a heart block every 3rd or 4th beat irregular irregular: no pattern such as atrial or ventricular fibrillation Amplitude (table 3-9 pg 90) decreased on a 0-4 scale: 4- bounding pulse 3- full, increased 2- expected, normal 1- diminished, barely palpable 0- absent, not palpable pulse pressure: 30-40 mmHg systolic – diastolic pressure Pulse Deficit difference between the distal pulse and the apical impulse rate: vascular occlusion TOS aneurysm atrial fibrillation pulsus alternans Category Systolic (mmHg) Diastolic (mmHg) Hypertension Stage 3- severe >180 >110 Stage 2- moderate 160-179 100-109 Stage 1- mild 140-159 90-99 High Normal 130-139 85-89 Normal <130 <85 Optimal <120 <80 Treatment Options for HTN Lifestyle Modifications quit smoking/ limit alcohol intake lose weight DASH diet vitamins & minerals exercise stress management Jugular Venous Pressure (JVP) (pg 267-269) TO ASSESS RIGHT SIDED HEART STATUS!!! Reflects status of the right side of the heart Level at which the pulse is visible gives an indication of right atrial pressure to assess the patient will be supine with the head elevated. turn patients head slightly away from side being evaluated use good lighting, find the external jugular vein on each side, then find the internal jugular venous pulsations identify the highest point of pulsation, measure the vertical distance in centimeters above the sternal angle where the horizontal object crosses the ruler if sternum is higher the vertical goes at the highest point of fill, if the point of fill is the highest point, the vertical goes on the sternum 1-3 cm is normal 5 Conditions that can elevate fill level tricuspid valve stenosis R ventricular failure pulmonic valve stenosis pulmonary hypertension tricuspid valve regurgitation Internal Jugular Pulsations rarely palpable soft, rapid, undulating quality, usually with two elevation and two troughs per heart beat pulsations eliminated by light pressure on the vein level of the pulsations changes with position, dropping as the patient becomes more upright level of the pulsations usually descends with inspiration * Right side of the heart is affected by respiration (valve closure and opening). Left side may not be affected at all. Carotid Pulsations palpable a more vigorous thrust with a single outward component pulsations not eliminated by this pressure level of the pulsations unchanged by position level of the pulsations not affected by inspiration Abdominal-Hepatojugular Reflux Test Test for venous congestion and Right sided heart status patient is supine breathing through open mouth. apply firm pressure over the liver for 20-30 seconds. Normal response in increased JVP distention < 1cm and returns to normal level with in 2 cardiac cycles. Abnormal > 1cm and remains elevated. Abnormal pulsations and sounds, where you hear it the best, and what location it represents Right, 2nd intercostal space, parasternally- assessing aortic valve (a left sided structure) Left, 2nd intercostal space, parasternally- assessing pulmonic valve (a right sided structure) Left, 4th intercostal space (Erb’s point)- assessing pulmonic and aortic valves (if there is an abnormality in either of these structures, it will be loudest at this point) Left, 5th intercostal space, parasternally- assess tricuspid (right sided structure) Left, 5th intercostal space, mid-clavicular- assess monkey valve (left sided structure) (APETM- a pet monkey) Precordial Inspection Shape of chest wall Apical impulse Pulsations Masses, lesions, vascular distentions Apical Impulse/Distentions Apical Impulse a. 5th ICS, left MCL Masses, lesions, vascular distentions aortic arch dilation with aortic regurgitation tumors superior vena cava obstruction Abnormal Pulsation Sternoclavicular: aortic arch aneurysm sternal notch: carotid artery transmission Right sternal border aorta aneurysm of ascending portion (upper) right ventricular enlargement (lower) 4. Epigastricabdominal aortic enlargement a. right ventricular enlargement Palpation of the Precordium confirm inspection findings locate and define tender areas locate and evaluate apical impulse evaluate/define abnormal pulsations detect any palpable thrills (can be felt upon palpation due to turbulent blood flow) Apical Impulse Patient instructions: exhale and hold breath Location: 5th ICS left MCL (mitral valve) Diameter: 2-3 cm (1-1.5 ICS) Amplitude: small, gentle tap Duration: <2/3 of systole Abnormal: cardiac output, systemic HTN, aortic/mitral valve regurgitation, aortic valve stenosis Left Lower Sternal Border Patient instruction: exhale and hold breath Location: left 4-5th ICS parasternally tricuspid valve assessment area Normal: children and thin adults Abnormal: right ventricular enlargement conditions of increased cardiac output S3 or S4 heart sound conditions Left Upper Sternal border Patient Instructions: exhale and hold breath Location: left 2nd ICS parasternally pulmonic valve assessment area Normal: children and thin adults Abnormal: pulmonary hypertension, pulmonary valve stenosis conditions of increased cardiac output Right Upper Sternal Border Patient instructions: exhale and hold Location: right 2nd ICs parasternally aortic valve assessment area No pulsations felt there normally Conditions aortic valve stenosis dilation/aneurysm of aortic arch Normal point of maximal impulse is over the apex. *Table 7-1 pg 286 Right sided cardiac events are most often affected by respiration. Auscultation of Heart Sounds pattern- “inch” from point to point concentrating on each of the auscultatory locations assess with both the diaphragm and bell four standard point evaluation positions supine upright Left lateral decubitus Upright, leaning forward Heart Sound Assessment S1 and S2 characteristics and changes Increase vs. decrease intensity extra discrete heart sounds splits- physiologic vs. Pathologic ejection click and opening snaps S3 and S4 continuous sounds or murmurs physiologic or pathologic Discrete HS Assessment location intensity cardiac cycle affect of respiration split- timing & width extra sounds Cardiac Auscultation (done with diaphragm and bell) Right sided cardiac events are most often affected by respiration Timing events for cardiac cycle- identify S1 and S2 by palpating the carotid artery Sounds preceding the peak of the carotid pulse are the systolic and S2 follows the pulse peak Carotid a. is heard between S1 and S2 (or between the lup and dup) Heart Sounds Assessment Sequence of valve closure: MVc TVc AVc PVc M1 T1 A2 P2 S1 S2 Heart Sounds Assessment Normally, only closing of the heart valves can be heard S1= closure of the AV valves (mitral and tricuspid) S2 – closure of the SL valves (aortic and pulmonic) Table 7-2 (Variations in S1) p.287 Table 7-3 (Variations in S2) p.288 Table 7-5 (Extra Diastolic Sounds) p. 290 Phase of systole- preceding the peak of the carotid pulse. Events occurring within diastole follow the peak of the carotid pulse. Murmur Features Location Cycle- timing and duration *know which cycle you can hear Intensity the abnormalities the best, which Respiration- quality and pitch side is affected, which structures Bell vs. diaphragm are affected, if it is heard better Radiation with the bell vs. diaphragm, or Body position upon inspiration Gradations of Murmurs Grade 1- very faint, heard only after listener has “tuned in”; may not be heard in all position (most are physiological) Grade 2- quiet, but heard immediately after placing the stethoscope on the chest (most are physiological) Grade 3- moderately loud (pathological until proven otherwise) Grade 4- loud, with palpable thrill (pathological) Grade 5- very loud, with thrill. May be beard when the stethoscope is partly off the chest (pathological) Grade 6- very loud, with thrill. May be heard with stethoscope entirely off the chest. (pathological) Diastolic murmurs are considered to be pathologic until proven otherwise Mitral/Tricuspid Valve failure to close – regurgitation Aortic/Pulmonic Valve failure- stenosis Heart sounds in S1 – systolic, heart sounds in S2 – diastolic S1 (systole) S2 (diastole) (KNOW THIS CHART) McTc (regurgitation) AcPc AoPo (stenosis) MoTo Innocent/Functional Murmur (all innocent murmurs occur in systole) Short mid-systolic ejection murmur Grade 2 or less No thrill or radiation of sounds No alteration of pulse Changes with respiration or position Disappears with inspiration Decreased with standing m/c at the pulmonic or mitral area aortic valvular sclerosis in an elderly pectus excavatum- pulmonary ejection murmur points with hyperdynamic circulation: anemia, hyperthyroidism, pregnancy, fever still’s murmur- normal in 50% of children, disappears by puberty Indicators of Pathologic/Organic Murmurs (WILL DEFINITELY BE ON THE TEST) loud murmur: grade 3/6 or greater any diastolic murmur associated with palpable thrill increased duration (holosystolic/pansystolic- same intensity all the way through) (table 7-7) radiation of sounds Table 9-11 Mechanism of Heart Murmurs (Library Handout) Table 7-9 Cardiovascular Sounds w/ Both Systolic and Diastolic Components (p. 295) Pericardial Rub Timing- may have 3 short components, each associated with cardiac movement. Atrial systole, ventricular systole, and ventricular diastole. Location- variable, but usually heard best in the 3rd interspace to the left of the sternum Radiation- little Intensity- variable. May increase when the patient leans forward, exhales, and holds breath Quality- scratchy, scraping Pitch- high (heard better with diaphragm Patent Ductus Arteriosus Timing- continuous murmur in both systole and diastole, often with a silent interval late in diastole. Is loudest in late systole, obscures S2 and fades in diastole Location- left 2nd interspace Radiation- toward the left clavicle Intensity- usually loud, sometimes associated with a thrill Quality- harsh, machinery-like Pitch- medium Venous Hum Timing- continuous murmur without a silent interval. Loudest in diastole Location- above the medial third of the clavicles, especially on the right Radiation- 1st and 2nd interspaces Intensity- soft to moderate. Can be obliterated by pressure o the jugular veins Quality- humming, roaring Pitch- low (heard better with a bell) Peripheral Vascular Exam Part of a complete physical exam Complaints Risk factors PVS Complaints Pain or cramping of muscles Swelling or lymph edema Dysethesia- abnormal sensation Changes to the skin Poor healing of superficial wounds Prominent vessels- varicose veins, more common in women in men. (due to increase in abdominal failures, pregnancy, sedentary lifestyle, or someone who has a stand-up job) Chest pain Shortness of breath Palpitations Cold hands/feet Risk of vascular insufficiency Risk for deep vein thrombosis Vascular Insufficiency Risk Recent trauma or surgery Hyperlipidemia HTN Hx. Of cancer Smoker Diabetes Type I & II Previous thrombosis or family Hx. Deep Vein Thrombus Risk Postpartum Difficult pregnancy Hx. Of cancer Post operative Obesity Hormone supplement Advanced age Injury, fracture, infections Right sided heart failure, CHF Varicose veins Family Hx. of blood clots Prolonged bed rest Arterial Exam Inspection Palpation: temperature & pulses Postural color changes Capillary refill Ankle: arm index (BP) Auscultation Inspection Upper & lower extremity in more than one position Size, symmetry, swelling Venous pattern Note color of skin Nail beds: thickness, color, clubbing Hair pattern (loss) Lesions Palpation Assess the extremities Temp changes Skin texture Turgor Moisture Mobility Lesions Pulses Compare RRA B/L & Upper/Lower ext. Exaggerated or widened pulse- aneurysm Diminished or absence of pulse- occlusion Raynaud’s (Table 14-1) Buerger’s Arterial Exam Chronic arterial occlusion Intermittent claudication Postural color changes Trophic changes to the skin Claudication: Location Hx. Of symptoms: pain, coldness, numbness, tingling Constant pain: acute occlusion If excruciating: major artery It distal pulse is diminished or absent: ER If collateral circulation is good: coldness & numbness may be only symptoms Postural Color Change Patient lies supine raises leg 60 degrees until pallor develops (usually less than 1 min) Have patient sit up/stand and note return of color to limb Normal almost immediately, normal ~ 15-20 seconds, elderly ~ 35 seconds 2 minutes severe claudication Capillary Refill blanch nail bed & observe return to normal is > 2 seconds time: longer time frame the greater the problem Arterial Assessment Auscultation Carotid, temporal, abdominal aorta, renal Measure BP Should be within 10 mm Hg Ankle: arm index (brachial) Systolic ratio Ankle Brachial Index Significance > 1 in young patient or > 0.9 in elderly patient normal 0.7 - 0.9 mild claudication 0.5 – 0.7 moderate claudication < 0.5 severe claudication, pain at rest likely < 0.3 limb threatening claudication Signs of Venous Insufficiency Varicose veins Thrombosis Hyperpigmentation Ulcer Pitting edema Venous Exam (Table 14-2/14-3) MATCHING ON TEST Inspection Palpation Manual compression test (mapping)- feel the dilated vein, then move the other hand up the leg at least 20cm. you are feeling for a downward impulse against your lower hand. This shows that there is an incompetent valve. Trendelenberg test (retrograde filling)- patient supine, elevate leg to 90 degrees to empty venous blood, next occlude the great saphenous vein in the upper thigh, but not the deeper vessels. Then ask the patient to stand, watch for venous filling. It fills from below and should fill within 35 seconds. (test results can be positive-negative, or positive-positive) (p. 459) Assessment for edema Measure circumference Forefoot <5mm Smallest area above ankle, abnormal > 1cm Largest point in calf, abnormal > 2cm Thigh ~ 5” above patella, abnormal > 2cm Pitting (14-4) 1+ slight pitting ~ 2 mm, no visible distortion 2+ deeper pit ~ 4 mm, no readily detectable distortion 3+ deeper pit ~ 6 mm, dependent edema 4+ deep pit that lasts ~ 8mm, dependent edema that grossly distorts extremity CLASSIC ARTERIAL vs. CLASSIC VASCULAR MATCHING ON TEST TABLE 14-1 (Review) ŚYEŻ/089™¾`"“"u%w%Ń%Ó%0&2&Ż&ß&2'4'<(>(*+,+W,Y,t-v-../N:q::‚:š<==5?7?+@į@ć@)B+B1B3BŃBXLüõüīüęüęüŽüŁüŁüŃüŃüÉüÉüÉüÉüÉüÉüÉüÉüÉüÉüĀŗ°ŗĀØ”Ā™Ā’™’™’™’Ā h [¾hƒ4¹h [¾hƒ4¹H* hn_nhƒ4¹h**÷hƒ4¹5hn_nhƒ4¹5>*hn_nhƒ4¹>* h**÷hƒ4¹hŠk¬hƒ4¹H*hŠk¬hƒ4¹5 hƒ4¹>*hƒ4¹hƒ4¹5h2žhƒ4¹H* h·Nhƒ4¹ hqC·hƒ4¹hƒ4¹9!"=^u‚ƒš¼Üģ)Nxyz‘œ©±¹ĢŽī÷żżżõõõšščččččččšššąąąąąąąą & Fgdƒ4¹ & Fgdƒ4¹gdƒ4¹ & Fgdƒ4¹KRLRžž÷’GVz‚”“Éć  C D Q d Ž ® Ļ ē " # $ ÷ņņņźźźźźźźźźņņņņāāāāāāāņņ & Fgdƒ4¹ & Fgdƒ4¹gdƒ4¹ & Fgdƒ4¹$ % B C Q X h q € Ō Ż Ž ß ż " / > T e y … † ė X k z { śśņņņņņņņņśśśźźāāāāāśśśśśś & Fgdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹gdƒ4¹{ ˆ Ō ü    ± -Yf€¦Ąą)=XYaŒ±¹śņźņņźźźźźźźśśāāāāāśśŚŚŚŚ & F gdƒ4¹ & F gdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹gdƒ4¹¹ČŚŪõ,=QYZqr|‰ ±ĆŁģ ÷÷ņņźāāāāāņņŚŚŚŚŚŚŚŚŚŚŚŃ„h^„hgdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹gdƒ4¹ & F gdƒ4¹2£ŌųEFtz›ĮÖš*+;wæ./7alöńééééńńįįįįįįįńńŁŁŁńńŃŃ & Fgdƒ4¹ & Fgdƒ4¹ & F gdƒ4¹ & Fgdƒ4¹gdƒ4¹„h^„hgdƒ4¹l~…˜¤„śūqšvŒĮĀĆŚąįł #$÷÷÷÷÷ņņņņźźźźźźņņņāŚŚŚŚŚā & Fgdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹gdƒ4¹ & Fgdƒ4¹$37>L]^tŒ­ÜóJUp¦¾×śJ]s÷÷ļ÷÷źźāŚŅŚŅŚŅāŚŅŚŅŚŚŅāŚ & Fgdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹gdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹s£Ėi…Ÿ±ÄŲ÷*HV—Ŗ®·ĖÜŻ=÷ļēēß×÷÷÷÷÷×÷ß×÷÷÷÷÷ŅŅŅŅgdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹=c„£¹ŠŃė'3=QZlmnæī?|·(ÄU śśśśśśśņźźźźźźźśśśāāŚŚŚŚŚ & Fgdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹ & Fgdƒ4¹gdƒ4¹U f g  © æ × ī ! 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„°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.h „$ „˜žĘ$ ^„$ `„˜ž‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „h„˜žĘh^„h`„˜žo(‡hˆH)h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH)h „8„˜žĘ8^„8`„˜žo(‡hˆH)h „ „˜žĘ ^„ `„˜žo(‡hˆH()h „„˜žĘ^„`„˜žo(‡hˆH()h „p„˜žĘp^„p`„˜žo(‡hˆH()h „Ų „˜žĘŲ ^„Ų `„˜žo(‡hˆH.h „@ „˜žĘ@ ^„@ `„˜žo(‡hˆH.h „Ø „˜žĘØ ^„Ø `„˜žo(‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.h „$ „˜žĘ$ ^„$ `„˜ž‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.h „p„˜žĘp^„p`„˜ž‡hˆH.’h „@ „L’Ę@ ^„@ `„L’‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.h „ą„˜žĘą^„ą`„˜ž‡hˆH.’h „°„L’Ę°^„°`„L’‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.h „P„˜žĘP^„P`„˜ž‡hˆH.’h „ „L’Ę ^„ `„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH. „@ „˜žĘ@ ^„@ `„˜ž‡hˆH. „„˜žĘ^„`„˜ž‡hˆH. „ą„L’Ęą^„ą`„L’‡hˆH. „°„˜žĘ°^„°`„˜ž‡hˆH. „€„˜žĘ€^„€`„˜ž‡hˆH. „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH. „@ „˜žĘ@ ^„@ `„˜ž‡hˆH. „„˜žĘ^„`„˜ž‡hˆH. „ą„L’Ęą^„ą`„L’‡hˆH. „°„˜žĘ°^„°`„˜ž‡hˆH. „€„˜žĘ€^„€`„˜ž‡hˆH. „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.h „$ „˜žĘ$ ^„$ `„˜ž‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „8„˜žĘ8^„8`„˜žo(‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „Ų „L’ĘŲ ^„Ų `„L’‡hˆH.h „Ø „˜žĘØ ^„Ø `„˜ž‡hˆH.h „x„˜žĘx^„x`„˜ž‡hˆH.’h „H„L’ĘH^„H`„L’‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.h „č„˜žĘč^„č`„˜ž‡hˆH.’h „ø„L’Ęø^„ø`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH. „h„˜žĘh^„h`„˜ž‡hˆH) „Š„˜žĘŠ^„Š`„˜ž‡hˆH) „8„˜žĘ8^„8`„˜ž‡hˆH) „ „˜žĘ ^„ `„˜ž‡hˆH() „„˜žĘ^„`„˜ž‡hˆH() „p„˜žĘp^„p`„˜ž‡hˆH() „Ų „˜žĘŲ ^„Ų `„˜ž‡hˆH. „@ „˜žĘ@ ^„@ `„˜ž‡hˆH. „Ø „˜žĘØ ^„Ø `„˜ž‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜ž‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜žo(‡hˆH.h „$ „˜žĘ$ ^„$ `„˜žo(‡hˆH.€ „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.€ „„˜žĘ^„`„˜ž‡hˆH.‚ „ą„L’Ęą^„ą`„L’‡hˆH.€ „°„˜žĘ°^„°`„˜ž‡hˆH.€ „€„˜žĘ€^„€`„˜ž‡hˆH.‚ „P„L’ĘP^„P`„L’‡hˆH.h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH.h „ „˜žĘ ^„ `„˜ž‡hˆH.’h „p„L’Ęp^„p`„L’‡hˆH.h „@ „˜žĘ@ ^„@ `„˜ž‡hˆH.h „„˜žĘ^„`„˜ž‡hˆH.’h „ą„L’Ęą^„ą`„L’‡hˆH.h „°„˜žĘ°^„°`„˜ž‡hˆH.h „€„˜žĘ€^„€`„˜ž‡hˆH.’h „P„L’ĘP^„P`„L’‡hˆH.h „h„˜žĘh^„h`„˜žo(‡hˆH)h „Š„˜žĘŠ^„Š`„˜žo(‡hˆH)h „8„˜žĘ8^„8`„˜žo(‡hˆH)h „ „˜žĘ ^„ `„˜žo(‡hˆH()h „„˜žĘ^„`„˜žo(‡hˆH()h „p„˜žĘp^„p`„˜žo(‡hˆH()h „Ų „˜žĘŲ ^„Ų `„˜žo(‡hˆH.h „@ „˜žĘ@ ^„@ 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