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122.395 716.74 122.711 716.768 122.882 716.768 c 123.141 716.768 123.4 716.68 123.428 716.336 c 123.716 716.336 l h 125.726 715.04 m 124.406 715.04 l 124.406 715.788 l 125.61 715.788 l 125.61 716.048 l 124.406 716.048 l 124.406 716.712 l 125.726 716.712 l 125.726 716.968 l 124.118 716.968 l 124.118 714.78 l 125.726 714.78 l 125.726 715.04 l h 129.088 716.308 m 129.056 716.68 128.769 717.028 128.194 717.028 c 127.564 717.028 127.189 716.568 127.189 715.876 c 127.189 715.04 127.68 714.696 128.166 714.696 c 128.338 714.696 129 714.724 129.116 715.588 c 128.828 715.588 l 128.741 715.068 128.398 714.984 128.194 714.984 c 127.68 714.984 127.476 715.384 127.476 715.904 c 127.476 716.48 127.796 716.768 128.194 716.768 c 128.398 716.768 128.741 716.712 128.801 716.308 c 129.088 716.308 l h 131.154 715.876 m 131.154 715.356 130.866 714.984 130.38 714.984 c 129.917 714.984 129.63 715.356 129.63 715.876 c 129.63 716.392 129.917 716.768 130.38 716.768 c 130.866 716.768 131.154 716.392 131.154 715.876 c h 131.441 715.876 m 131.441 716.336 131.209 717.028 130.38 717.028 c 129.574 717.028 129.315 716.336 129.315 715.876 c 129.315 715.416 129.574 714.696 130.38 714.696 c 131.209 714.696 131.441 715.416 131.441 715.876 c h 133.192 715.212 m 133.164 715.212 l 132.071 716.968 l 131.728 716.968 l 131.728 714.78 l 132.015 714.78 l 132.015 716.536 l 133.136 714.78 l 133.451 714.78 l 133.451 716.968 l 133.192 716.968 l 133.192 715.212 l h 133.682 716.712 m 134.428 716.712 l 134.428 714.78 l 134.743 714.78 l 134.743 716.712 l 135.461 716.712 l 135.461 716.968 l 133.682 716.968 l 133.682 716.712 l h 136.035 715.732 m 136.753 715.732 l 137.096 715.732 137.128 715.5 137.128 715.328 c 137.128 715.24 137.128 714.924 137.184 714.78 c 137.559 714.78 l 137.559 714.84 l 137.443 714.868 137.443 714.924 137.443 715.04 c 137.415 715.444 l 137.415 715.76 137.272 715.816 137.156 715.848 c 137.299 715.932 137.471 716.048 137.471 716.392 c 137.471 716.856 137.096 716.968 136.753 716.968 c 135.72 716.968 l 135.72 714.78 l 136.035 714.78 l 136.035 715.732 l h 136.035 716.712 m 136.753 716.712 l 136.897 716.712 137.156 716.68 137.156 716.364 c 137.156 716.02 136.925 715.96 136.697 715.96 c 136.035 715.96 l 136.035 716.712 l h 139.509 715.876 m 139.509 715.356 139.222 714.984 138.735 714.984 c 138.277 714.984 137.989 715.356 137.989 715.876 c 137.989 716.392 138.277 716.768 138.735 716.768 c 139.222 716.768 139.509 716.392 139.509 715.876 c h 139.796 715.876 m 139.796 716.336 139.569 717.028 138.735 717.028 c 137.93 717.028 137.67 716.336 137.67 715.876 c 137.67 715.416 137.93 714.696 138.735 714.696 c 139.569 714.696 139.796 715.416 139.796 715.876 c h 140.37 716.968 m 140.083 716.968 l 140.083 714.78 l 141.491 714.78 l 141.491 715.04 l 140.37 715.04 l 140.37 716.968 l h 103.874 711.872 m 104.073 711.24 l 104.393 711.24 l 103.615 713.428 l 103.272 713.428 l 102.438 711.24 l 102.753 711.24 l 102.985 711.872 l 103.874 711.872 l h 103.068 712.132 m 103.415 713.112 l 103.443 713.112 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712.188 l 113.522 712.188 113.55 711.96 113.55 711.784 c 113.55 711.7 113.55 711.384 113.609 711.24 c 113.98 711.24 l 113.98 711.296 l 113.869 711.324 113.869 711.384 113.869 711.496 c 113.837 711.9 l 113.837 712.216 113.693 712.276 113.581 712.304 c 113.725 712.392 113.896 712.504 113.896 712.852 c 113.896 713.312 113.522 713.428 113.179 713.428 c 112.146 713.428 l 112.146 711.24 l 112.461 711.24 l 112.461 712.188 l h 112.461 713.168 m 113.179 713.168 l 113.322 713.168 113.581 713.14 113.581 712.824 c 113.581 712.476 113.35 712.42 113.119 712.42 c 112.461 712.42 l 112.461 713.168 l h 115.907 711.496 m 114.587 711.496 l 114.587 712.248 l 115.791 712.248 l 115.791 712.504 l 114.587 712.504 l 114.587 713.168 l 115.907 713.168 l 115.907 713.428 l 114.299 713.428 l 114.299 711.24 l 115.907 711.24 l 115.907 711.496 l h 117.055 711.556 m 117.027 711.556 l 116.421 713.428 l 116.078 713.428 l 116.884 711.24 l 117.199 711.24 l 118 713.428 l 117.657 713.428 l 117.055 711.556 l h 119.867 711.496 m 118.547 711.496 l 118.547 712.248 l 119.755 712.248 l 119.755 712.504 l 118.547 712.504 l 118.547 713.168 l 119.867 713.168 l 119.867 713.428 l 118.26 713.428 l 118.26 711.24 l 119.867 711.24 l 119.867 711.496 l h 121.677 711.672 m 121.65 711.672 l 120.557 713.428 l 120.214 713.428 l 120.214 711.24 l 120.501 711.24 l 120.501 712.996 l 121.622 711.24 l 121.937 711.24 l 121.937 713.428 l 121.677 713.428 l 121.677 711.672 l h 122.164 713.168 m 122.914 713.168 l 122.914 711.24 l 123.229 711.24 l 123.229 713.168 l 123.947 713.168 l 123.947 713.428 l 122.164 713.428 l 122.164 713.168 l h 124.521 713.428 m 124.234 713.428 l 124.234 711.24 l 124.521 711.24 l 124.521 713.428 l h 126.675 712.332 m 126.675 711.816 126.388 711.44 125.897 711.44 c 125.438 711.44 125.151 711.816 125.151 712.332 c 125.151 712.852 125.438 713.224 125.897 713.224 c 126.388 713.224 126.675 712.852 126.675 712.332 c h 126.962 712.332 m 126.962 712.792 126.731 713.484 125.897 713.484 c 125.095 713.484 124.836 712.792 124.836 712.332 c 124.836 711.872 125.095 711.152 125.897 711.152 c 126.731 711.152 126.962 711.872 126.962 712.332 c h 128.713 711.672 m 128.685 711.672 l 127.592 713.428 l 127.249 713.428 l 127.249 711.24 l 127.536 711.24 l 127.536 712.996 l 128.657 711.24 l 128.972 711.24 l 128.972 713.428 l 128.713 713.428 l 128.713 711.672 l f* 124.637 730.188 m 124.808 731.368 125.095 732.32 125.526 733.212 c 126.388 734.884 127.62 736.264 129.259 737.16 c 130.866 738.108 132.821 738.628 135.03 738.628 c 136.61 738.628 138.448 738.312 140.398 737.764 c 140.398 734.452 l 138.504 735.576 136.554 736.12 134.655 736.064 c 132.534 736.008 130.866 735.288 129.69 733.876 c 128.513 732.492 127.879 730.792 127.851 728.808 c 127.879 727.368 128.226 726.012 128.828 724.804 c 129.431 723.592 130.348 722.556 131.529 721.808 c 132.733 721.06 134.169 720.712 135.776 720.712 c 137.702 720.772 139.74 721.404 141.866 722.556 c 141.978 722.556 l 140.398 719.244 l 139.509 718.872 138.647 718.64 137.874 718.524 c 137.096 718.408 136.294 718.38 135.433 718.38 c 132.561 718.408 130.061 719.216 127.967 720.712 c 126.073 722.068 124.892 724.084 124.577 726.732 c 124.378 725.64 124.003 724.632 123.4 723.652 c 122.567 722.212 121.303 721.06 119.612 720.196 c 117.945 719.332 115.819 718.84 113.322 718.84 c 106.287 718.84 l 106.287 718.956 l 107.204 719.448 107.635 720.396 107.635 721.78 c 107.635 721.808 l 107.635 735.172 l 107.635 736.64 107.204 737.56 106.287 737.848 c 106.287 737.936 l 113.725 737.936 l 116.106 737.936 118.176 737.476 119.839 736.64 c 121.562 735.748 122.854 734.596 123.632 733.156 c 124.146 732.264 124.461 731.256 124.637 730.188 c h 110.766 721.176 m 111.169 721.116 111.886 721 112.864 720.944 c 115.073 720.972 117.055 721.548 118.718 722.584 c 120.385 723.68 121.303 725.352 121.39 727.596 c 121.506 729.672 121.159 731.34 120.385 732.58 c 119.612 733.788 118.635 734.652 117.426 735.144 c 116.222 735.576 114.929 735.832 113.494 735.832 c 112.72 735.832 111.799 735.688 110.766 735.516 c 110.766 721.176 l f* 88.97 727.596 m 88.854 729.64 89.201 731.512 90.003 733.212 c 90.864 734.884 92.101 736.264 93.736 737.16 c 95.347 738.108 97.297 738.628 99.511 738.628 c 101.09 738.628 102.925 738.312 104.879 737.764 c 104.879 734.452 l 102.985 735.576 101.031 736.12 99.136 736.064 c 97.01 736.008 95.347 735.288 94.167 733.876 c 92.99 732.492 92.36 730.792 92.332 728.808 c 92.36 727.368 92.703 726.012 93.305 724.804 c 93.911 723.592 94.829 722.556 96.005 721.808 c 97.214 721.06 98.649 720.712 100.257 720.712 c 102.179 720.772 104.217 721.404 106.343 722.556 c 106.458 722.556 l 104.879 719.244 l 103.99 718.872 103.128 718.64 102.351 718.524 c 101.577 718.408 100.771 718.38 99.91 718.38 c 97.038 718.408 94.542 719.216 92.444 720.712 c 90.35 722.212 89.142 724.516 88.97 727.568 c 88.97 727.596 l f* BT /F4 1 Tf 9.12 0 0 9.12 346.08 697.2 Tm 0 g -0.03 Tc [(64)-23(9)]TJ /F2 1 Tf 2.368 0 TD -0.025 Tc -0.001 Tw [(D)13(e)-22(cl)-48(in)7(e)-33( i)-10(n)-31( D)-16(e)-16(a)1(t)-8(h)-19(s )-47(fro)-23(m)1( )-11(H)-16(e)-16(a)1(rt)]TJ -0.026 -0.974 TD -0.002 Tc -0.024 Tw [(Di)24(se)24(as)24(e)-10( a)7(n)24(d)-8( St)24(r)19(oke)24( )-11(\227)]TJ T* -0.026 Tc 0.034 Tw [(U)-11(.)-11(S)-28(.,)-11( 19)-19(00)-23(\2261)-19(99)-19(9)]TJ /F4 1 Tf -2.342 -1.263 TD -0.03 Tc [(65)-23(6)]TJ /F2 1 Tf 2.368 0 TD -0.026 Tc 0.011 Tw [(G)-11(e)4(o)-15(g)0(r)-28(a)0(p)-26(h)-26(ic V)62(a)-28(ri)-11(a)-32(t)0(i)-11(o)-15(n )-38(in)6( )-21(Pe)-17(ni)-37(ci)-11(l)-11(l)-49(in)]TJ -0.026 -0.974 TD [(R)-20(e)-20(s)0(i)-11(s)-35(ta)-17(nc)-23(e i)-32(n)0( )]TJ 9.12 0 1.939 9.12 425.04 659.04 Tm -0.005 Tc [(S)-5(t)21(r)-7(e)21(p)-8(t)21(oc)21(oc)21(cus)]TJ -6.103 -1 TD -0.007 Tc [(pne)19(um)19(on)19(i)-15(a)19(e)]TJ /F6 1 Tf 9.12 0 0 9.12 420.48 649.92 Tm ( )Tj /F2 1 Tf 0.316 0 TD -0.027 Tc 0.012 Tw [(\227 S)-27(e)-27(l)-1(ec)-36(te)-18(d S)-29(i)-1(t)-33(e)-1(s)-38(,)]TJ -6.132 -0.974 TD 0.001 Tw [(U)-12(n)-33(it)-10(e)-18(d)-1( )-28(St)-33(at)-10(e)-24(s)-1(,)-50( 19)-20(97)]TJ /F4 1 Tf -2.342 -1.263 TD -0.03 Tc [(66)-23(1)]TJ /F2 1 Tf 2.368 0 TD -0.026 Tc 0.041 Tw [(P)6(r)-43(imar)-28(y Mu)6(l)-11(t)-47(id)-26(ru)6(g)-29(-)0(R)-20(e)-20(s)0(i)-11(s)-35(ta)-17(nt)]TJ -0.026 -0.974 TD 0 Tw [(T)85(u)-15(be)-28(rc)-20(ul)-32(os)-37(is )-37(\227 )-11(I)-11(v)-19(an)-19(o)-19(v)0(o)-32( O)-11(b)-32(las)-35(t)0(,)]TJ T* -0.028 Tc 0.002 Tw [(R)-21(u)-21(s)-2(s)-39(i)-2(a,)-51( 19)-21(99)]TJ /F4 1 Tf -2.342 -1.263 TD -0.03 Tc [(66)-23(4)]TJ /F2 1 Tf 2.368 0 TD -0.025 Tc -0.001 Tw [(Mo)7(r)-40(t)1(a)-33(l)1(i)-10(t)-8(y)-33( P)7(a)-31(tt)-8(e)-27(r)1(n)-28(s)-28( \227 )-11(U)-10(.)-10(S)-27(.,)-10( )-11(1)-18(9)1(9)-18(7)]TJ ET 0 g 143.012 670.214 m 142.237 670.214 l 128.928 635.516 l 118.591 635.516 l 118.591 670.875 l 117.939 670.875 l 102.675 635.516 l 91.743 635.516 l 116.338 700.167 l 127.385 700.167 l 127.567 663.562 l 128.277 663.562 l 142.476 700.167 l 154.827 700.167 l 154.827 673.607 l 143.012 642.581 l 143.012 670.214 l f* 194.57 670.214 m 193.802 670.214 l 180.494 635.516 l 170.156 635.516 l 170.156 670.875 l 169.505 670.875 l 154.233 635.516 l 143.309 635.516 l 167.896 700.167 l 179.009 700.167 l 179.125 663.562 l 179.843 663.562 l 194.033 700.167 l 206.393 700.167 l 206.393 635.516 l 194.57 635.516 l 194.57 670.214 l f* 221.244 665.7 m 222.077 665.7 l 235.385 700.407 l 245.657 700.407 l 245.657 665.048 l 246.309 665.048 l 261.581 700.407 l 272.57 700.407 l 247.918 635.69 l 236.87 635.69 l 236.746 672.36 l 235.979 672.36 l 221.838 635.69 l 209.478 635.69 l 209.478 700.407 l 221.244 700.407 l 221.244 665.7 l f* 285.161 690.246 m 273.816 661.598 l 269.716 650.967 l 263.833 635.813 l 251.185 635.813 l 257.068 650.967 l 272.57 691.138 l 274.765 696.899 l 276.077 700.291 l 276.25 700.646 l 290.985 700.646 l 292.71 700.703 l 294.55 700.646 l 296.447 700.349 l 298.287 699.87 l 300.069 699.16 l 301.736 698.327 l 303.402 697.32 l 304.888 696.131 l 306.307 694.761 l 307.561 693.275 l 308.683 691.608 l 309.64 689.825 l 310.407 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105.291 625.117 l 105.167 625.711 l 105.109 626.363 l 105.167 627.015 l 105.291 627.609 l 105.464 628.146 l 105.703 628.558 l 106.058 628.979 l 106.413 629.276 l 106.891 629.45 l 107.37 629.507 l 107.898 629.45 l 108.376 629.276 l 108.731 628.979 l 109.028 628.558 l 109.325 628.146 l 109.507 627.609 l 109.565 627.015 l 109.622 626.421 l 109.565 625.768 l 109.507 625.174 l 109.267 624.58 l 109.028 624.159 l 108.731 623.746 l 108.319 623.507 l 107.898 623.334 l 107.37 623.268 l h 107.304 621.551 m 108.261 621.666 l 109.152 621.906 l 109.919 622.318 l 110.571 622.855 l 111.107 623.565 l 111.528 624.399 l 111.759 625.414 l 111.883 626.478 l 111.759 627.428 l 111.586 628.261 l 111.231 629.095 l 110.753 629.805 l 110.101 630.341 l 109.325 630.82 l 108.434 631.059 l 107.428 631.175 l 106.479 631.059 l 105.588 630.82 l 104.812 630.399 l 104.16 629.805 l 103.624 629.095 l 103.269 628.261 l 103.03 627.312 l 102.915 626.305 l 102.972 625.348 l 103.212 624.456 l 103.566 623.631 l 104.103 622.971 l 104.697 622.376 l 105.464 621.964 l 106.297 621.666 l 107.304 621.551 l f* 116.396 629.45 m 117.402 629.507 l 117.997 629.45 l 118.533 629.211 l 118.83 628.798 l 118.953 628.261 l 118.83 627.667 l 118.475 627.254 l 117.939 627.015 l 117.229 626.899 l 116.396 626.899 l 116.396 629.45 l h 114.317 621.724 m 116.396 621.724 l 116.396 625.414 l 117.048 625.414 l 117.642 625.29 l 118.063 625.051 l 118.359 624.638 l 118.591 623.862 l 118.953 622.5 l 119.185 621.724 l 121.388 621.724 l 121.033 622.797 l 120.612 624.341 l 120.439 624.935 l 120.142 625.472 l 119.779 625.826 l 119.366 626.066 l 119.366 626.124 l 119.96 626.421 l 120.496 626.957 l 120.851 627.609 l 120.967 627.964 l 121.033 628.385 l 120.967 629.037 l 120.793 629.507 l 120.496 629.986 l 120.142 630.341 l 119.605 630.696 l 118.888 630.935 l 118.12 631.059 l 117.172 631.117 l 115.563 631.059 l 114.317 630.878 l 114.317 621.724 l f* 126.379 629.507 m 127.27 629.574 l 127.922 629.507 l 128.392 629.276 l 128.689 628.979 l 128.755 628.501 l 128.689 628.022 l 128.334 627.667 l 127.798 627.428 l 127.089 627.37 l 126.379 627.37 l 126.379 629.507 l h 124.3 621.782 m 125.249 621.666 l 126.61 621.609 l 127.864 621.666 l 128.871 621.848 l 129.646 622.145 l 130.24 622.5 l 130.653 622.855 l 130.95 623.334 l 131.131 623.862 l 131.189 624.456 l 131.065 625.29 l 130.653 625.942 l 130.117 626.421 l 129.349 626.718 l 129.349 626.776 l 130.059 627.13 l 130.537 627.609 l 130.768 628.146 l 130.892 628.74 l 130.768 629.334 l 130.595 629.87 l 130.24 630.283 l 129.762 630.58 l 129.226 630.82 l 128.631 630.993 l 127.922 631.059 l 127.031 631.117 l 125.488 631.059 l 124.3 630.878 l 124.3 621.782 l h 126.379 625.826 m 127.089 625.826 l 127.864 625.768 l 128.458 625.529 l 128.689 625.348 l 128.871 625.117 l 128.986 624.877 l 128.986 624.522 l 128.986 624.159 l 128.871 623.928 l 128.689 623.689 l 128.458 623.507 l 127.922 623.268 l 127.204 623.152 l 126.379 623.21 l 126.379 625.826 l f* 134.333 631.059 2.079 -9.335 re f* 141.997 629.392 m 142.946 629.507 l 143.606 629.45 l 144.134 629.276 l 144.671 629.095 l 145.091 628.74 l 145.446 628.319 l 145.685 627.849 l 145.801 627.254 l 145.859 626.536 l 145.801 625.768 l 145.685 625.051 l 145.388 624.522 l 145.025 624.044 l 144.555 623.689 l 144.019 623.449 l 143.425 623.334 l 142.715 623.268 l 141.997 623.334 l 141.997 629.392 l h 139.86 621.782 m 140.867 621.666 l 142.294 621.609 l 143.54 621.724 l 144.728 621.906 l 145.743 622.318 l 146.576 622.855 l 147.171 623.507 l 147.641 624.341 l 147.996 625.348 l 148.119 626.602 l 147.996 627.725 l 147.698 628.74 l 147.171 629.507 l 146.51 630.102 l 145.801 630.58 l 144.968 630.878 l 143.961 631.059 l 142.715 631.117 l 141.164 631.059 l 139.86 630.878 l 139.86 621.782 l f* 151.032 631.059 2.079 -9.335 re f* 159.348 629.276 m 156.848 629.276 l 156.848 631.059 l 163.977 631.059 l 163.977 629.276 l 161.427 629.276 l 161.427 621.724 l 159.348 621.724 l 159.348 629.276 l f* 169.208 621.724 m 169.208 625.529 l 166.295 631.059 l 168.671 631.059 l 169.62 628.798 l 170.338 627.015 l 171.047 628.798 l 171.996 631.059 l 174.373 631.059 l 171.287 625.587 l 171.287 621.724 l 169.208 621.724 l f* 183.225 625.711 m 183.819 627.667 l 184.232 629.45 l 184.71 627.667 l 185.304 625.711 l 183.225 625.711 l h 185.601 624.101 m 186.311 621.724 l 188.572 621.724 l 185.659 631.059 l 182.928 631.059 l 180.074 621.724 l 182.276 621.724 l 182.928 624.101 l 185.601 624.101 l f* 191.599 621.724 m 191.599 631.059 l 194.099 631.059 l 195.997 627.609 l 196.83 626.066 l 197.54 624.456 l 197.424 626.305 l 197.367 628.319 l 197.367 631.059 l 199.322 631.059 l 199.322 621.724 l 197.127 621.724 l 195.106 625.29 l 194.273 626.957 l 193.505 628.616 l 193.439 628.616 l 193.563 624.522 l 193.563 621.724 l 191.599 621.724 l f* 204.611 629.392 m 205.559 629.507 l 206.211 629.45 l 206.805 629.276 l 207.284 629.095 l 207.696 628.74 l 208.059 628.319 l 208.29 627.849 l 208.472 627.254 l 208.53 626.536 l 208.472 625.768 l 208.29 625.051 l 207.993 624.522 l 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623.746 l 233.479 624.159 l 233.24 624.58 l 233.067 625.117 l 232.943 625.711 l 232.885 626.363 l 232.943 627.015 l 233.067 627.609 l 233.24 628.146 l 233.479 628.558 l 233.776 628.979 l 234.197 629.276 l 234.61 629.45 l 235.146 629.507 l 235.682 629.45 l 236.095 629.276 l 236.507 628.979 l 236.804 628.558 l 237.044 628.146 l 237.225 627.609 l 237.34 627.015 l 237.398 626.421 l 237.34 625.768 l 237.225 625.174 l 237.044 624.58 l 236.804 624.159 l 236.507 623.746 l 236.095 623.507 l 235.682 623.334 l 235.146 623.268 l h 235.088 621.551 m 236.037 621.666 l 236.928 621.906 l 237.695 622.318 l 238.355 622.855 l 238.883 623.565 l 239.304 624.399 l 239.543 625.414 l 239.601 626.478 l 239.543 627.428 l 239.304 628.261 l 238.949 629.095 l 238.471 629.805 l 237.877 630.341 l 237.101 630.82 l 236.21 631.059 l 235.204 631.175 l 234.255 631.059 l 233.364 630.82 l 232.588 630.399 l 231.937 629.805 l 231.4 629.095 l 230.988 628.261 l 230.748 627.312 l 230.691 626.305 l 230.748 625.348 l 230.988 624.456 l 231.342 623.631 l 231.821 622.971 l 232.473 622.376 l 233.182 621.964 l 234.073 621.666 l 235.022 621.551 l 235.088 621.551 l f* 244.296 629.45 m 245.302 629.507 l 245.896 629.45 l 246.432 629.211 l 246.73 628.798 l 246.845 628.261 l 246.73 627.667 l 246.375 627.254 l 245.839 627.015 l 245.121 626.899 l 244.296 626.899 l 244.296 629.45 l h 242.217 621.724 m 244.296 621.724 l 244.296 625.414 l 244.947 625.414 l 245.542 625.29 l 245.954 625.051 l 246.251 624.638 l 246.49 623.862 l 246.845 622.5 l 247.084 621.724 l 249.279 621.724 l 248.924 622.797 l 248.512 624.341 l 248.33 624.935 l 248.033 625.472 l 247.678 625.826 l 247.266 626.066 l 247.266 626.124 l 247.86 626.421 l 248.388 626.957 l 248.751 627.609 l 248.866 627.964 l 248.924 628.385 l 248.866 629.037 l 248.685 629.507 l 248.388 629.986 l 248.033 630.341 l 247.497 630.696 l 246.787 630.935 l 246.012 631.059 l 245.063 631.117 l 243.463 631.059 l 242.217 630.878 l 242.217 621.724 l f* 254.328 629.276 m 251.837 629.276 l 251.837 631.059 l 258.965 631.059 l 258.965 629.276 l 256.407 629.276 l 256.407 621.724 l 254.328 621.724 l 254.328 629.276 l f* 262.942 625.711 m 263.478 627.667 l 263.899 629.45 l 263.957 629.45 l 264.427 627.667 l 264.963 625.711 l 262.942 625.711 l h 265.318 624.101 m 266.036 621.724 l 268.288 621.724 l 265.384 631.059 l 262.645 631.059 l 259.798 621.724 l 261.993 621.724 l 262.645 624.101 l 265.318 624.101 l f* 271.027 631.059 m 273.164 631.059 l 273.164 623.507 l 276.844 623.507 l 276.844 621.724 l 271.027 621.724 l 271.027 631.059 l f* 279.757 631.059 2.079 -9.335 re f* 287.66 629.276 m 285.161 629.276 l 285.161 631.059 l 292.289 631.059 l 292.289 629.276 l 289.797 629.276 l 289.797 621.724 l 287.66 621.724 l 287.66 629.276 l f* 297.817 621.724 m 297.817 625.529 l 294.847 631.059 l 297.281 631.059 l 298.229 628.798 l 298.947 627.015 l 299.657 628.798 l 300.606 631.059 l 302.982 631.059 l 299.896 625.587 l 299.896 621.724 l 297.817 621.724 l f* 93.228 601.998 m 89.483 617.804 l 93.286 617.804 l 94.474 611.325 l 95.423 605.803 l 95.489 605.803 l 95.959 608.477 l 96.496 611.382 l 97.865 617.804 l 101.66 617.804 l 102.915 611.151 l 103.385 608.477 l 103.74 605.861 l 103.806 605.861 l 104.218 608.593 l 104.697 611.382 l 106 617.804 l 109.622 617.804 l 105.522 601.998 l 101.66 601.998 l 100.357 608.832 l 99.944 611.209 l 99.581 613.702 l 99.524 613.702 l 99.111 611.209 l 98.633 608.832 l 97.147 601.998 l 93.228 601.998 l f* 124.416 608.708 m 118.591 608.708 l 118.591 604.969 l 125.067 604.969 l 125.067 601.998 l 115.026 601.998 l 115.026 617.804 l 124.77 617.804 l 124.77 614.89 l 118.591 614.89 l 118.591 611.622 l 124.416 611.622 l 124.416 608.708 l f* 140.454 608.708 m 134.63 608.708 l 134.63 604.969 l 141.106 604.969 l 141.106 601.998 l 131.065 601.998 l 131.065 617.804 l 140.809 617.804 l 140.809 614.89 l 134.63 614.89 l 134.63 611.622 l 140.454 611.622 l 140.454 608.708 l f* 147.047 617.804 m 150.611 617.804 l 150.611 610.854 l 150.669 610.854 l 151.741 612.571 l 155.305 617.804 l 159.761 617.804 l 154.53 611.085 l 160 601.998 l 155.842 601.998 l 151.98 608.832 l 150.611 607.165 l 150.611 601.998 l 147.047 601.998 l 147.047 617.804 l f* 164.992 617.804 m 168.556 617.804 l 168.556 605.027 l 174.851 605.027 l 174.851 601.998 l 164.992 601.998 l 164.992 617.804 l f* 180.849 601.998 m 180.849 608.477 l 175.857 617.804 l 179.958 617.804 l 181.559 613.999 l 182.813 611.028 l 184.001 613.999 l 185.601 617.804 l 189.644 617.804 l 184.413 608.593 l 184.413 601.998 l 180.849 601.998 l f* 206.632 615.13 m 207.226 615.245 l 208.29 615.245 l 209.363 615.13 l 209.842 614.948 l 210.196 614.717 l 210.493 614.42 l 210.732 614.057 l 210.848 613.586 l 210.906 613.108 l 210.848 612.571 l 210.667 612.158 l 210.493 611.745 l 210.138 611.449 l 209.718 611.151 l 209.248 610.97 l 208.711 610.854 l 208.059 610.788 l 206.632 610.788 l 206.632 615.13 l h 203.125 601.998 m 206.632 601.998 l 206.632 608.238 l 207.696 608.238 l 208.653 608.114 l 209.066 607.941 l 209.363 607.701 l 209.66 607.347 l 209.899 606.926 l 210.312 605.679 l 210.906 603.302 l 211.384 601.998 l 215.064 601.998 l 214.767 602.708 l 214.47 603.839 l 213.76 606.513 l 213.406 607.52 l 212.985 608.353 l 212.391 609.005 l 211.681 609.426 l 211.681 609.484 l 212.688 610.021 l 213.167 610.433 l 213.579 610.854 l 213.934 611.382 l 214.231 611.977 l 214.412 612.637 l 214.47 613.347 l 214.355 614.42 l 214.057 615.311 l 213.637 616.021 l 212.985 616.673 l 212.036 617.267 l 210.906 617.688 l 209.478 617.862 l 207.878 617.919 l 205.205 617.862 l 203.125 617.565 l 203.125 601.998 l f* 230.394 608.708 m 224.569 608.708 l 224.569 604.969 l 231.103 604.969 l 231.103 601.998 l 221.005 601.998 l 221.005 617.804 l 230.748 617.804 l 230.748 614.89 l 224.569 614.89 l 224.569 611.622 l 230.394 611.622 l 230.394 608.708 l f* 240.789 615.13 m 241.383 615.187 l 242.274 615.245 l 242.926 615.187 l 243.463 615.072 l 243.933 614.89 l 244.353 614.593 l 244.651 614.296 l 244.89 613.883 l 245.005 613.405 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-1.14 TD -0.004 Tc 0.074 Tw [(w)15(a)-18(s)19( pr)19(o)-7(m)43(pte)19(d, in)19( )-24(pa)19(r)13(t, by)19( )-24(s)8(e)17(e)17(m)10(i)18(ngl)19(y)-7( c)8(o)26(unte)19(r)13(intu)19(itiv)19(e)17( da)19(ta)19(:)-6( A)-12(m)43(e)-12(r)19(i)-17(c)19(a)17(n)26( )-24(b)26(u)-9(s)19(i)18(ne)19(s)8(s)8( e)-8(x)19(e)17(c)8(u-)]TJ 0 -1.116 TD -0.006 Tc -0.017 Tw [(tiv)17(e)15(s)6(,)-8( p)-6(r)17(e)-20(s)41(u)-9(m)17(a)15(b)-1(l)17(y)-9( a)15(m)8(o)24(ng the)17( be)17(st-fe)17(d pe)17(r)-24(s)17(o)24(n)-11(s)17(,)16( )-18(h)17(a)-2(d)17( )-18(h)17(i)-1(g)17(h)-1( r)-14(a)17(te)17(s )-18(o)17(f)0( )-17(h)17(e)15(a)-14(r)17(t d)-9(i)-9(s)17(e)15(a)15(s)6(e)15(,)-8( w)13(h)-1(i)17(l)-9(e)17( in)]TJ 0 -1.14 TD -0.003 Tc -0.042 Tw [(pos)44(t-wa)20(r)14( E)27(u)-3(r)20(ope)20(, )25(C)13(V)13(D)21( r)14(a)18(t)-6(e)-6(s)44( h)27(a)1(d)20( )24(de)20(c)9(r)-11(e)20(a)18(s)9(e)18(d )25(s)9(h)1(a)20(r)14(ply)20( )24(in)20( t)11(h)20(e)-6( )25(w)16(a)18(k)9(e)18( o)27(f)3( r)14(e)18(duc)44(ed)20( f)11(o)20(od )25(s)9(u)27(ppl)20(i)-6(e)20(s)9(.)]TJ 0 -1.116 TD -0.004 Tc 0.028 Tw [(K)12(e)-8(y)19(s)8( )24(pos)19(t)10(u)19(l)-7(a)19(te)19(d a)17( c)8(o)-4(r)19(r)13(e)-7(l)19(a)17(tion)19( be)19(tw)19(e)-8(e)19(n)-7( )21(c)19(hol)19(e)17(s)8(t)-5(e)-5(r)19(ol)19( l)-7(e)19(v)17(e)17(l)-17(s)19( a)17(n)9(d)19( C)12(V)12(D)-3( )25(an)19(d i)18(niti)19(ate)19(d)-6( )22(a)-6( )22(s)19(tud)19(y)]TJ 0 -1.14 TD -0.005 Tc -0.018 Tw [(of M)9(i)17(nne)18(s)7(ota)18( b)8(u)18(s)7(ine)18(s)7(s)7(m)32(en)18( )-16(\(th)18(e)16( )-20(fi)18(r)-23(s)18(t p)-5(r)18(o)-10(s)18(p)25(e)-19(c)42(tiv)18(e)-8( s)7(t)9(u)18(d)-1(y)18( )-18(o)18(f)-6( )-24(C)18(V)11(D)19(\))2( )-16(\()]TJ 10.32 0 2.194 10.32 398.4 360.24 Tm (1)Tj 10.32 0 0 10.32 403.92 360.24 Tm -0.023 Tc 0.023 Tw [( )22(\))-25(,)-25( cu)7(l)-34(m)24(i)-21(n)-21(a)0(t)-17(i)-17(n)0(g)-21( in)-22( wh)7(a)-18(t)]TJ -29.907 -1.14 TD -0.02 Tc 0.044 Tw [(c)-8(a)1(m)-6(e)1( t)-14(o)-14( b)10(e)1( k)-8(n)-7(ow)-18(n as)-8( t)-14(h)-14(e)3( Seven)-15( Co)10(u)-7(n)]TJ 17.512 0 TD -0.003 Tc 0.011 Tw [(trie)20(s)9( S)20(tudy)20( )14(\()]TJ 10.32 0 2.194 10.32 334.08 348.48 Tm (2)Tj 10.32 0 0 10.32 339.84 348.48 Tm -0.006 Tc 0.03 Tw [( )46(\). )27(The)17(s)6(e)15( s)29(tudi)17(e)-20(s)17( )30(fou)17(n)-6(d)-6( )24(s)17(t)-5(r)17(ong)17( a)15(s)6(s)6(o)0(-)]TJ -23.698 -1.116 TD -0.021 Tc 0.068 Tw [(c)-9(i)-24(at)-15(i)-15(o)2(n)-26(s)2( b)-17(e)2(t)-18(w)2(ee)-17(n )-24(t)-7(h)2(e)-24( CVD )-24(rat)-19(e)-19( o)9(f)-15( a)-24( p)9(o)-11(p)-11(u)2(l)-24(a)2(t)-15(i)-15(o)2(n)-16( an)-15(d)-15( aver)-29(ag)-17(e s)-9(e)0(r)-21(u)2(m)-7( c)-9(h)9(o)-19(l)-19(e)2(s)-9(t)-16(ero)-19(l)-19( an)-8(d p)-17(e)2(r)]TJ 0 -1.14 TD -0.004 Tc -0.019 Tw [(c)8(a)17(pita)19( )-25(i)19(nta)19(k)8(e)17( )-18(o)19(f)-20( s)8(a)17(tur)19(ate)19(d fa)19(tty a)-18(c)43(i)-7(d)-7(s)19(.)18( )]TJ 1.395 -1.116 TD -0.006 Tc 0.03 Tw [(F)15(r)-6(o)17(m)8( )28(the)17( e)15(a)15(r)-13(l)17(y)-9( )21(1)17(9)-10(5)17(0)15(s,)-11( )19(K)17(e)15(y)-20(s)17( )21(a)17(c)6(tiv)17(e)15(l)-9(y)17( p)-6(r)17(o)-9(m)41(ote)17(d)-6( )24(h)-6(i)-6(s)41( fin)17(din)17(g)-11(s)17( )27(to )27(an)17( i)16(n)-11(c)17(r)11(e)-10(a)17(si)16(ngl)17(y)-6( )24(h)-6(e)17(a)15(lth-)]TJ -1.395 -1.14 TD -0.004 Tc 0.12 Tw [(c)8(o)9(n)19(s)8(c)8(i)1(o)19(u)-9(s)19( p)9(u)19(bl)19(i)-17(c)19(.)-6( T)26(h)0(e)19( r)-12(e)19(s)8(u)26(ltin)19(g \223)17(c)8(h)9(o)19(l)-7(e)19(s)8(t)1(e)19(r)-4(o)19(l)-6( c)8(o)9(n)19(tro)19(v)-8(e)19(r)13(s)8(y)17(\224)-7( r)13(e)17(v)-8(e)19(a)17(l)-7(e)19(d)1( )23(s)8(h)0(a)19(r)13(p d)26(i)-7(v)19(i)-17(s)19(i)18(ons)19( )22(in)]TJ T* 0.121 Tw [(pos)43(t-wa)19(r)13( )-24(s)31(c)8(i)-7(e)19(nti)19(f)-20(i)18(c)8( c)8(u)1(l)19(ture)19( ov)19(e)17(r)-11( w)15(h)26(eth)19(e)-12(r)19( the)19( s)8(t)1(a)19(t)-7(i)-7(s)19(ti)19(c)8(i)-7(a)19(n)-9(s)19(\222)18( \223)17(s)8(tro)19(ng a)17(s)8(s)8(o)26(c)8(i)-7(a)19(tio)19(n)-9(s)19(\224)17( c)8(o)9(u)19(l)1(d)]TJ 0 -1.116 TD -0.043 Tw [(pr)19(ov)19(id)19(e)-7( s)8(c)8(i)-7(e)19(nti)19(f)-7(i)-7(c)19( c)8(e)17(rta)19(in)19(ty)66(.)-6( T)9(h)19(i)-17(s)19( c)8(o)9(n)19(trov)19(e)17(r)13(s)8(y)-7( l)-7(e)19(ft gr)19(e)-8(a)19(te)19(r)-11( o)9(p)19(por)19(t)6(u)6(n)19(ity)19( )-25(f)10(o)19(r)-11( c)8(o)-7(m)43(p)0(e)19(ting)19( )-25(f)10(o)19(od)]TJ 0 -1.14 TD -0.005 Tc 0.121 Tw [(in)18(dus)18(tr)18(y)16( )-25(g)-5(r)18(o)8(u)18(p)-10(s)18(,)17( )-25(he)18(a)16(lth)18( )-25(p)25(r)-5(o)18(m)9(oti)18(on a)16(s)7(s)7(o)-10(c)18(i)17(a)16(tion)18(s)7(,)-7( foo)18(d fad)18(d)-8(i)-8(s)42(t)-9(s)18(,)-7( phy)18(s)7(i)17(c)7(i)-8(a)18(n)-10(s)18(,)17( )-25(a)16(n)25(d i)-8(n)-8(s)18(u)25(r)-11(-)]TJ 0 -1.116 TD 0.146 Tw [(a)-9(n)-9(c)18(e)16( c)7(o)-8(m)18(pani)18(e)-19(s)18( to u)-10(s)42(e)-8( )25(the)18( a)16(m)9(b)25(igu)18(itie)18(s)7( )24(an)18(d )25(m)9(e)16(thod)18(olo)18(g)-8(i)-8(c)42( q)8(u)18(ibb)18(l)-8(e)18(s)7( i)17(nhe)18(r)12(e)16(nt i)17(n)0( s)30(u)-10(c)18(h)]TJ 0 -1.14 TD -0.004 Tc -0.066 Tw [(s)8(t)6(u)6(d)19(i)-7(e)19(s)8( )-25(to )-23(p)26(u)-4(r)19(s)8(ue)19( )-25(t)10(h)19(e)-7(i)19(r)-11( ow)19(n ag)19(en)19(da)19(s)8(.)-6( In)19( )-25(i)-7(t)-7(s)43( )-25(s)8(i)18(m)10(p)1(l)19(e)-18(s)19(t)2( for)19(m)10(,)18( )-25(the)19( de)19(ba)19(te ov)19(e)17(r)-11( di)19(eta)19(r)13(y)-7( fat a)17(n)9(d)]TJ T* -0.005 Tc 0.028 Tw [(C)11(V)11(D)-5( p)25(itte)18(d \223)16(inte)18(r)12(v)-9(e)18(nti)18(o)8(n)18(i)-18(s)18(t)-9(s)18(\224)16( a)16(g)-1(a)18(i)0(n)18(s)7(t tho)18(s)7(e)-12( )16(c)18(a)16(l)-7(l)-7(i)18(ng f)9(o)18(r )23(fur)18(the)18(r)-12( s)30(tudi)18(e)-19(s)18(\227)18(p)25(r)-13(e)18(fe)18(r)-13(a)18(b)25(l)-8(y)18( c)7(l)-7(i)18(n)0(i-)]TJ 0 -1.116 TD -0.022 Tc -0.001 Tw [(c)-10(a)-1(l)-20( )-21(or)-29( l)-25(a)1(b)-9(o)1(r)-30(a)1(t)-18(o)-18(r)1(y )-36(st)-12(u)-12(d)1(i)-25(e)1(s)-10(.)]TJ 1.395 -1.14 TD -0.004 Tc 0 Tw [(K)12(e)17(y)17(s)8( )-28(a)17(l)18(w)-10(a)19(y)17(s)8( ha)19(s)8( b)19(e)-8(e)19(n)26( )-17(c)19(ons)43(ide)19(r)13(e)0(d)19( )-7(a)19(n)0( in)19(t)-5(e)-5(r)19(v)17(e)17(ntio)19(n)-7(i)-7(s)19(t.)19( )-5(H)-5(e)19( g)19(e)0(n)19(e)-12(r)19(a)17(l)-6(l)19(y h)19(a)-18(s)43( )-17(s)19(hun)19(ne)19(d fo)19(o)9(d)]TJ -1.395 -1.116 TD -0.023 Tc 0.02 Tw [(f)-18(a)0(d)-28(s)0( )-27(an)7(d)-18( )-26(vi)-18(go)-23(ro)-10(us)-11(l)-26(y)0( )-27(p)7(r)-23(om)-9(o)-17(t)-17(e)0(s)-11( t)-19(h)-19(e)0( )-27(b)-19(e)0(n)7(e)-21(f)-21(i)0(t)-27(s)0( )-27(o)7(f)-17( )-26(\223r)-31(eas)-11(o)-10(na)-19(bl)-26(y l)-23(o)-23(w)0(-)-17(f)-17(a)0(t)-21( d)-21(i)-21(e)0(t)-27(s)0(,\224)-25( )-5(in)-28(st)-18(ea)-19(d o)-19(f)-19( f)-19(o)-19(l)-23(-)]TJ 0 -1.14 TD -0.005 Tc -0.017 Tw [(lo)18(w)-10(i)18(ng \223)16(the)18( N)12(o)18(rth)18( A)-13(m)42(e)-13(r)18(i)-18(c)18(a)16(n)0( h)25(a)16(bit f)9(o)18(r)-12( m)32(a)-19(k)42(ing)18( the)18( s)7(t)9(o)18(m)9(a)16(c)7(h )25(the)18( ga)18(r)12(b)-1(a)18(g)-1(e)18( di)18(s)7(p)8(o)18(s)7(a)-8(l)18( u)8(n)18(it f)9(o)18(r)]TJ T* -0.065 Tw [(a)16( )-25(lo)18(ng l)-7(i)18(s)7(t)1( )-23(o)25(f)1( )-23(ha)18(r)12(m)9(ful)18( )-25(f)9(o)18(o)8(d)18(s)7(.)-8(\224)18( K)-15(e)18(y)16(s)7(\222)-7( s)7(t)9(u)18(die)18(s)7( a)16(nd r)12(e)16(c)7(o)-8(m)18(m)32(en)18(da)18(tio)18(n)-10(s)18( ha)18(v)16(e)-8( h)25(a)-1(d)18( )-25(a)16( s)7(u)8(b)18(s)7(ta)18(ntia)18(l)]TJ 0 -1.116 TD -0.004 Tc -0.019 Tw [(i)-15(m)19(p)26(a)17(c)8(t)2( )-17(on)19( )-36(c)19(h)26(an)19(ge)19(s)8( )-25(i)19(n)2( )-17(th)19(e)-7( U.S)19(.)18( )-21(di)19(e)17(t)-2( )-21(a)19(nd the)19( )-30(r)19(e)17(s)8(ulti)19(ng d)9(o)19(wn)19(w)15(a)-12(r)19(d)1( tre)19(n)9(d)19( )-21(in)19( )-31(C)19(V)12(D)20(.)]TJ 9.6 0 2.041 9.6 95.28 143.76 Tm -0.005 Tc [(R)12(e)-24(fer)20(ences)]TJ 9.6 0 0 9.6 95.28 132.96 Tm -0.046 Tw [(1.)-180(K)12(eys A, T)131(a)-24(ylor)20( HL, B)12(l)4(a)-30(c)20(kbur)20(n)-19( H)17(,)-27( B)12(r)9(ozek J, Ander)20(son J)12(T)95(, S)12(imonson E. 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C)-14(i)-14(r)19(culation )-25(1993;88:1973\22698.)]TJ -1.75 -1.125 TD 0.003 Tc 0.119 Tw [(2)15(0)-22(.)-344(C)-8(D)-22(C)-2(.)-22( )-25(C)6(h)-22(a)-16(n)-11(g)-11(e)-16(s)6( )-28(i)-19(n)-11( )-25(m)8(o)-22(rt)-22(a)-16(l)-19(i)-19(t)-14(y)-16( )-25(f)-14(r)3(o)-22(m)0( )-28(h)-11(e)-16(a)-16(r)0(t)-22( f)-14(a)-16(i)-19(l)-19(u)-11(re)-22(\227)-22(U)17(n)-47(i)14(t)-22(e)-16(d)-11( St)-22(a)17(t)-22(e)-16(s)6(,)-22( 1)-16(9)-16(8)15(0)-22(\226)9(1)-22(9)-16(9)15(5)-22(.)-19( MMWR )-28(1)-16(9)15(9)-22(8)-16(;)]TJ 1.75 -1.125 TD -0.005 Tc (47:633\2267.)Tj 10.8 0 0 10.8 102.48 564.24 Tm 1 g -0.001 Tc -0.021 Tw [(Hear)21(t)-12( D)-7(i)-7(s)21(ea)21(s)-12(e)-12( and S)-7(t)-7(r)21(oke)21( )-33(\227)21( )-33(C)21(o)21(n)-23(t)-12(i)]TJ 15.778 0 TD -0.011 Tc (nued)Tj /F4 1 Tf 12 0 0 12 177.36 534.24 Tm 0 g 0.002 Tc -0.002 Tw [(G)20(e)-11(o)22(g)13(rap)22(h)13(i)0(c)22( V)82(a)18(ria)22(tio)22(n)13( )-7(in)22( )-11(P)22(e)18(n)13(ici)22(llin)22( )18(R)-11(e)18(si)22(stan)22(ce)]TJ -5.56 -1.1 TD 0.011 Tc [(in)31( )]TJ 12 0 2.551 12 124.56 521.04 Tm -0.009 Tc 0.014 Tw [(Stre)11(pt)-9(o)-9(c)11(oc)-14(c)-14(u)11(s)-15( p)11(n)2(e)7(u)2(m)-14(o)11(ni)-14(a)-14(e)]TJ 12 0 0 12 279.12 521.04 Tm 0 Tc -0.02 Tw [( )-22(\227)20( )-19(Se)20(l)-3(e)-3(c)20(ted)20( )-18(Site)20(s, U)-11(n)20(ite)20(d)11( )-17(State)20(s, 1)-8(9)20(9)-8(7)]TJ /F2 1 Tf 10.8 0 2.296 10.8 102.48 499.92 Tm -0.006 Tc 0.095 Tw [(S)-11(t)-11(r)16(eptoc)16(o)-12(c)-12(c)16(u)-11(s)-11( pneumoni)16(a)-11(e)-11( )]TJ 10.8 0 0 10.8 244.8 499.92 Tm -0.003 Tc 0.092 Tw [( )-11(i)8(s)-25( the l)8(e)-2(a)19(ding c)8(ause)19( )-11(of bact)19(e)-14(r)-14(i)19(a)-13(l)19( )-11(pneumoni)19(a)-13(,)19( )-11(menin-)]TJ -14.511 -1.222 TD 0.009 Tc 0.213 Tw [(gitis, a)20(n)-13(d )-11(otitis me)20(d)-13(ia i)9(n)-13( )11(t)-14(h)-2(e U)20(n)-13(ite)-13(d)9( S)-13(t)9(a)-13(tes. S)-13(i)20(nc)20(e 1995, C)20(D)-13(C )22(has)31( )-11(mai)31(n)-2(tai)31(ne)9(d)9( a)]TJ T* -0.003 Tc 0.004 Tw [(p)-14(opul)19(a)-8(t)-8(i)19(on-bas)19(e)-5(d)-5( s)-5(u)-5(r)19(v)-8(e)-8(i)19(l)8(l)8(anc)19(e)-14( )-10(s)19(y)-14(s)19(tem for)19( )]TJ 10.8 0 2.296 10.8 299.76 473.52 Tm -0.009 Tc 0.001 Tw [(S)-20(.)13( pneumon)-31(ia)-8(e)]TJ 10.8 0 0 10.8 376.32 473.52 Tm 0.001 Tc 0 Tw [( )12( )-10(a)-10(s)23( par)23(t of the Emer)23(gi)23(n)23(g)-21( )12(In-)]TJ -26.689 -1.2 TD 0 Tc 0.133 Tw [(f)-23(e)-11(c)22(t)-23(i)11(o)22(n)-22(s)-22( )22(P)-11(r)11(o)-11(gram\222)89(s)11( )-11(Activ)22(e)-10( B)23(a)-5(c)-6(t)22(e)-11(r)-11(i)22(a)-10(l)22( )11(Cor)22(e)-10( Sur)22(ve)22(i)-22(l)22(l)11(anc)22(e)-10( to )22(c)-6(o)-5(l)22(l)11(e)-11(c)22(t)-11( i)11(nfor)22(mati)22(o)22(n)-22( )11(o)6(n)6( t)6(h)6(e)]TJ 0 -1.222 TD -0.002 Tc 0.035 Tw [(s)-8(u)-8(s)20(c)-13(e)20(p)-13(t)20(i)-7(b)-7(i)20(l)9(i)9(t)-7(y)-7( )11(patte)20(r)-8(n)-8(s)20( of )11(a)21(l)-24(l)20( i)9(nva)20(s)-24(i)20(ve)20( s)-13(t)20(r)-13(a)-13(i)20(ns)20( of )]TJ 10.8 0 2.296 10.8 326.64 447.36 Tm -0.007 Tc 0 Tw [(S)-18(.)15( pneumo)-29(n)-7(i)15(a)-6(e)]TJ 10.8 0 0 10.8 403.2 447.36 Tm 0.003 Tc 0.003 Tw [( wit)25(h)-8(i)14(n )6(the )-16(e)26(ntir)25(e ar)25(ea)]TJ -29.178 -1.222 TD -0.002 Tc 0.113 Tw [(o)-13(f)20( )-33(s)9(urv)20(e)-12(i)20(l)-24(l)20(anc)20(e)-12( \()9(p)9(o)-24(pul)20(a)-7(t)-7(i)20(on-bas)20(ed\) )-22(i)9(n)-2(s)20(tead o)-13(f)-13( f)-13(r)20(om )-22(s)9(e)-12(l)20(e)-13(c)20(ted h)20(o)-24(s)9(p)-2(i)20(t)-7(a)-7(l)20(s)-24( onl)20(y)-12( \()-13(s)20(entine)20(l)]TJ 0 -1.2 TD 0.001 Tc -0.012 Tw [(s)-5(u)-5(r)23(vei)23(l)12(l)12(ance)23(\))-10(.)-10( )33(T)-10(h)1(i)23(s)12( r)-10(e)23(p)23(o)-21(r)12(t)-10( )11(pr)23(e)-10(s)23(ents)23( s)-5(u)-5(r)23(vei)23(l)12(l)12(ance)23( data )11(for)23( 19)23(97,)23( w)23(h)-21(i)12(c)12(h)1( )11(i)12(n)-10(di)23(c)12(ated )33(t)12(h)-21(a)24(t)-10( )11(t)7(h)7(e)]TJ 0 -1.222 TD 0 Tc -0.056 Tw [(p)-11(r)11(ev)22(a)-10(l)22(ence)22( o)-11(f)22( )]TJ 10.8 0 2.296 10.8 158.16 408 Tm -0.008 Tc -0.026 Tw [(S)-19(.)14( pneumoni)14(a)-7(e)]TJ 10.8 0 0 10.8 234.24 408 Tm 0 Tc -0.067 Tw [( )-56( )-11(that was)22( )-11(n)-11(ot s)11(u)-6(s)-6(c)22(epti)22(bl)22(e)-10( to p)-11(e)23(n)]TJ 14.822 0 TD -0.011 Tc -0.056 Tw [(icil)-33(l)11(i)0(n)-11( v)-16(a)-16(r)11(ie)-11(d)-11( among)-33( )-11(geo)-11(-)]TJ -28.356 -1.222 TD -0.003 Tc -0.019 Tw [(g)-14(r)8(aphi)19(c)8( )-44(r)19(egi)19(ons and among )-16(hos)19(pita)19(l)-25(s)19( )-11(withi)19(n a)-13( geogra)19(p)-14(h)-3(i)19(c)8( )-44(r)19(egi)19(on.)]TJ 1.333 -1.2 TD 0 Tc 0.003 Tw [(I)11(n)0( 199)22(7)-10(,)22( s)-7(u)-7(r)22(v)-5(e)-5(i)22(l)11(l)11(ance)22( per)22(s)11(o)22(n)-22(n)11(e)22(l)-22( )25(conduct)22(ed ac)22(t)-11(i)22(v)-5(e)-5( )25(s)11(u)-11(r)11(v)1(e)22(i)-22(l)22(l)11(anc)22(e for)22( )-19(i)22(nva)22(s)-22(i)22(ve)22( )]TJ 10.8 0 2.296 10.8 475.44 381.84 Tm -0.006 Tc 0 Tw [(S)-17(.)16( pneu)-6(-)]TJ -35.607 -1.222 TD -0.022 Tc [(mo)-44(n)-22(i)0(a)-21(e)]TJ 10.8 0 0 10.8 126 368.64 Tm 0.002 Tc 0.131 Tw [( )111( )22(inf)-20(e)-9(c)24(t)-21(i)13(o)-9(n)2( )22(in seven r)13(e)13(g)-20(i)13(o)-9(ns )22(in the United State)-20(s)13( )-11(with a)-8( )22(t)-21(otal )22(p)-9(o)24(p)-20(ulati)24(o)8(n)8( o)13(f)]TJ -3.511 -1.222 TD -0.001 Tc -0.021 Tw [(1)-6(6)-6( m)-7(i)-7(l)21(l)10(i)10(o)-12(n.)21( )-11(T)-12(h)10(e)21( )-44(s)21(urv)21(e)-11(i)21(l)-23(l)21(anc)21(e)-11( s)-23(i)21(te)21(s)-23( wer)21(e)-11( C)-6(a)-6(l)21(i)10(forni)21(a)-11( \(Sa)21(n)-12( )-11(F)-12(r)21(anc)21(i)10(s)-23(c)21(o)-1( C)10(o)10(u)-23(nty)21(\))-12(,)-12( Connec)21(t)-12(i)21(cut)]TJ 0 -1.2 TD [(\(enti)21(r)-12(e)21( )-44(s)21(tate)21(\))-12(,)21( )-11(Geor)21(gi)21(a)-11( \(20-)21(county Atl)21(anta a)22(r)-12(e)21(a)-6(\))-6(,)21( )-11(Mar)21(y)-11(l)21(and \()-12(s)-12(i)21(x-)21(county Ba)21(l)-12(t)-12(i)21(mor)21(e)-11( a)-12(r)21(ea)21(\))-12(,)]TJ 0 -1.222 TD -0.002 Tc 0.069 Tw [(Minnes)20(ota \()-13(s)20(eve)20(n)-13(-)-13(c)20(ounty Mi)20(nneapol)20(i)-24(s)20(-St.)20( )-11(P)9(a)20(u)-13(l)9( )-11(a)21(r)-13(e)20(a)-7(\))-7(,)20( )-11(O)-13(r)20(egon \(thr)20(ee-c)20(ounty Por)20(t)-7(l)-7(a)20(n)20(d)]TJ T* -0.001 Tc -0.01 Tw [(a)-12(r)21(ea\),)21( a)22(n)-12(d )33(T)121(ennes)21(s)-12(e)21(e)-11( )11(\()-7(f)-7(i)21(ve)21( ur)21(b)-12(a)22(n )11(c)10(o)-12(unti)21(e)-12(s)21(\))-12(.)21( I)10(n)5(v)5(a)21(s)-23(i)21(ve)21( i)10(nfec)21(t)-12(i)21(o)21(n)-23( )23(was)21( d)5(e)5(f)21(ined )33(a)-12(s)21( i)10(s)10(o)-1(l)21(a)-6(t)-6(i)21(o)21(n)]TJ 0 -1.2 TD 0.011 Tc [(of)33( )]TJ 10.8 0 2.296 10.8 100.8 303.12 Tm -0.008 Tc -0.036 Tw [(S)-19(.)-19( pneumoni)14(a)-7(e)]TJ 10.8 0 0 10.8 177.12 303.12 Tm -0.002 Tc -0.042 Tw [( )-33( )-10(from a)-12( norma)20(l)-24(l)20(y)-12( s)9(t)-7(e)-7(r)20(i)-24(l)20(e)-12( s)9(i)9(t)-7(e)-7(,)20( )-33(s)9(uch a)-13(s)20( )-10(b)-13(l)9(ood o)-7(r)-7( c)9(e)-13(r)20(ebr)20(ospi)20(nal)20( )]TJ 28.044 0 TD 0.003 Tc -0.037 Tw [(flui)25(d,)25( i)14(n)]TJ -36.289 -1.222 TD 0 Tc 0 Tw [(a)-7( )-7(r)-7(e)22(s)-22(i)22(dent of one of the sur)22(vei)22(l)11(l)11(ance)22( )-7(a)-7(r)-7(e)22(a)-11(s)22(. Pneumoc)22(o)-11(c)11(c)11(a)-10(l)22( )-16(i)-16(s)22(ol)22(ates)22( wer)22(e)-11( )-11(s)22(ent to r)22(efe)22(r)-11(-)]TJ T* -0.001 Tc 0.134 Tw [(e)10(n)-23(c)-12(e)-12( )22(labo)-23(r)10(ator)21(i)10(e)-12(s)-12(,)21( )11(w)-12(h)10(e)21(r)-12(e)21( )-11(i)10(n)-1( v)-11(i)21(t)-12(r)21(o a)22(n)-12(t)21(i)-6(b)-6(i)21(oti)21(c)-23( )22(s)-7(u)-7(s)21(c)10(epti)21(b)]TJ 25.333 0 TD -0.002 Tc 0.113 Tw [(i)9(l)9(i)9(t)-7(y)-7( t)-8(e)-8(s)20(ting w)-13(a)21(s)-24( conduc)20(ted )-22(b)9(y)]TJ -25.333 -1.2 TD -0.008 Tc 0.119 Tw [(b)-19(r)3(oth m)-20(icro)-19(d)-8(i)14(lu)-8(t)-8(i)14(o)-19(n)-8(.)14( )]TJ 9.867 0 TD 0.001 Tc 0.143 Tw [(Inte)23(rmedi)23(ate)23( s)12(u)-5(s)-5(c)23(epti)23(bi)23(l)-21(i)23(ty )33(to )11(p)12(e)23(n)]TJ 16.022 0 TD -0.011 Tc 0.144 Tw [(icil)-33(l)11(i)0(n)-11( w)-11(a)-11(s)11( )-11(de)]TJ 6.289 0 TD 0 Tc 0.111 Tw [(fined a)-11(s)22( )-11(a)-10( mi)22(ni-)]TJ -32.178 -1.222 TD -0.001 Tc 0.045 Tw [(m)21(u)-23(m i)10(nhi)21(bitor)21(y)-11( c)10(once)21(n)-12(t)21(r)-12(a)21(tion \(MI)21(C)-6(\))-6( )22(of 0)-11(.)21(12)21(\226)-12(1)-12(.)21(0)-11( )]TJ /F7 1 Tf 22.622 0 TD (m)Tj /F2 1 Tf 0.578 0 TD 0 Tc 0.022 Tw [(g/)22(mL;)22( )-33(r)11(e)-11(s)22(i)11(s)-6(t)-6(a)22(n)-11(c)11(e)-10( w)-11(a)23(s)-22( defi)22(n)-11(e)23(d )-22(a)-11(s)22( )-33(a)23(n)]TJ -23.2 -1.222 TD [(MIC)22( )]TJ /F7 1 Tf 2.133 0 TD (\263)Tj /F2 1 Tf 0.556 0 TD -0.023 Tc [(2.)-33(0 )]TJ /F7 1 Tf 1.622 0 TD (m)Tj /F2 1 Tf 0.578 0 TD 0 Tc -0.044 Tw [(g/)22(mL \()]TJ 10.8 0 2.296 10.8 172.56 237.36 Tm (1)Tj 10.8 0 0 10.8 178.56 237.36 Tm -0.002 Tc -0.02 Tw [( )-11(\))-13(.)20( )-11(T)20(h)-24(e)21( )-11(t)-7(e)-7(r)20(m \223nonsus)20(c)-13(e)20(ptibl)20(e\224)20( )-11(r)-13(e)20(f)-7(e)-7(r)20(s)-24( to both i)9(nter)20(medi)20(ate and r)9(e)-13(s)20(i)9(s)-13(-)]TJ -8.378 -1.2 TD -0.001 Tc -0.021 Tw [(tant organi)21(s)10(m)-7(s)-7(.)]TJ 1.333 -1.222 TD -0.003 Tc 0.103 Tw [(T)119(o)-3( )11(deter)19(mi)19(ne )-11(whether)19( pneumococ)19(c)8(a)-13(l)19( r)-14(e)19(s)-25(i)19(s)8(tance)19( i)8(n)-14( i)8(ndi)19(v)-13(i)19(d)19(u)-25(a)20(l)-25( )11(hos)19(pit)19(a)-13(l)19(s)-25( )11(would )11(b)8(e)]TJ -1.333 -1.222 TD 0.004 Tc 0.263 Tw [(r)-7(e)-18(pre)-18(sen)-18(ta)-18(tive)-18( )-11(o)15(f)-18( )-11(r)-7(e)-7(s)26(istance in a s)15(u)-7(r)15(veil)26(lance area,)26( )-11(t)15(h)-18(e )23(p)-7(r)15(o)-7(p)26(o)-18(r)15(t)-19(i)15(o)26(n)-18( )-11(of p)-7(enic)26(i)-18(l)26(l)-18(i)26(n)-7(-)]TJ 0 -1.2 TD 0.04 Tw [(n)-7(o)9(n)9(s)26(usc)26(epti)26(bl)26(e)-6( i)15(s)15(o)-7(l)15(a)27(tes )22(f)-7(r)26(o)26(m)-18( )11(i)15(n)26(d)-18(i)15(v)-6(i)]TJ 16.467 0 TD -0.002 Tc 0.057 Tw [(dual)20( hos)20(pita)20(l)-24(s)20( was)20( c)9(ompar)20(ed )11(wi)20(th )11(the )33(propor)20(t)-13(i)20(o)20(n)]TJ -16.467 -1.222 TD 0 Tc 0.022 Tw [(o)-11(f)22( )-11(n)-11(ons)22(u)-6(s)-6(c)22(epti)22(bl)22(e)-10( i)11(sol)22(ates)22( )-11(f)-11(r)22(om the enti)22(r)-11(e)22( 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[(DRSP)190(, su)-10(c)12(h)]TJ -34.622 -1.2 TD -0.002 Tc 0.035 Tw [(a)-13(s)-13( )11(pool)20(ed )11(hospi)20(t)-7(a)-7(l)20( anti)20(bi)20(o)20(g)-24(r)9(ams)20(,)9( e)-12(l)20(e)-13(c)20(t)-13(r)20(o)20(n)-24(i)9(c)9( l)9(abor)20(atory)20( s)9(u)-13(r)9(v)-1(e)20(i)-24(l)20(l)9(anc)20(e)-12(,)20( and )11(s)9(enti)20(nel)20( net-)]TJ 0 -1.222 TD 0.001 Tc -0.023 Tw [(w)-10(o)1(r)23(k)12(s)-21( that us)23(e)-9( m)-11(a)24(ny h)-10(o)1(s)23(p)1(i)23(tal)23(s)-21( i)12(n)1( s)-10(e)-10(l)23(e)-10(c)23(ted r)12(egi)23(o)23(n)-21(s)12( )-11(of a)-9( s)-5(t)-4(a)23(te,)23( )-44(i)23(s)12( )-11(b)-10(e)24(ing eva)23(lua)23(ted.)]TJ 1.333 -1.222 TD 0 Tc -0.044 Tw [(The f)-11(i)22(n)22(d)-22(i)11(ngs)22( )-10(in thi)22(s)11( )-10(study h)6(a)6(v)22(e)-10( at l)11(eas)22(t)-11( two l)-22(i)22(mi)22(tati)22(ons)22(.)-22( F)23(i)-22(r)22(s)11(t)-11(,)-11( d)11(e)22(s)-6(p)-5(i)22(te pr)22(evi)22(ous)22( )-10(a)-11(s)22(so-)]TJ -1.333 -1.2 TD -0.001 Tc -0.021 Tw [(c)-23(i)21(a)-6(t)-6(i)21(ons betwee)21(n )-22(hi)21(gher)21( )-11(l)-11(e)21(v)-6(e)-6(l)21(s)10( )-11(of r)-12(e)21(s)-23(i)21(s)10(tanc)21(e)-11( i)10(n)-1( c)-7(h)-6(i)21(l)10(dren a)22(n)21(d)-23( )-11(l)10(ower)21( )-11(l)10(evel)21(s)10( )-11(i)10(n)-12( )12(b)-12(l)10(a)-12(c)21(k)10(s)-23( \()]TJ 10.8 0 2.296 10.8 502.32 444.72 Tm (6)Tj 10.8 0 0 10.8 508.08 444.72 Tm 0.011 Tc -0.022 Tw [( \),)]TJ -38.889 -1.222 TD 0 Tc 0.067 Tw [(the f)-11(i)22(n)-11(d)0(i)22(ngs des)22(c)11(r)-22(i)22(bed i)11(n)0( this)22( )-11(r)11(eport i)11(ndic)22(ate)22( )-11(that thes)22(e)-10( )]TJ 26.511 0 TD -0.004 Tc 0.071 Tw [(demogr)18(aphi)18(c)-26( c)7(har)18(a)-15(c)18(t)-9(e)-9(r)18(i)7(s)-15(t)-15(i)18(c)7(s)]TJ -26.511 -1.222 TD -0.001 Tc 0.023 Tw [(w)-12(e)22(r)-12(e)21( )-33(not cons)21(i)-23(s)21(tentl)21(y)-11( c)10(o)-7(r)-6(r)21(e)-11(l)21(ate)21(d )-22(wi)21(th the propor)21(t)-12(i)21(o)-12(n)-1( of nonsus)21(c)10(epti)21(b)-12(l)10(e)-11( i)10(s)10(ola)21(t)-7(e)-7(s)21( )-11(i)-6(n)-6( a)22(n)]TJ 0 -1.2 TD 0.001 Tc 0.132 Tw [(in)-21(d)-10(ividu)-21(a)-10(l)-10( h)-10(o)6(s)6(p)-21(ita)-21(l)12(.)-21( T)-10(h)12(e)-21( )11(s)-10(t)-21(u)23(d)-21(y)-9( m)12(a)-21(y)-9( n)23(o)-21(t)-22( )11(h)-10(a)2(v)-21(e)-9( )22(h)-10(a)12(d)-21( )-11(suf)-21(f)-10(i)-10(c)23(ient)-21( )11(d)7(a)7(t)-21(a)-9( )22(t)12(o)-21( )11(d)-10(efine c)12(h)-10(a)-10(r)23(a)-10(c)1(-)]TJ 0 -1.222 TD -0.002 Tc -0.065 Tw [(t)-7(e)-7(r)20(i)-24(s)20(t)-13(i)20(c)9(s)-24( of )-23(hos)20(p)-13(i)9(ta)20(l)-24(s)20( )-11(and )-23(popula)20(tions)20( )-33(i)9(n)-2( w)20(h)-24(i)9(c)9(h)-2( the prev)20(a)-12(l)20(ence)20( )-11(o)-13(f)20( )-33(r)9(e)-13(s)20(i)9(s)-8(t)-7(a)]TJ 32.667 0 TD 0 Tc -0.056 Tw [(nce )11(i)11(s)11( h)-11(i)11(gher)22( or)]TJ -32.667 -1.222 TD -0.002 Tc -0.02 Tw [(lower)20( )-11(than i)9(n)-2( the )22(gener)20(a)-12(l)20( )]TJ 11.911 0 TD -0.014 Tc [(popu)-36(la)]TJ 3.222 0 TD -0.001 Tc -0.01 Tw [(tion.)21( Se)21(cond,)21( the )33(r)-12(e)21(p)-12(r)10(e)-12(s)21(entat)21(i)-11(v)21(e)-11( )11(r)10(ange )11(of )33(n)15(o)16(n)-23(s)10(us)21(cep-)]TJ -15.133 -1.2 TD 0.001 Tc 0.088 Tw [(tibi)23(l)12(i)12(ty for)23( )-11(a)-9( s)12(u)-10(r)12(v)2(e)23(i)-21(l)23(l)12(anc)23(e)-9( a)-10(r)23(ea was)23( )-11(defi)23(ned a)-10(s)23( )]TJ /F7 1 Tf 21.867 0 TD (\261)Tj /F2 1 Tf 0.556 0 TD 0 Tc 0.089 Tw [(5)23(%)-11( of the over)22(a)-10(l)22(l)11( )-11(pr)22(o)-11(p)6(o)6(r)22(t)-11(i)22(o)22(n)-22( )-11(of )22(n)22(o)-22(n)11(-)]TJ -22.422 -1.222 TD 0.001 Tc 0.11 Tw [(suscept)-21(i)12(ble )-22(i)12(solates f)12(o)-21(r)12( )-33(t)12(h)-21(e)-9( area.)23( )-33(Furth)-21(e)-10(r)23( )-33(w)23(o)-21(r)12(k)-21( i)-15(s)-15( n)-10(eeded to )-22(defi)23(ne a)-9( )]TJ 33.556 0 TD -0.011 Tc 0.144 Tw [(clin)-22(ica)-21(l)11(l)0(y)-21( a)12(n)11(d)]TJ -33.556 -1.222 TD -0.002 Tc 0.069 Tw [(epide)20(miol)20(ogic)20(a)-12(l)20(l)9(y)-12( meani)20(ngful)20( )-33(t)20(h)-13(r)9(e)-13(s)20(h)4(o)4(l)20(d)-13( )-11(of anti)20(bi)20(otic)20( )-11(nonsus)20(c)-13(e)20(p)-13(t)20(i)-7(b)-7(i)20(l)9(i)9(t)-7(y)-7( )]TJ 33.422 0 TD -0.009 Tc 0.098 Tw [(among pneu)-9(-)]TJ -33.422 -1.2 TD -0.022 Tc [(mo)-44(c)-11(o)-22(cc)-44(i.)]TJ 1.333 -1.222 TD -0.003 Tc 0.114 Tw [(A)-9(s)-9( )22(t)8(h)-25(e)20( )-11(pre)19(v)-8(a)-8(l)19(enc)19(e)-13( of r)8(e)-14(s)19(i)-25(s)19(tanc)19(e)-13( i)8(n)-3(c)19(r)-8(e)-8(a)19(s)-14(e)19(s)-25(,)19( )-11(the publ)19(i)8(c)-25( hea)19(l)-14(t)19(h)-14( )11(r)-14(e)-14(s)19(ponse)19( )-11(r)-14(e)19(q)-14(u)-3(i)19(r)8(e)-14(s)19( )-11(a)]TJ -1.333 -1.222 TD 0.004 Tc 0.107 Tw [(m)-8(ulti)26(d)-7(i)15(s)-13(c)-13(i)26(p)-7(l)15(inary a)15(p)-18(proach. S)-18(u)2(rvei)26(l)-18(l)26(a)15(n)-18(c)15(e)-6( )-22(can )-22(i)15(n)-7(c)15(rease a)15(w)-18(a)-7(r)26(e)15(n)-18(e)-7(s)-7(s)26( )-33(a)15(m)15(o)-18(n)10(g)10( )-22(c)-18(l)26(inic)26(ians)]TJ 0 -1.2 TD -0.002 Tc 0.046 Tw [(and )-23(publ)20(i)9(c)-24( heal)20(th pra)20(c)-13(t)-13(i)20(t)-13(i)20(oner)20(s)-24( and a)-13(s)20(s)-24(i)20(s)9(t)-13( i)-7(n)-7( t)-7(a)-7(r)20(geti)20(ng a)-13(r)20(e)-7(a)-7(s)20( )-11(for)20( )-11(i)9(n)-13(t)20(e)-13(r)20(venti)20(o)20(n)-24(.)9( )-11(C)21(l)-24(i)20(n)-2(i)20(c)-13(a)20(l)]TJ 0 -1.222 TD -0.001 Tc -0.021 Tw [(g)-12(u)-1(i)21(del)21(i)10(nes)21( )-44(c)21(an )-25(i)21(mpr)21(o)-12(v)22(e )-22(ma)21(n)-12(a)22(gement )-20(of c)-23(l)21(i)10(n)-1(i)21(c)-12(a)21(l)-23( s)10(yndromes)21( )-11(commonl)21(y)-11( attr)21(i)10(b)21(u)-23(t)21(able)21( )-33(t)21(o)]TJ T* -0.002 Tc 0.08 Tw [(p)-13(n)9(e)20(u)-13(moc)20(o)-8(c)-8(c)20(a)-12(l)20( i)9(nfec)20(t)-13(i)20(o)20(n)-24(s)9( \()]TJ 10.8 0 2.296 10.8 222.24 260.88 Tm -0.023 Tc [(7,)-33(8)]TJ 10.8 0 0 10.8 236.88 260.88 Tm -0.003 Tc 0.081 Tw [( )67(\))-14(.)19( Adopti)19(o)19(n)-25( )23(o)-14(f)19( i)8(n)-14(t)19(e)-8(r)-8(v)19(enti)19(o)19(n)-25( )23(s)-14(t)-14(r)19(ate)19(g)-14(i)8(e)20(s)-25(,)19( i)8(n)-3(c)19(ludi)19(ng )11(us)19(e)-13( )11(o)8(f)]TJ -13.778 -1.2 TD -0.002 Tc 0.035 Tw [(p)-13(n)9(e)20(u)-13(moc)20(o)-8(c)-8(c)20(a)-12(l)20( v)21(a)-13(c)-13(c)20(i)9(nes)20( and )11(c)9(ampai)20(gns )35(to)-24( )33(promote )33(j)20(u)20(d)]TJ 25.956 0 TD -0.011 Tc 0.013 Tw [(icio)-22(u)-11(s)11( u)-33(s)0(e)-14( o)-14(f)-14( )-20(a)]TJ 6.756 0 TD -0.001 Tc 0.034 Tw [(ntibi)21(oti)21(c)-23(s)21(,)10( offe)21(r)]TJ -32.711 -1.222 TD 0.112 Tw [(p)-12(ote)21(ntia)21(l)-23( to pr)21(event i)10(nfec)21(t)-12(i)21(o)-12(n)-1(s)21( )-11(w)-12(i)10(th DRSP \()]TJ 10.8 0 2.296 10.8 310.8 234.72 Tm (9)Tj 10.8 0 0 10.8 316.8 234.72 Tm -0.002 Tc 0.113 Tw [( )122(\))-13(.)20( )-11(I)9(nforma)20(t)-13(i)20(o)-13(n)-2( a)21(n)-13(d m)9(a)20(t)-7(e)-7(r)20(i)-12(a)20(l)-24(s)20( )-11(r)9(egar)20(di)20(n)20(g)]TJ -21.178 -1.222 TD 0.009 Tc 0.28 Tw [(j)9(u)-13(di)-13(c)31(i)9(o)-13(u)-2(s)-13( )22(use of a)20(n)-13(t)-14(i)20(mi)-8(c)-8(r)31(obial)31( )]TJ 15.556 0 TD -0.008 Tc [(agen)-30(t)-19(s)-19( )]TJ 3.733 0 TD 0.002 Tc 0.287 Tw [(are )22(avail)24(a)13(b)-20(l)13(e)-8( o)8(n)8( the W)46(orld-Wide W)46(eb at)]TJ -19.289 -1.2 TD 0 Tc -0.056 Tw [(h)-11(t)22(tp:/)22(/)11(w)22(w)-22(w)77(.)-22(c)22(dc)22(.gov/)22(nc)22(idod/)22(d)22(b)-22(md/)22(anti)22(bi)22(otic)22(r)11(e)-11(s)22(i)-22(s)22(tanc)22(e)-10(;)22( addi)22(tional)22( s)11(u)-11(r)11(v)1(e)22(i)-22(l)22(l)11(anc)22(e)-10( )11(data )11(a)-11(r)22(e)]TJ 0 -1.222 TD -0.002 Tc -0.02 Tw [(avai)20(l)9(abl)20(e)-12( at )-22(http:)20(/)9(/)9(w)-13(w)20(w)42(.)9(c)9(d)-8(c)-7(.)20(gov/)20(n)-7(c)-8(i)20(dod/dbmd/)20(abc)20(s)-24(.)20( )-44(I)20(nfor)20(mati)20(on )-22(i)20(s)-24( a)-12(l)20(s)9(o)-13( )-11(ava)20(i)-24(l)20(abl)20(e)-12( f)-13(r)20(o)-13(m)]TJ T* 0.002 Tc 0.065 Tw [(A)-9(B)25(C)-9(s)-9(,)24( )-11(Res)24(pir)24(at)24(o)-9(r)13(y)-8( Di)24(s)-9(e)24(a)-9(s)24(e)-9(s)-9( B)25(ranc)24(h,)24( )-33(Di)24(v)-8(i)24(s)13(ion of Bac)24(ter)24(i)13(a)-8(l)24( )-11(and Mycoti)24(c)13( )-11(D)-4(i)-4(s)24(eas)24(e)-9(s)24(,)13( )-11(Na-)]TJ 0 -1.2 TD 0 Tc 0.055 Tw [(tional)22( )22(Center)22( for)22( I)11(nfec)22(t)-11(i)22(ous )33(D)-11(i)11(s)11(e)-5(a)-5(s)22(e)-11(s)22(,)11( Mai)22(l)11(stop )33(C-23,)22( 1)23(600 )33(C)-11(l)22(i)11(fton )11(Road,)22( N)22(.)-5(E)-5(.)22(,)11( Atl)22(anta)22(,)]TJ 0 -1.222 TD -0.001 Tc -0.021 Tw [(GA 3033)21(3)-11(.)]TJ 9.6 0 2.041 9.6 88.08 136.8 Tm -0.003 Tc [(Refer)22(ences)]TJ 9.6 0 0 9.6 87.6 126 Tm -0.005 Tc 0.08 Tw [(1.)-230(National C)12(o)-19(m)14(m)14(ittee for )25(Clinical )25(L)7(a)-30(bor)20(atory )25(Standar)20(d)-19(s)20(. Per)20(f)-22(o)-5(r)20(m)14(ance standar)20(ds for)20( antim)20(i)-9(c)-9(r)20(o)-19(-)]TJ 1.05 -1.2 TD -0.006 Tc 0.081 Tw [(bial )-25(s)19(usceptibilit)-31(y tests \(M)19( )-22(100-S)19(8\). )-25(V)86(o)3(l 18. )-25( V)11(illanova, P)-20(ennsylvania: National C)-7(o)-8(m)19(m)13(i)5(t)-31(t)8(e)-6(e for)]TJ 0 -1.225 TD [(C)11(lin)-31(ic)19(al )-25(Labor)19(a)6(t)7(o)-31(r)8(y S)11(t)-23(andar)19(ds, 1)-25(998.)]TJ -1.05 63.425 TD [(S)11(treptococc)19(us p)-20(neum)19(o)16(n)-31(iae)]TJ 9.6 0 2.041 9.6 211.2 711.6 Tm -0.01 Tc 0.084 Tw [( \227)-7( C)7(o)12(n)-35(tinued)]TJ /F4 1 Tf 9.6 0 0 9.6 88.08 730.56 Tm -0.006 Tc 0.028 Tw [(6)6(6)-31(0)-18950(M)13(M)13(W)-14(R)-13631(A)16(u)10(g)10(u)-31(s)19(t)8( 6, )28(1999)]TJ ET endstream endobj 75 0 obj << /ProcSet [ /PDF /Text ] /ColorSpace << /DefaultRGB 1 0 R >> /Font << /F2 13 0 R /F4 14 0 R /F7 41 0 R >> >> endobj 76 0 obj << /Filter /LZWDecode /Width 77 /Height 99 /BitsPerComponent 8 /ColorSpace [ /Indexed /DeviceRGB 255 9 0 R ] /Length 799 >> stream 5P8$ BaPRDbPhtN-5ⱘvHc /$Ay\r[ 3)_ gR.Q)Oj%M3 ]6 UFTժtTW^Wpiv?lUZ: hh$V[-uY \n:冱KTk5С]~i+1|U{?EWCqe5=EC;Ra:+M>='x_/dzسq罏A<8k]vYx{6Ȭ3۽m:> Klij(.صml+Ѿ R.ZA{5H22+r-3@ǭ&-+ Bo/#> stream 1 g 47.52 768.48 510.48 -730.08 re f* BT /F2 1 Tf 9.6 0 0 9.6 87.6 695.04 Tm 0 Tr 0 g -0.007 Tc 0.132 Tw [(2.)-232(C)10(D)-18(C)18(.)-1( Defining t)6(h)6(e)-32( )28(p)15(u)-32(blic )25(h)10(e)-32(alth i)-10(m)18(pact of d)-7(r)18(u)15(g)-32(-)-10(r)18(esis)18(t)-24(ant )]TJ 9.6 0 2.041 9.6 360 695.04 Tm -0.008 Tc 0.133 Tw [(S)9(t)-11(r)17(e)5(p)5(t)-33(oc)17(o)-22(c)17(cus pneum)17(o)-22(niae)]TJ 9.6 0 0 9.6 483.84 695.04 Tm -0.006 Tc 0.131 Tw [(: r)8(eport)]TJ -40.225 -1.2 TD -0.008 Tc 0.082 Tw [(of )-26(a wor)17(king)-33( g)-8(r)17(o)14(u)-33(p. M)11(M)-14(W)17(R)9( )-23(1996;45\(no)-33(. R)9(R)9(-)-25(1\).)]TJ -1.05 -1.225 TD -0.006 Tc 0.105 Tw [(3.)-231(B)11(u)13(t)-31(l)-7(e)-7(r)19( J)-8(C)19(, Hofm)19(a)8(n)8(n)-31( J, C)11(e)-5(tr)19(o)6(n)7( M)-20(S)19(, Elliott JA, Facklam)19( R)11(R)11(,)0( B)11(r)8(ei)-31(m)13(an R)11(F)150(. The c)19(o)16(n)-31(tinued e)-6(m)19(e)-11(r)-6(-)]TJ 1.05 -1.225 TD -0.007 Tc 0.057 Tw [(gence of d)-7(r)18(u)-21(g-r)18(esistant )]TJ 9.6 0 2.041 9.6 205.44 660 Tm [(S)10(t)-10(r)18(e)10(p)-32(t)1(ococ)18(cus pneumoniae)]TJ 9.6 0 0 9.6 328.56 660 Tm [( )56( in )-25(the United States: an u)10(p)9(d)-32(ate f)-10(r)18(om)18( t)12(h)-32(e)]TJ -24.05 -1.2 TD -0.006 Tc 0.18 Tw [(C)11(e)11(n)-31(ter)19(s for)19( Disease C)11(o)9(n)9(t)-31(r)8(o)2(l a)8(n)8(d)-31( P)-6(r)19(event)-31(ion\222)69(s)19( )-23(Pneum)19(ococcal S)11(entine)-31(l )24(S)-10(u)-10(r)19(veillan)-31(c)19(e)3( S)11(ystem.)]TJ 0 -1.225 TD -0.005 Tc 0.079 Tw [(J I)9(n)-30(fec)20(t)-22( Dis)20( )-23(1996;174:986\22693.)]TJ -1.05 -1.2 TD -0.004 Tc [(4)5(.)-229(T)13(h)13(o)-29(r)10(nsber)21(r)10(y)5( C, O)24(g)5(i)5(l)-29(vie P)207(,)2( K)13(a)13(h)-29(n)10( J, M)15(auriz)21( Y)138(.)2( S)13(u)-4(r)21(veillan)-29(c)21(e)5( o)-18(f)7( antim)21(i)-8(c)-8(r)21(o)18(b)-29(ial r)10(esis)21(t)-21(a)4(n)5(c)21(e)5( )-25(i)5(n)4( )]TJ 9.6 0 2.041 9.6 490.32 625.2 Tm -0.017 Tc [(St)-20(r)8(e)0(p)-42(-)]TJ -40.64 -1.225 TD -0.009 Tc -0.044 Tw [(tococcus)16( pneu)-34(m)10(oniae)]TJ 9.6 0 0 9.6 195.6 613.44 Tm -0.006 Tc (, )Tj 9.6 0 2.041 9.6 200.4 613.44 Tm -0.001 Tc (Haem)Tj 2.75 0 TD -0.009 Tc [(ophi)-34(lus)16( influ)-34(enz)16(a)3(e)]TJ 9.6 0 0 9.6 307.92 613.44 Tm 0.021 Tc -0.099 Tw [(, an)34(d)33( )]TJ 9.6 0 2.041 9.6 331.68 613.44 Tm -0.004 Tc -0.046 Tw [(M)-7(o)-7(r)21(axella catarr)21(halis)]TJ 9.6 0 0 9.6 425.76 613.44 Tm -0.007 Tc -0.043 Tw [( )-44( in the United States)]TJ -34.175 -1.225 TD 0.081 Tw [(in )-26(1996\2261997 r)7(espir)18(a)-26(tor)18(y season. )-26(D)15(iagn)-32( M)12(i)-11(c)-11(r)18(obio)-32(l Infect )]TJ 26.725 0 TD -0.005 Tc 0.08 Tw [(Dis 1997;29)-30(:249\226)20(5)-24(7)4(.)]TJ -27.775 -1.2 TD -0.004 Tc 0.128 Tw [(5.)-229(Pfalle)-29(r)10( M)15(A)-2(, Jones R)13(N)1(, Doer)21(n)10( )-26(G)24(V)113(, Kugler)21( K. )24(Bac)21(t)-21(e)-9(r)21(ial )]TJ 26.575 0 TD -0.009 Tc 0.131 Tw [(pathog)-34(ens )22(isolated)-34( )25(f)-26(r)5(om)16( patien)-34(ts)16( with)]TJ -25.525 -1.225 TD -0.007 Tc -0.069 Tw [(bloo)-32(ds)18(t)-24(r)7(eam)18( infe)-32(c)18(tio)-32(n: f)-10(r)18(eque)-32(nc)18(ies o)12(f)-32( oc)18(c)-7(u)-7(r)18(rence and antimic)18(robial susc)18(e)10(p)-32(tibility p)6(a)6(t)-32(te)-12(r)18(ns f)-10(r)18(om)]TJ 0 -1.2 TD -0.005 Tc -0.022 Tw [(the )-22(S)20(ENTR)20(Y)12( a)12(n)-30(tim)20(i)-9(c)-9(r)20(obial )-22(sur)20(veillance )-23(pr)20(ogr)20(a)-24(m)14( \(United)-30( S)12(tates a)9(n)9(d)-30( C)12(anada, )-21(1997\). Antim)20(i)-9(c)-9(r)20(o)17(b)]TJ 0 -1.225 TD -0.006 Tc 0.081 Tw [(Agents C)11(h)-20(e)-6(m)19(other 1998;42:17)-31(62\226)19(70.)]TJ -1.05 -1.225 TD -0.044 Tw [(6.)-231(Hofm)19(a)8(n)8(n)-31( J, C)11(e)-25(t)-9(r)19(o)7(n)6( M)-20(S)19(, Farley M)13(M)13(,)-28( )28(e)-25(t)5( al. The p)-6(r)19(e)6(v)-31(alence of d)-6(r)19(u)9(g)9(-)-31(r)8(esis)19(t)7(a)6(n)-31(t)5( )]TJ 9.6 0 2.041 9.6 426 543.36 Tm -0.01 Tc -0.04 Tw [(S)7(t)-13(r)15(ept)-35(oc)15(o)-24(c)15(cus pneu)-35(-)]TJ -33.945 -1.2 TD -0.021 Tc [(mon)-46(i)-14(a)-13(e)]TJ 9.6 0 0 9.6 131.52 531.84 Tm -0.007 Tc 0.082 Tw [( )81( in )-25(A)15(tla)-32(nta. N E)15(n)-32(gl J Med 1995)-32(;333:481\2266.)]TJ -4.575 -1.225 TD -0.006 Tc 0.106 Tw [(7.)-231(B)11(artlett )-25(JG)19(, )-25(B)11(r)8(eiman R)-8(F)144(, M)13(a)11(n)-31(d)1(ell LA, File T)-20(M)13( J)-11(r)94(. C)11(o)-20(m)13(m)13(u)6(n)7(i)-31(ty-acquir)19(ed )-25(pneum)19(o)-20(nia in a)11(d)-31(ults:)]TJ 1.05 -1.2 TD 0.081 Tw [(guid)-31(elines for)19( )-22(m)13(a)0(nagement. Clin Inf)-31(ec)19(t )-25(D)16(is 19)-31(98;26:811\22638.)]TJ -1.05 -1.225 TD -0.005 Tc 0.08 Tw [(8.)-230(Dowell S)-7(F)145(, B)12(u)14(t)-30(l)-6(e)-6(r)20( JC, Giebink G)-10(S)20(, e)9(t)-30( al. Acute o)14(t)-30(itis)20( )-22(m)14(edia: managem)20(e)12(n)-30(t)6( and sur)20(veilla)-30(n)6(c)20(e i)9(n)]TJ 1.05 -1.225 TD -0.006 Tc 0.031 Tw [(an )-25(e)-11(r)19(a of )-25(pneum)19(o)-20(c)19(occal r)8(esistance\227)19(a)-25( r)8(eport f)-9(r)19(om the D)-20(r)19(ug-r)19(esistant )]TJ 9.6 0 2.041 9.6 410.4 485.04 Tm -0.007 Tc 0.054 Tw [(S)10(t)-24(r)7(eptococc)18(u)-21(s)18( pneum)18(o)-21(-)]TJ -32.32 -1.2 TD -0.009 Tc (niae)Tj 9.6 0 0 9.6 116.64 473.52 Tm -0.007 Tc 0.106 Tw [( )105( Ther)18(a)10(p)-32(eutic )24(W)43(o)-7(r)18(king G)21(roup. Pediatr)18( Infect )24(D)-7(i)-7(s)18( J )24(1999;1)-32(8:1\226)18(9.)]TJ -3.025 -1.225 TD -0.005 Tc 0.002 Tw [(9.)-230(Gonzales R)20(,)-6( S)20(t)4(eine)-30(r)9( JF)145(, Lum A)20(,)-7( )-5(B)-7(a)-7(r)20(r)9(ett PH Jr)95(. Decr)20(easing antibiot)-30(ic)20( use in am)20(bulato)-30(r)9(y)-2( pr)20(actice:)]TJ 1.05 -1.2 TD -0.006 Tc 0 Tw [(i)-9(m)19(p)-20(a)0(c)19(t)-1( of a m)19(u)5(l)5(t)-31(idim)19(ensional intervention on the)-31( )22(treatm)19(e)7(n)7(t)-31( )22(o)13(f)-31( )22(u)16(n)-31(c)19(omplicated ac)19(u)-20(t)3(e )19(bronchitis)]TJ 0 -1.225 TD 0.081 Tw [(in )-25(adults. J)-8(A)-8(M)19(A 1999;281)-31(:1512\2269.)]TJ /F4 1 Tf 12 0 0 12 178.56 395.76 Tm 0.001 Tc 0.001 Tw [(P)12(r)7(i)6(m)21(ary)21( Mu)21(ltid)21(ru)21(g)12(-)14(R)-12(e)17(si)21(stan)21(t T)141(u)-17(b)21(e)17(rcu)21(l)-10(o)21(si)21(s \227)]TJ 3.64 -1.1 TD 0.002 Tw [(I)-5(v)21(a)-12(n)21(o)12(v)17(o)12( O)21(b)-10(l)21(ast,)21( Ru)21(ssi)21(a, )23(1)-7(9)21(9)-7(9)]TJ /F2 1 Tf 10.8 0 0 10.8 102.48 361.44 Tm 1 g -0.003 Tc 0.003 Tw [(Mul)19(tidr)19(ug-Res)19(i)8(s)-9(t)-9(a)19(n)-14(t)19( T)108(uber)19(c)-9(u)-9(l)19(o)-9(s)-8(i)19(s)8( )11(\227)-14( )22(Continued)]TJ 0 g 0 0 TD -0.001 Tc -0.021 Tw [(The i)10(n)-1(c)21(idenc)21(e)-11( )22(o)-12(f)21( )-11(tuber)21(c)-7(u)-6(l)21(o)-7(s)-6(i)21(s)10( )-11(\(TB\) )22(i)10(n)-12( )12(the R)22(u)-12(s)10(s)10(i)-11(a)21(n)-1( Fede)21(r)-12(a)21(tion h)10(a)21(s)-23( )22(i)-7(n)-7(c)21(r)10(e)-6(a)-6(s)21(ed s)10(tea)21(d)-6(i)-6(l)21(y)]TJ -1.333 -1.222 TD 0.002 Tc -0.046 Tw [(from 34)24( )-10(per 1)25(00,)24(000)24( )-10(p)24(o)-20(p)8(u)8(l)24(ati)24(o)8(n)8( in 1)25(991 to 78)24( )-10(per )23(100,)24(00)24(0)-8( i)13(n)2( 19)24(98 \()24(Centr)24(a)-8(l)24( )-10(T)124(u)-9(ber)24(c)13(ulos)24(i)13(s)]TJ T* -0.001 Tc -0.043 Tw [(R)-6(e)-6(s)21(e)-6(a)-6(r)21(c)10(h)-12( )-33(I)10(n)-1(s)21(t)-12(i)21(tute,)21( )-33(u)21(n)-23(publ)21(i)10(shed )-22(data)21(,)-23( 1999)21(\))-12(.)-12( )-22(T)143(o)-1( )-22(r)-12(e)21(v)-6(e)-6(r)21(s)-12(e)21( )-33(thi)21(s)-23( t)-12(r)21(end, i)-6(n)-6( 1995)21(,)-23( feder)21(a)-11(l)21( )-33(a)22(n)21(d)]TJ T* -0.003 Tc -0.031 Tw [(l)-8(o)-8(c)19(a)-13(l)19( gove)19(rnments)19(,)8( wi)19(th )10(a)20(s)-25(s)19(i)8(s)-9(t)-8(a)]TJ 14.6 0 TD 0.001 Tc -0.068 Tw [(nce f)-10(r)23(o)6(m)6( )-23(t)23(h)-10(e)24( )-11(W)45(o)-10(r)12(l)12(d)1( H)-10(e)24(a)-9(l)23(th O)-10(r)23(g)-10(a)24(niz)23(ati)23(o)7(n)7( )-23(\(W)23(HO\),)23( )-11(impl)23(e-)]TJ -14.6 -1.2 TD -0.002 Tc 0.046 Tw [(mented )-23(a)-12( p)-13(i)9(l)9(ot )-23(pr)20(oje)20(c)-13(t)-13( u)-8(s)-7(i)20(ng )-23(the WHO TB-c)20(o)20(n)-24(t)-13(r)20(ol)20( )-34(s)9(t)-13(r)20(ategy of )-23(di)20(r)9(e)-13(c)20(t)-7(l)-7(y)20( )-34(obs)20(e)-13(r)20(ved )-23(the)20(r)-13(-)]TJ 0 -1.222 TD -0.001 Tc 0.367 Tw [(a)-23(p)10(y)43(,)-23( )33(sh)-23(o)-12(r)-7(t)-7(-)-23(cou)-23(r)10(s)-12(e)-12( )33(\()-24(DOTS)-23(\)* i)-6(n)-6( )-12(I)10(v)-23(a)10(n)-23(o)10(v)-23(o)-12( o)-12(blast)-23( \()-24(199)-23(8)-11( )10(p)-12(o)-12(p)21(u)-23(l)-6(a)-6(t)-23(ion)-23(:)-23( )10(a)10(p)-23(p)-12(rox)-23(ima)-23(tely)]TJ T* -0.002 Tc -0.042 Tw [(1)-12(.)20(3)-12( )-22(mi)20(l)9(l)9(ion\),)20( )-33(a)21( )-33(di)20(s)-13(t)20(r)-24(i)20(c)9(t)-13( )-22(1)21(6)-7(5)-7( mi)20(l)-12(e)20(s)-24( \(280)20( )-33(k)9(m\) n)20(o)-24(r)9(thea)20(s)-13(t)-13( of M)20(o)-24(s)9(c)9(o)20(w)42(.)9( )-33(Thi)20(s)9( )-33(r)9(epor)20(t)-13( )-22(doc)20(uments)]TJ 0 -1.2 TD 0.003 Tc 0.108 Tw [(a)-19( )-11(su)-19(b)-8(stan)-19(t)-20(i)14(a)-8(l)-8( increas)25(e)-7( )-22(i)14(n)-8( )-11(p)-8(r)14(imary m)-9(ulti)25(d)-8(r)14(u)-8(g-resi)25(stan)-19(t)-8( T)-8(B)-8( \()-20(P)14(-)14(M)-19(D)14(R)25(T)9(B)8(\))-19( )-11(in t)-20(he )-22(c)14(i)-8(v)-8(i)25(l)-19(i)25(a)14(n)]TJ 0 -1.222 TD -0.003 Tc -0.064 Tw [(p)-14(opul)19(a)-8(t)-8(i)19(on o)-14(f)-14( I)8(v)-2(a)19(n)-14(o)8(v)19(o)-14( )-11(f)-14(r)19(om Ja)19(n)-14(u)8(a)19(r)-14(y)19( )-11(1996)19( )-11(through O)19(ctober)19( )-11(19)19(9)-8(8)-8( and a)20( )-11(high pr)19(eva)19(l)-13(e)19(n)-14(c)8(e)]TJ T* 0.092 Tw [(o)-14(f)19( )-33(a)20(l)-25(c)19(oholi)19(s)8(m)-9(,)-9( pr)19(e)-8(v)-8(i)19(ous)19( )-11(i)-9(n)-8(c)19(a)-14(r)19(c)-14(e)19(r)-14(a)19(t)-14(i)19(o)-14(n,)19( )-11(unempl)19(o)-14(y)20(ment,)19( )-11(and h)-14(i)8(s)8(tor)19(y)-13( of h)19(o)-25(m)8(e)19(l)-13(e)19(s)-25(s)19(nes)19(s)]TJ 0 -1.2 TD -0.001 Tc 0.179 Tw [(a)-23(m)21(o)-23(n)-12(g)-12( )12(p)-12(e)-23(r)10(s)-1(o)-23(n)-12(s)-23( )22(inf)-23(e)-12(c)21(te)-23(d with)-23( )12(b)-12(o)10(t)-23(h)-1( 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[(smea)21(r)32(-pos)21(i)-12(t)-12(i)21(v)22(e)-3( )-25(TB pati)21(ents)21( )-22(had p)-12(o)5(or)21( )-33(t)-12(r)21(ea)21(tment )-20(outc)21(omes \()-12(i)21(.)10(e)-11(.)21(,)-23( r)10(e)-11(l)21(apse)21(,)-23( t)-12(r)21(eatme)21(nt )-22(fa)21(i)10(l)-12(-)]TJ T* 0.011 Tc 0.122 Tw [(ure, o)6(r)6( de)11(a)11(t)-11(h)22(\))-11(.)-11( )22(P-)-12(M)33(D)-11(R)34(TB, )22(de)11(f)]TJ 14.244 0 TD -0.004 Tc 0.126 Tw [(ined)-26( a)-15(s)-15( )]TJ 10.8 0 2.296 10.8 284.4 164.4 Tm 0.007 Tc 0.104 Tw [(M. t)-16(u)29(b)-15(e)-4(r)29(c)1(ul)29(os)18(i)18(s)]TJ 10.8 0 0 10.8 364.32 164.4 Tm 0.006 Tc 0.127 Tw [( )144( )-11(isola)-16(tes resistan)-16(t t)6(o)6( at )22(least)]TJ -25.578 -1.2 TD -0.001 Tc -0.021 Tw [(i)-23(s)21(oni)21(a)-6(z)-6(i)21(d )-20(and r)-23(i)21(fampi)21(n i)-6(n)-6( neve)21(r)32(-)-7(t)-7(r)21(ea)21(ted T)-12(B)22( )-22(pat)21(i)-11(e)21(n)-12(t)21(s)-23(,)21( )-11(w)-12(a)22(s)-23( s)10(uspec)21(ted to be a)-11( maj)21(o)-12(r)10( )-11(c)10(o)-12(n)10(-)]TJ 9.6 0 0 9.6 87.6 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fa)21(c)-12(-)]TJ T* 0.004 Tc 0.14 Tw [(tors)26( \()]TJ 10.8 0 2.296 10.8 115.92 549.6 Tm (5)Tj 10.8 0 0 10.8 121.68 549.6 Tm -0.001 Tc 0.112 Tw [( )122(\))-12(.)-12( Anal)21(y)-12(s)-12(i)21(s)10( )-33(of the impac)21(t)-12( o)-12(f)21( )-33(t)5(h)5(e)21(s)-12(e)-12( fa)21(ctor)21(s)10( )-33(o)5(n)5( t)-12(r)21(eatment outc)21(ome )]TJ 31.467 0 TD -0.009 Tc 0.12 Tw [(amon)-31(g)-9( the)]TJ -34.578 -1.2 TD 0 Tc -0.022 Tw [(p)-11(a)23(t)-11(i)22(ents i)11(n)0( I)-10(v)22(anovo )-20(i)22(s)11( )-11(u)22(n)-22(d)11(e)22(r)-22( w)6(a)6(y)67(.)]TJ 1.333 -1.222 TD -0.002 Tc 0.113 Tw [(T)20(h)-24(e)-12( f)-25(i)9(n)-13(dings )-22(i)9(n)-13( )-11(t)9(h)-24(i)9(s)-24( repo)-24(r)9(t)-25( )]TJ 13.178 0 TD 0.003 Tc 0.13 Tw [(are )22(s)8(u)8(b)-19(j)14(ect to at l)14(eas)25(t)-8( thr)25(ee )22(l)14(imi)25(tat)25(ions)25(.)-19( )22(F)-7(i)25(r)14(s)-8(t)-8(,)25( )11(detai)25(l)14(s)]TJ -14.511 -1.222 TD -0.006 Tc 0.003 Tw [(abou)-28(t)16( )-6(p)-9(r)-9(e)16(v)-16(i)16(o)-17(u)-6(s)16( )-8(p)-11(r)16(i)-28(s)16(on and hospi)16(t)-11(a)-11(l)16(iz)-6(a)]TJ 17.6 0 TD 0 Tc -0.022 Tw [(tion h)-11(i)11(s)11(tor)22(y )-25(wer)22(e)-10( n)22(o)-22(t)22( )-25(ava)22(i)11(l)-10(a)22(b)-11(l)11(e)-10( for)22( )-33(a)-11(l)22(l)11( )-44(s)22(tudy )-18(pa)22(r)-11(-)]TJ -17.6 -1.2 TD -0.067 Tw [(t)-11(i)-11(c)22(i)11(pants)22(.)-22( T)-11(h)0(i)22(s)11( )-33(l)11(i)11(mite)22(d)-11( )-11(the )-23(abi)22(l)11(i)11(ty )-23(to )-23(i)11(denti)22(fy spec)22(i)11(f)-11(i)22(c)-22( h)-11(i)11(gh-r)22(i)11(s)-22(k)22( )-33(ex)22(p)-11(o)0(s)22(ure)22(s)-22( in t)11(h)-22(e)23( )-33(c)11(o)22(m)-22(m)22(u-)]TJ 0 -1.222 TD 0.001 Tc 0.021 Tw [(n)-10(i)12(ty)68(.)12( )-33(S)24(econd,)23( )-33(the r)12(e)-9(l)23(ati)23(vel)23(y)-9( smal)23(l)12( )-11(s)-10(a)23(m)-11(p)1(l)23(e)-9( s)12(i)-10(z)23(e)-9( l)-21(i)23(mi)23(ted the p)23(o)-21(wer)23( )-11(to )-22(d)12(e)23(tec)23(t)-10( )-22(s)12(tati)23(s)12(t)-10(i)23(c)-10(a)23(l)-21(l)23(y)]TJ T* -0.001 Tc 0.023 Tw [(s)-23(i)21(gni)21(f)-12(i)-12(c)21(ant d)-12(i)10(ffe)21(r)-12(e)21(n)-12(c)10(e)-12(s)21( )-33(b)10(e)21(t)9(w)-23(e)22(en )-22(c)10(a)-12(s)21(e)-12(s)-12( and contr)21(o)-7(l)-7(s)21(.)10( )-33(Thi)21(r)10(d)-12(,)10( )-11(c)10(a)-6(s)-6(e)21(-pati)21(ents)21( )-33(a)22(n)-12(d c)10(o)-12(ntr)21(ol)21(s)]TJ T* 0.068 Tw [(d)-12(e)22(s)-23(c)21(r)10(ibe)21(d)-12( )-11(i)10(n)-1( thi)21(s)-23( r)10(epor)21(t)-12( )-22(a)22(r)-12(e)21( )-11(l)-23(i)21(mi)21(ted to I)10(vanovo and may not be r)-12(e)21(pre)21(senta)21(t)-6(i)-6(v)21(e)-11( of T)10(B)]TJ 0 -1.2 TD -0.021 Tw [(p)-12(a)22(t)-12(i)21(ents i)10(n)-1( o)-12(t)21(h)-12(e)22(r)-23( geogr)21(aphic)21( )-11(r)10(egions)21( )-11(w)-12(i)10(thi)21(n )-22(R)21(u)]TJ 21.689 0 TD -0.011 Tc [(ssia)-21(.)]TJ -20.356 -1.222 TD -0.001 Tc 0.068 Tw [(On the b)-12(a)22(s)-23(i)21(s)10( )-33(of thes)21(e)-11( findi)21(ngs,)21( )-11(Situs Slot Gacor )-22(m)10(a)21(de )-22(two r)-12(e)21(commendati)21(ons to impr)21(ove the)]TJ -1.333 -1.222 TD 0.034 Tw [(o)-12(utc)21(omes)21( of )11(TB-contr)21(ol)21( a)-12(c)21(t)-12(i)21(v)-11(i)21(t)-12(i)21(e)-7(s)-7( )27(i)-7(n)-7( )27(I)-7(v)21(anovo. )33(Fi)21(r)-23(s)21(t)-12(,)21( to )37(p)-23(r)10(ev)21(ent )11(fur)21(ther)21( s)10(p)-12(r)10(e)0(a)21(d)-12( )29(o)-5(f)-5( )11(dr)21(u)-12(g)10(-)]TJ 0 -1.2 TD -0.066 Tw [(r)-12(e)21(s)-23(i)21(s)10(tant and d)-12(r)10(ug-s)21(u)-12(s)10(c)10(epti)21(ble)21( )-33(T)10(B)21(,)-23( TB-c)21(ontrol)21( )-11(effor)21(t)-12(s)21( )-11(m)-13(u)-1(s)21(t)-12( t)-6(a)-6(r)21(get hi)21(gh-ri)21(s)10(k)10( )-11(p)21(o)-23(pul)21(a)-6(t)-6(i)21(ons)]TJ 0 -1.222 TD 0.001 Tc 0.077 Tw [(for )11(a)24(c)-10(t)-10(i)23(ve)23( c)12(ase)23( f)-10(i)23(n)23(d)-21(i)12(n)7(g)7( )11(and )11(a)24(s)-21(s)23(ura)23(nce )34(o)-10(f)23( c)12(o)23(m)-21(p)1(l)23(eti)23(o)7(n)7( )11(of )34(ther)23(a)7(p)7(y)68(.)12( Se)23(cond,)23( r)12(api)23(d)-10( )23(dr)23(u)-10(g)12(-)]TJ T* -0.001 Tc -0.021 Tw [(s)-7(u)-7(s)21(c)-12(e)21(p)-12(t)21(i)-6(b)-6(i)21(l)10(i)10(t)-6(y)-6( t)-6(e)-6(s)21(t)-12(i)21(ng and the use)21( )-11(of a)22(p)-12(pr)21(opri)21(at)21(e)-11( s)10(e)-12(c)21(o)21(n)-23(d-l)21(i)10(ne TB )22(drug r)10(egi)21(mens)21( )-11(for)21( )-11(p)10(a)-1(-)]TJ 0 -1.2 TD 0.009 Tc 0.224 Tw [(t)-14(i)9(e)9(n)-13(ts )11(wi)9(t)9(h)-13( d)20(e)-13(m)31(o)-13(nstrat)-13(e)20(d)-13( M)31(D)-13(R)32(TB )11(s)20(h)-2(o)31(u)-13(l)20(d)-2( )22(be )33(i)14(m)14(p)-13(l)20(e)20(m)]TJ 26.089 0 TD -0.002 Tc [(ented)-24( )11(t)-25(o)-2( i)9(m)-14(prove treatmen)-24(t)]TJ -26.089 -1.222 TD 0 Tc -0.044 Tw [(o)-11(utc)22(omes)22( )-10(i)-5(n)-5( a)23(c)-11(t)-11(i)22(ve)22( )-10(T)-11(B)23( )-10(p)-11(a)23(t)-11(i)22(ents a)23(n)-11(d )23(to r)-11(e)22(d)22(u)-22(c)11(e)-10( )23(the wi)22(d)-11(e)23(s)-6(p)-6(r)22(ead )23(emer)22(gence)22( )-10(of M)11(D)11(R)22(TB )23(i)11(n)]TJ 0 -1.2 TD -0.001 Tc 0.023 Tw [(this)21( )-33(communi)21(ty)66(.)-23( Unti)21(l)-23( s)-12(e)-12(c)21(ond-l)21(ine )-22(dr)21(u)5(g)5( )-22(s)10(u)-12(s)10(c)10(epti)21(b)]TJ 23.2 0 TD 0.001 Tc 0.043 Tw [(i)12(l)12(i)12(ty te)23(s)-10(t)-10(i)23(n)7(g)7( i)12(s)-21( wi)23(del)23(y)-9( av)23(a)-9(i)23(l)-9(a)23(ble)23(,)-21( o)12(n)12(e)]TJ -23.2 -1.222 TD -0.001 Tc 0.068 Tw [(o)-12(r)10( )-11(mor)21(e)-11( s)10(e)-12(c)21(o)16(n)16(d)-23(-)21(l)-23(i)21(ne t)-12(r)21(ea)21(tment r)10(egi)21(mens )23(w)]TJ 20.4 0 TD -0.006 Tc 0.05 Tw [(ill )-34(need t)-6(o)-6( )-23(b)-6(e)-6( u)-17(s)5(e)-6(d)-6( empi)16(r)-28(i)16(ca)-16(l)16(l)-16(y)16( )]TJ 14.689 0 TD 0 Tc 0.044 Tw [(\(bas)22(ed o)22(n)]TJ -35.089 -1.222 TD 0.089 Tw [(knowle)22(d)22(g)-22(e)23( )-33(of dr)22(u)-11(g-r)22(e)-11(s)22(i)11(s)-11(t)22(ance)22( )-33(pr)22(ofi)22(l)-10(e)22(s)-22( i)11(n)0( )-22(the c)]TJ 21.978 0 TD -0.014 Tc [(ommu)-36(n)-14(i)]TJ 3.956 0 TD 0.003 Tc 0.097 Tw [(ty\) )11(for)25( t)14(h)-19(e)26(s)-8(e)25( p)-8(a)26(t)-8(i)25(ents.)25( )]TJ 10.6 0 TD -0.008 Tc [(Expan)-8(-)]TJ -36.533 -1.2 TD -0.003 Tc 0.07 Tw [(s)-25(i)19(on )-22(of r)-14(a)19(p)-14(i)8(d drug s)-9(u)-9(s)19(c)-14(e)19(p)-14(t)19(i)-8(b)-8(i)19(l)8(i)-14(t)19(y)-13( )-22(te)19(s)-14(t)-14(i)19(ng and )-22(a)-13( r)8(e)-13(l)19(i)-13(a)19(ble)19( )-33(dr)19(ug )-22(s)8(u)19(p)-25(p)-3(l)19(y)-13( w)-8(i)-9(l)19(l)8( )-11(f)-9(a)-9(c)19(i)-25(l)19(i)8(tate)19( )-33(the)]TJ 0 -1.222 TD -0.002 Tc 0.024 Tw [(d)-13(e)21(s)-24(i)20(g)4(n)4( of more)20( )-11(indi)20(v)-12(i)20(dual)20(i)-13(z)20(ed t)-13(r)20(eatment r)9(egi)20(mens)20( )-11(i)9(n)-13( )19(pati)20(ents)20( )-11(with )24(d)-24(r)9(ug-r)20(e)-13(s)20(i)-24(s)20(tant )24(T)-24(B)21(,)]TJ T* -0.001 Tc 0.112 Tw [(imp)-23(r)10(o)-12(v)-6(e)-6( t)-24(he l)-17(i)-17(k)21(e)-12(l)-12(i)21(h)-12(o)21(o)-23(d)-1( )-22(of )-22(c)10(u)-12(r)10(e)-12(,)-12( p)-12(r)10(e)-23(v)0(e)21(nt )-22(the t)-12(r)21(ansmi)21(s)10(s)-23(i)21(on )-22(of drug-r)21(e)-12(s)21(i)10(s)-7(t)-6(a)21(n)-12(t)21( )-33(TB,)21( )-33(a)22(n)21(d)]TJ 0 -1.2 TD 0 Tc -0.022 Tw [(aver)22(t)-11( pre)22(matur)22(e)-10( d)-11(e)23(aths)22( )-32(a)]TJ 11.756 0 TD 0.008 Tc (ttri)Tj 1.333 0 TD -0.002 Tc -0.02 Tw [(butabl)20(e)-12( to M)20(D)-24(R)43(TB.)]TJ 9.6 0 2.041 9.6 88.08 241.92 Tm -0.003 Tc [(Refer)22(ences)]TJ 9.6 0 0 9.6 87.6 231.12 Tm -0.006 Tc 0.131 Tw [(1.)-231(C)11(h)6(i)7(n)-31(a T)105(uberc)19(u)-20(los)19(is C)11(o)-20(ntr)19(ol Collabor)19(a)8(t)-31(ion. R)11(esults of )-25(dir)19(ectly obser)19(ve)6(d)-31( s)19(h)-20(o)-6(r)19(t-cour)19(se chem)19(o)-20(-)]TJ 1.05 -1.225 TD -0.02 Tw [(therapy i)8(n)-31( 112,842 )-22(C)19(hinese )-20(patients )-20(with s)-12(m)19(ear)44(-positive t)-23(uber)19(culosis. Lancet 1996;347)-31(:358\226)19(6)-25(2)3(.)]TJ -1.05 -1.2 TD -0.004 Tc 0.029 Tw [(2)5(.)-229(K)13(umar)21(esan JA)21(, Ahs)21(a)13(n)-29( )27(Ali A)18(K)13(,)-26( )27(Park)21(kali LM)21(. T)107(uber)21(culosis )30(control )30(in)-29( )31(Bangladesh: s)21(u)-18(c)21(cess)21( o)7(f)7( )25(t)15(h)-29(e)]TJ 1.05 -1.225 TD -0.006 Tc 0.08 Tw [(D)-6(O)19(T)-20(S)11( s)-8(t)-7(r)19(ateg)-31(y)75(.)0( )-26(Int J )-26(T)105(uber)19(c L)8(u)8(n)-31(g)8( D)-6(i)-6(s)19( )-23(1998;2:992\2268.)]TJ -1.05 -1.225 TD 0.106 Tw [(3.)-231(W)44(orld Health )-25(O)-14(r)19(ganization. )-25(Global )-25(tuber)19(culosis contr)19(o)-20(l)-2(: W)-9(H)19(O r)8(e)11(p)-31(o)-6(r)19(t)5( 1999)-31(. G)22(e)-25(neva, S)11(w)5(i)-31(t)-4(z)19(e)-11(r)-6(-)]TJ 1.05 -1.2 TD -0.007 Tc 0.107 Tw [(land: W)43(o)-7(r)18(l)7(d)-32( )28(H)15(e)-26(alth )25(O)-15(r)18(g)7(a)7(n)-32(i)-10(z)18(atio)-32(n, )25(1999; r)7(epor)18(t)-24( )28(no. W)]TJ 24.725 0 TD -0.003 Tc [(HO/C)22(D)19(S)-10(/)-10(C)22(PC)22(/)11(T)-28(B)14(/99.259.)]TJ -25.775 -1.225 TD -0.006 Tc 0.106 Tw [(4.)-231(W)44(orld )25(Health O)-14(r)19(ganization)-31(. )25(W)44(o)-20(r)8(l)2(d health r)8(eport )25(1999: m)13(aking )25(a differ)19(e)11(n)-31(c)19(e. G)22(e)11(n)-31(eva, )25(S)11(w)5(i)-31(t)-4(z)19(e)-11(r)-6(-)]TJ 1.05 -1.2 TD -0.008 Tc 0.082 Tw [(land: )-26(W)42(o)-8(r)17(l)6(d)-33( H)14(e)-27(alth O)-16(r)17(g)6(a)6(n)-33(i)-11(z)17(atio)-33(n, 1999.)]TJ -1.05 -1.225 TD -0.006 Tc 0.08 Tw [(5.)-231(W)44(orld Health )-26(O)-14(r)19(ganization)-31(. Anti-tu)-31(ber)19(culosis)19( )-23(dr)19(u)16(g)-31( r)8(e)-25(s)19(istance )-26(in t)-23(he w)13(o)-31(r)8(ld: )-26(the )-26(W)19(HO/IU)19(A)66(TLD)]TJ 1.05 -1.225 TD -0.007 Tc 0.057 Tw [(glob)-32(al p)-7(r)18(o)-21(j)-2(ec)18(t )-25(on )-25(anti-tub)-32(e)-12(r)18(culosis)18( d)-21(r)7(ug r)7(esistance s)-7(u)-7(r)18(veillan)-32(c)18(e, 1)-26(994\226)18(19)-32(97. Geneva, S)10(w)4(i)-32(t)-5(z)18(e)-12(r)-7(-)]TJ 0 -1.2 TD -0.005 Tc 0.08 Tw [(land: )-25(W)20(H)-3(O Global )-25(T)106(uber)20(culosis Pr)20(o)17(g)-30(r)9(a)-5(m)20(,)1( 1)-24(997; r)9(e)12(p)-30(o)-5(r)20(t)6( n)17(o)-30(. W)-8(H)20(O/TB)20(/9)-30(7.229.)]TJ -1.05 -1.225 TD -0.006 Tc 0.031 Tw [(6.)-231(C)11(rofton )-25(J, Chaulet )-25(P)205(,)0( )-25(M)13(aher)19( )-22(D)16(.)0( )-25(G)22(u)7(i)6(d)-31(elines for)19( )-22(the m)13(a)-25(nagem)19(e)7(n)7(t)-31( of drug-r)19(esistant t)-23(uber)19(culosi)-6(s.)]TJ 1.05 -1.2 TD 0.106 Tw [(Geneva, S)11(witzer)19(land: W)44(o)-6(r)19(l)3(d H)16(ealt)-31(h)8( )25(O)-14(r)19(ganization)-31(, )25(1997; r)8(epor)19(t)5( no. )25(WHO)19(/)8(T)-31(B)11(/96.210 \()-9(r)19(e)6(v)44(. )25(1\).)]TJ /F4 1 Tf -1 66.6 TD 0.001 Tw [(V)66(ol. 48 / No. 30)-13431(M)13(M)13(W)-14(R)-18956(663)]TJ /F2 1 Tf 9.6 0 2.041 9.6 88.08 710.4 Tm 0.006 Tw [(Multidr)19(u)-20(g-R)19(esistant )6(T)94(uberc)19(u)7(l)7(o)-31(s)19(i)-6(s)-6( \227)-6( C)19(ontin)-31(u)8(e)8(d)]TJ ET endstream endobj 87 0 obj << /ProcSet [ /PDF /Text ] /ColorSpace << /DefaultRGB 1 0 R >> /Font << /F2 13 0 R /F4 14 0 R >> >> endobj 88 0 obj << /Filter /LZWDecode /Width 77 /Height 99 /BitsPerComponent 8 /ColorSpace [ /Indexed /DeviceRGB 255 9 0 R ] /Length 798 >> stream 5P8$ BaPRDbPhtN-5ⱘvHc /$Ay\r[ e%de4US?S%DѨ]6} ƨXԲWSU3e //a6z[R*rMGNMN[l& -D-ֹWZ;)c^0Zw/;G<2,wg_ja+Xl^ꕺ]-}þpy-l4EZw}IBq;7]Uo]+#\0~ \spnR+0 3ۜ1 k `@Bz~A.ңP[3l L7z:nQf(cOĎ$% -z 3J2[R0y50G'˰F D0T!ɑQM̿/;@stζϑ4aJM\wM;KN}Q4UqkEʔe49SUs j22dsZ",AaSHĵPkLf͡> stream 1 g 47.52 768.48 510.48 -730.08 re f* BT /F2 1 Tf 9.6 0 0 9.6 87.6 695.04 Tm 0 Tr 0 g -0.006 Tc 0.031 Tw [(7.)-231(C)11(o)16(n)-31(inx )30(R, )30(Mathieu C)11(,)0( D)16(e)-25(bac)19(k)-9(e)-9(r)19( M)13(,)0( et al. 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Int )-26(J T)105(uberc)19( L)-25(ung )]TJ 34.95 0 TD -0.005 Tc [(Dis 1999;3:45)-30(1\226)20(3)4(.)]TJ 10.8 0 0 10.8 102.48 647.28 Tm 1 g -0.003 Tc 0.003 Tw [(Mul)19(tidr)19(ug-Res)19(i)8(s)-9(t)-9(a)19(n)-14(t)19( T)108(uber)19(c)-9(u)-9(l)19(o)-9(s)-8(i)19(s)8( )11(\227)-14( )22(Continued)]TJ /F4 1 Tf 12 0 0 12 187.2 617.28 Tm 0 g 0 Tc [(M)24(o)11(r)-11(t)5(a)20(l)-4(i)20(t)-11(y)16( )-8(P)20(a)16(tte)4(rn)20(s \227)20( U)20(n)11(ited)20( )21(S)-13(t)5(a)20(t)2(es)20(, 1)20(9)-8(9)20(7)]TJ /F2 1 Tf 10.8 0 0 10.8 102.48 596.16 Tm 1 g 0.001 Tc -0.023 Tw [(Mort)23(a)-9(l)23(ity)23( )-22(Pa)23(tter)23(ns \227)-10( Conti)]TJ 12.356 0 TD -0.011 Tc (nued)Tj 0 g -12.356 0 TD 0 Tc -0.044 Tw [(I)11(n)0( )-22(1)23(997,)22( )-10(a)-10( total)22( )-33(of 2)-10(,)22(314)22(,)11(245 deaths)22( )-10(w)-11(e)23(r)-11(e)-11( r)11(egi)22(s)-6(t)-5(e)22(r)-11(e)22(d)0( )-22(i)11(n)0( )-22(t)22(h)-11(e)23( )-10(Uni)22(ted State)22(s)-11(\227)22(445 fe)22(w)-11(e)23(r)]TJ -1.333 -1.222 TD -0.067 Tw [(than the r)11(e)-11(c)22(ord hi)22(g)6(h)6( of 2)-10(,)22(31)22(4)-10(,)22(690 i)11(n)0( 19)22(96 \()]TJ 10.8 0 2.296 10.8 295.2 582.96 Tm (1)Tj 10.8 0 0 10.8 300.96 582.96 Tm -0.001 Tc -0.055 Tw [( )-45(\))-12(.)-12( )33(T)-12(h)10(e)21( over)21(a)-11(l)21(l)10( age-adj)21(us)21(ted )11(death )11(r)10(ate)21(* w)-12(a)22(s)]TJ -19.711 -1.222 TD 0.005 Tc 0.161 Tw [(4)-17(79.1)-17( per )-12(100,000 )]TJ 9.111 0 TD 0.002 Tc 0.154 Tw [(stan)-20(dard )-22(\(1940\) p)-9(o)24(p)-20(ulation, t)13(h)-20(e)-8( l)7(o)7(w)-20(e)-9(s)24(t)-21( )-10(ever r)-9(e)-9(c)24(o)-9(r)13(d)-9(ed. I)13(n)-9( )-10(1997,)]TJ -9.111 -1.2 TD 0 Tc -0.034 Tw [(n)-11(e)23(a)-11(r)22(l)-10(y)22( two )10(thi)22(r)-6(d)-6(s)22( of )10(d)6(e)6(a)22(ths )33(r)-11(e)-11(s)22(ul)22(ted )10(f)-11(r)22(om )10(hear)22(t)-11( )33(d)-11(i)11(s)11(eas)22(e)-10(,)22( c)11(anc)22(e)-11(r)89(,)11( a)23(n)22(d)-22( )22(s)-11(t)-11(r)22(ok)22(e)-10(.)22( T)6(h)6(i)22(s)-22( )33(r)11(eport)]TJ 0 -1.222 TD -0.011 Tw [(summar)22(i)11(z)-6(e)-6(s)22( morta)22(l)-22(i)22(ty )11(patt)22(erns)22( i)11(n)-11( 19)22(97 )11(\()]TJ 10.8 0 2.296 10.8 288 543.6 Tm (1)Tj 10.8 0 0 10.8 294 543.6 Tm -0.002 Tc -0.02 Tw [( )-11(\))-13( and compar)20(e)-13(s)20( )-11(them w)-13(i)9(th patter)20(n)-8(s)-8( i)9(n)-2( 1996)20(.)]TJ -17.733 -1.222 TD -0.001 Tc 0.068 Tw [(Na)21(tional)21( )-11(deat)21(h)-12( )-11(s)10(tati)21(s)10(t)-12(i)21(c)-23(s)21( )-11(a)-12(r)21(e)-11( bas)21(ed o)21(n)-23( )-11(i)10(nfor)21(mati)21(o)21(n)-23( )-11(f)-12(r)21(om death c)10(e)-12(r)21(t)-7(i)-7(f)21(i)-23(c)21(ate)21(s)-23( f)-12(i)21(l)10(ed i)10(n)]TJ -1.333 -1.2 TD 0.005 Tc 0.002 Tw [(sta)27(te vi)27(tal)27( )-4(s)-6(t)27(ati)27(s)-6(t)-6(i)27(c)16(s)0( offi)27(c)16(e)-6(s)27( )11(a)9(n)9(d)-17( a)27(r)-6(e)27( )-26(c)]TJ 16.889 0 TD -0.001 Tc 0.003 Tw [(ompi)21(l)-11(e)21(d)-12( by Situs Slot Gacor )24(into a)21( nati)21(onal)21( databas)21(e)-11(.)21( C)-6(a)21(u)-12(s)10(e-)]TJ -16.889 -1.222 TD -0.003 Tc 0.047 Tw [(o)-14(f)19(-death s)-8(t)-8(a)19(t)-14(i)19(s)-14(t)-14(i)19(c)8(s)-25( a)-14(r)19(e)-13( bas)19(ed on )-23(the)19( )-34(under)19(l)8(y)-13(i)19(n)19(g)-25( )-11(c)8(aus)19(e)-13( o)-14(f)19( )-34(dea)19(t)8(h)]TJ 8.4 0 0 8.4 404.64 507.84 Tm (\206)Tj 10.8 0 0 10.8 409.2 504.24 Tm -0.001 Tc 0.045 Tw [(.)-23( Ca)21(u)-12(s)10(e)-12(s)21( )-11(of death a)-12(r)21(e)]TJ -29.733 -1.222 TD -0.002 Tc 0.135 Tw [(recorded)-24( )11(o)-13(n)-2( )22(t)-25(he death)-24( )11(c)-13(e)-13(r)20(t)-13(i)20(f)-13(i)20(c)-13(a)20(t)-7(e)-7( b)9(y)20( )-11(the )22(attendi)20(ng phys)20(i)9(c)-24(i)20(an,)20( )-11(m)9(e)20(d)-13(i)9(c)9(a)-12(l)20( )-11(e)21(xami)20(ner)109(,)-24( )22(or)]TJ T* 0 Tc 0.044 Tw [(c)-6(o)-6(r)22(oner )22(u)-11(s)11(i)11(n)6(g)6( a)-10( for)22(mat s)11(peci)22(f)-11(i)22(ed by t)22(h)-11(e)23( )-11(W)44(orl)22(d H)6(e)6(a)22(l)-11(t)22(h)-11( )11(O)-11(r)22(gani)22(zati)22(o)6(n)6( and )]TJ 33.889 0 TD -0.011 Tc 0.055 Tw [(endo)-33(rse)-11(d)-11( by)]TJ -33.889 -1.2 TD 0 Tc (Situs Slot Gacor.)Tj 1.333 -1.222 TD -0.001 Tc -0.043 Tw [(Compar)21(ed wi)21(th 1)22(996,)21( )12(death )23(r)-12(a)21(t)-7(e)-7(s)21( )-10(dec)21(r)10(e)-6(a)-6(s)21(ed f)21(o)-12(r)10( )12(a)-11(l)21(l)-23( )23(age )23(groups)21( )-10(e)22(x)-6(c)-6(e)21(pt p)10(e)21(r)-23(s)21(ons )23(a)5(g)5(e)21(d)]TJ /F7 1 Tf -1.333 -1.222 TD (\263)Tj /F2 1 Tf 0.556 0 TD 0.001 Tc 0.088 Tw [(85)23( )-33(y)24(ear)23(s)-21(.)23( )-11(The l)-9(a)23(rges)23(t)-10( per)23(c)-10(e)23(n)-10(t)23(age d)-10(e)24(c)-21(r)23(ea)23(s)-10(e)-10(s)23( )-11(o)-5(c)-5(c)23(urr)23(ed i)12(n)1( p)-10(e)24(r)-21(s)23(ons a)24(ged 25\226)23(34 y)24(ear)23(s)]TJ -0.556 -1.2 TD 0.002 Tc -0.024 Tw [(\(9.)24(2%\),)24( )-11(35\226)24(44)24( )-32(y)24(ear)24(s)-20( \(8)24(.)-8(2)24(%)-4(\))-4(,)24( )-11(and )-19(1)24(\226)-9(4)-9( ye)24(a)-9(r)24(s)-20( \(6.)24(5%)24(\))-9(.)]TJ 1.333 -1.222 TD -0.002 Tc -0.042 Tw [(F)-13(r)20(om )-22(19)20(9)-7(6)-7( )-22(t)20(o)-13( )-10(199)20(7)-12(,)20( )-33(age-a)20(d)-13(j)9(us)20(ted d)-13(e)21(ath r)-13(a)20(t)-7(e)-8(s)20( )-33(dec)20(l)9(i)9(n)-13(e)21(d)-13( )-10(among w)-13(h)-2(i)20(t)-7(e)-8(s)20( )-10(\(from 466)20(.)-12(8)20( )-33(t)20(o)]TJ -1.333 -1.222 TD [(456.)20(5)-7(\))-7( and among bla)20(c)-24(k)20(s)9( )-10(\(from 7)21(3)-7(8)-7(.)20(3)-12( to 705)20(.)-12(3)20(\))]TJ 8.4 0 0 8.4 318 402.96 Tm (\247)Tj 10.8 0 0 10.8 322.56 399.12 Tm 0.001 Tc -0.045 Tw [(.)-21( I)12(n)1( )-22(1)24(997,)23( )-10(the over)23(a)-9(l)23(l)12( )-33(d)7(e)7(a)23(th )-22(r)12(ate)23(s)-21( for t)7(h)7(e)]TJ -21.711 -1.2 TD -0.005 Tc -0.062 Tw [(b)-16(l)6(a)-16(c)17(k)6( )-11(p)-16(opul)17(a)-10(t)-10(i)17(on w)-16(e)18(r)-16(e)-16( hi)17(gher)17( )-11(t)6(h)-27(a)18(n)-5( )-23(f)17(o)-16(r)6( )-11(the whi)17(t)-10(e)-10( popula)17(t)-16(i)17(o)-16(n)-5(;)]TJ /F4 1 Tf 27.378 0 TD ( )Tj /F2 1 Tf 0.222 0 TD 0 Tc -0.034 Tw [(for)22( s)11(e)1(v)22(en )10(of )33(t)6(h)6(e)22( 1)23(5)-10( )33(l)11(eadi)22(n)22(g)]TJ -27.6 -1.222 TD 0.1 Tw [(caus)22(e)-11(s)22(,)11( )-22(a)23(g)-11(e)23(-adj)22(uste)22(d)-11( deat)22(h)-11( r)11(ates)22( w)-11(e)23(r)-11(e)22( )-22(a)23(t)-11( )-11(l)11(e)1(a)22(s)-11(t)-11( )11(1)-10(.)22(5)-10( )11(t)-11(i)22(mes)22( gr)22(eater)22( for)22( bla)22(c)-22(k)22(s)11( than )11(for)]TJ T* 0.001 Tc -0.012 Tw [(w)-10(h)1(i)23(t)-5(es)23(.)12( The )11(l)12(a)-10(r)23(g)-10(e)24(s)-10(t)-10( )11(di)23(ffe)23(renc)23(e)-10(s)23( i)12(n)1( )11(r)-10(a)23(te)-5(s)23( w)-10(e)24(r)-10(e)23( for )33(h)23(u)-21(m)12(a)23(n)-10( )23(i)12(m)17(m)17(u)-21(nodefi)23(c)12(i)-9(e)23(ncy )33(v)-9(i)23(r)12(u)-10(s)12( \()23(H)-10(I)12(V)1(\))]TJ 0 -1.2 TD -0.002 Tc 0.069 Tw [(infe)20(c)-13(t)-13(i)20(on )-22(\(7)20(.)9(5)-12( )-22(t)-13(i)20(mes)20(\))-13( and )-22(homi)20(c)-24(i)20(de \()-7(6)-7(.)20(0)-12( t)-13(i)20(mes)20(\))-13( \()9(T)109(abl)20(e)-12( 1\))]TJ 8.4 0 0 8.4 368.4 350.4 Tm (\266)Tj 10.8 0 0 10.8 372.96 346.8 Tm 0 Tc 0.078 Tw [(.)11( Death )11(r)11(ates)22( w)-11(e)23(r)-11(e)22( lower)22( for)]TJ -26.378 -1.222 TD 0.1 Tw [(b)-11(l)11(a)-11(c)22(k)11(s)-22( )11(t)6(h)6(a)22(n)-11( )22(w)-11(h)0(i)22(t)-5(e)-6(s)22( for)22( thr)22(ee)22( l)11(eadi)22(n)22(g)-22( )22(c)-11(a)22(u)-11(s)11(e)-11(s)22(:)11( c)11(hroni)22(c)-22( )33(o)22(b)-22(s)11(t)-11(r)22(ucti)22(ve)22( p)6(u)6(l)22(m)-12(onar)22(y)-10( )33(d)-6(i)-5(s)22(eas)22(e)]TJ T* 0.003 Tc 0.13 Tw [(\()-20(0)-7(.)25(8)-7( t)-8(i)25(m)-9(es\),)25( )-11(Alzheimer\222)114(s)-19( di)25(sease )22(\()-20(0)26(.)-7(7)25( )-11(t)-8(i)25(mes)25(\))-8(,)25( )]TJ 21.378 0 TD -0.001 Tc 0.112 Tw [(and s)-6(u)-6(i)21(c)10(ide \()-6(0)-6(.)21(6)-11( t)-12(i)21(mes)21(\))-12(.)-12( The )-22(1)22(997 age-)]TJ -21.378 -1.2 TD 0 Tc -0.022 Tw [(adjus)22(ted death r)11(ates)22( )-11(decl)22(i)11(ned 4)-10(.)22(3% f)-11(r)22(om 1996)22( )-26(for)22( )-11(the Hi)22(spani)22(c)11( )-11(p)22(o)-22(p)6(u)6(l)22(ati)22(o)6(n)6( \()-6(f)-6(r)22(om 365.)22(9)]TJ 0 -1.222 TD 0.001 Tc 0.001 Tw [(to )-20(3)24(50.)23(3\).)23( The thre)23(e)-10( )-9(l)23(eadi)23(n)23(g)-21( )-20(c)23(aus)23(e)-10(s)23( )-31(of )24(d)-10(e)24(ath for)23( Hi)23(spani)23(c)12(s)-4( wer)23(e he)23(a)-10(r)23(t)-5( )-4(d)-5(i)-5(s)23(ea)23(s)-10(e)-10(,)23( )-20(c)23(anc)23(e)-10(r)112(,)]TJ T* -0.003 Tc -0.001 Tw [(and uni)19(ntenti)19(onal)19( )-26(i)19(n)-3(j)19(u)-8(r)-8(i)19(e)-14(s)19(.)]TJ 1.333 -1.222 TD 0 Tc -0.022 Tw [(I)11(n)0( )-22(19)22(9)-5(7)-5(,)22( )-32(a)22(g)-11(e)23(-adj)22(usted death r)-11(a)22(t)-6(e)-5(s)22( )-26(for)22( )-26(mal)22(e)-11(s)22( )-26(wer)22(e)-10( hi)22(g)-11(h)11(e)22(r)-22( than 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l)-22(i)22(ve)22( )-33(bi)22(r)11(ths,)22( )-10(and was)22( )-10(m)22(o)-22(r)11(e)-10( t)6(h)6(a)22(n)]TJ 0 -1.2 TD -0.002 Tc -0.02 Tw [(thre)20(e)-12( time)20(s)-24( hi)20(g)20(h)-24(e)21(r)-24( for)20( )-11(b)-13(l)9(a)-13(c)20(k)9( )-33(t)20(h)-13(a)21(n)-2( )-22(for)20( )-11(w)-13(h)-2(i)20(t)-7(e)-7( women.)]TJ 1.333 -1.222 TD [(I)9(n)-2( )-22(19)20(9)-7(7)-7(,)20( )-22(the)20( )-44(i)20(nfant )-19(mor)20(t)-7(a)-7(l)20(i)9(t)-7(y)-7( r)-13(a)20(t)-7(e)-7( w)-13(a)21(s)-24( 7)-12(.)20(2)-12( i)9(nfant deaths)20( )-11(p)-13(e)21(r)-24( 10)20(0)-7(0)-7( l)9(i)-12(v)20(e)-12( b)-7(i)-7(r)20(ths)20(;)-24( i)9(n)-2( 1996)20(,)]TJ -1.333 -1.222 TD 0.001 Tc -0.001 Tw [(infa)23(n)-10(t)23( mor)23(tal)23(i)-10(t)23(y was)23( )-5(hi)23(gher)23( but the)23( )-5(di)23(ffer)23(enc)23(e was)23( not )22(s)-5(t)-5(a)23(t)-10(i)23(s)-10(t)-10(i)23(c)12(a)-9(l)23(l)-9(y)23( )-22(s)23(i)12(g)-10(n)1(i)23(f)-10(i)23(c)12(ant.)23( )]TJ 36.291 0 TD -0.009 Tc (Among)Tj -36.291 -1.2 TD -0.002 Tc -0.02 Tw [(the 10)20( )-11(l)9(eadi)20(ng c)9(aus)20(e)-13(s)20( )-11(of )22(i)9(nfant d)9(e)20(ath)]TJ 8.4 0 0 8.4 271.92 566.4 Tm -0.013 Tc (\206\206)Tj 10.8 0 0 10.8 281.04 562.8 Tm -0.006 Tc -0.038 Tw [(,)-28( only)16( )-33(pneumon)-28(ia)-16( and )-22(in)-6(f)-6(l)16(uenza d)-17(e)17(c)-28(r)16(ea)]TJ 18.022 0 TD 0.002 Tc -0.046 Tw [(sed by )-22(a)]TJ -35.889 -1.222 TD 0.098 Tw [(st)-4(a)24(t)-9(i)-9(s)24(t)-9(i)24(c)13(a)-8(l)24(l)-8(y)24( s)-20(i)24(g)8(n)8(i)24(f)-9(i)-9(c)24(ant )]TJ 10.8 0 TD -0.006 Tc 0.073 Tw [(amou)-28(n)-6(t)-6( d)16(u)-28(ring )-22(199)16(6)-17(\226)16(1997)16(.)]TJ 10.8 0 2.296 10.8 341.04 549.6 Tm ( )Tj 10.8 0 0 10.8 344.88 549.6 Tm 0.002 Tc 0.087 Tw [(T)24(h)-20(e)25( )-11(i)13(nfant m)7(o)7(r)24(tal)24(i)13(ty r)13(ate )22(was )22(t)13(w)13(o)]TJ -23.778 -1.222 TD -0.001 Tc -0.021 Tw [(time)21(s)-23( hi)21(g)21(h)-23(e)22(r)-23( for)21( )-11(b)-12(l)10(a)-12(c)21(k)10( )-11(infa)21(n)-12(t)-12(s)21( )-11(than for whit)21(e)-11( infa)21(n)-12(t)21(s)-23( \()]TJ 10.8 0 2.296 10.8 352.56 536.4 Tm (1)Tj 10.8 0 0 10.8 358.56 536.4 Tm 0.011 Tc -0.022 Tw [( \).)]TJ -23.711 -1.2 TD 0.002 Tc -0.002 Tw [(F)-9(r)24(om 19)24(96 )22(to 19)24(97,)24( mor)24(tal)24(i)13(ty )22(in)-4(c)24(r)13(eas)24(ed fr)24(om s)24(epti)24(c)13(emi)24(a \(2)24(.)-8(4)24(%)-4(\))-4( )22(and k)24(i)13(d)24(n)-20(e)25(y)-8( )22(d)-4(i)-3(s)24(eas)24(e)]TJ -1.333 -1.222 TD 0.003 Tc [(\(4.)25(4%\);)25( )8(h)10(o)10(w)-19(e)26(ver)114(,)14( )-32(m)8(o)8(r)25(tal)25(i)14(ty dec)25(r)14(eas)25(ed for the thr)25(ee )-6(l)25(e)4(a)25(d)-8(i)14(ng ca)25(uses)25( of de)25(ath: )23(hear)25(t di)25(s)-8(-)]TJ T* 0 Tc -0.022 Tw [(e)-5(a)-5(s)22(e)-10( \()-5(3)-5(.)22(0%\))22(,)-22( c)11(ance)22(r)-22( \(1)22(.)-10(8)22(%)-6(\))-6(,)22( )-11(and )-22(s)22(t)-11(r)22(oke )22(\()-5(1)-5(.)22(9%\).)22( )-11(HI)22(V)67(-infe)22(c)-11(t)-11(i)22(o)6(n)6( mort)22(a)-10(l)22(i)-5(t)-5(y)22( )-11(dropped i)11(n)0( r)11(ank-)]TJ 0 -1.2 TD -0.001 Tc 0.29 Tw [(in)-23(g)-12( )11(f)-24(rom)-23( )-11(t)10(h)-23(e)-11( eig)-23(h)-12(t)10(h)-23( )-11(l)10(e)-23(a)10(d)-23(ing)-23( )-11(cau)-23(s)-12(e)-12( i)10(n)-12( )11(1996 t)10(o)-23( )11(t)-24(he 14th)-23( )11(i)-6(n)-6( 1997 \()10(T)110(able 1)-6(\))-6(.)21( )-11(T)21(h)-23(e)]TJ 0 -1.222 TD 0.001 Tc -0.023 Tw [(age-adj)23(ust)23(ed )-20(deat)23(h)-10( )-11(r)12(ate for HIV)23( )-44(i)23(nfec)23(t)-10(i)23(o)-10(n)1( decr)23(ea)23(s)-10(e)23(d)-10( )-11(47.)23(7%)23(,)12( )-25(the l)-9(a)23(rges)23(t)-10( decl)23(i)12(ne )]TJ 36.467 0 TD -0.011 Tc (among)Tj -36.467 -1.222 TD 0 Tc -0.044 Tw [(the 15 l)11(e)1(a)22(d)-11(i)11(n)6(g)6( c)-11(a)22(uses)22( )-10(of death.)22( )-10(I)11(n)0( 1997)22(,)-22( 1)23(6)-10(,)22(516 )23(deaths)22( )-10(wer)22(e)-10( attr)22(i)11(buted to HI)22(V)-11( i)11(nfec)22(t)-11(i)22(o)6(n)6(.)]TJ 0 -1.2 TD 0.067 Tw [(A)-11(g)11(e)22(-adjus)22(ted death r)-11(a)22(t)-5(e)-6(s)22( )-33(for)22( )-33(HI)22(V)-11( wer)22(e)-10( )-22(hi)22(ghes)22(t)-11( )-22(for)22( )-11(b)-11(l)11(a)-11(c)22(k)11( )-33(mal)22(e)23(s)-22( \(38.)22(5)-5(\))-5(,)22( )-11(bl)22(a)-11(c)22(k)-22( fe)22(m)-12(a)23(l)-10(e)22(s)]TJ 0 -1.222 TD -0.002 Tc 0.091 Tw [(\(13.)20(3)-7(\))-7(,)20( )-11(w)20(h)-24(i)9(t)-7(e)-7( mal)20(e)-13(s)20( )-11(\()-7(5)-7(.)20(6)-7(\))-7(,)20( )-11(and white)20( )-11(femal)20(e)-13(s)20( )-11(\()-7(1)-7(.)20(0)-7(\))-7(.)20( )-11(HI)20(V)-13( i)9(n)-13(f)20(e)-8(c)-7(t)20(ion c)9(o)20(n)-24(t)-13(i)20(nued to be the)]TJ T* 0 Tc 0.122 Tw [(f)-6(i)-6(f)22(th )11(l)11(eadi)22(n)6(g)6( )11(c)11(ause)22( of )11(d)6(e)6(a)22(th )11(for)22( bl)22(a)-11(c)22(k)-22( )33(femal)22(e)-11(s)22( a)23(g)-11(e)23(d)0( )11(15\226)22(24)22( yea)22(r)-22(s)22(,)11( the )33(s)-22(i)22(xt)22(h)-11( )22(for)22( bl)22(a)-11(c)22(k)]TJ 0 -1.2 TD 0.001 Tc 0.066 Tw [(mal)23(e)-10(s)-10( a)24(g)-10(e)24(d)1( 5)-10(\226)23(14 y)24(ear)23(s)-21(,)23( )-11(t)23(h)-10(e)24( )-11(s)-21(i)23(xt)23(h)-10( )12(for bl)23(a)-10(c)23(k)12( )-11(mal)23(e)-10(s)23( )-11(aged 1)24(5\2262)23(4)-9( ye)23(a)-10(r)23(s)-21(,)23( )-11(and t)7(h)7(e)23( )-11(l)12(eadi)23(n)23(g)]TJ 0 -1.222 TD 0.002 Tc -0.024 Tw [(caus)24(e)-8( for)24( )-27(bl)24(a)-9(c)24(k)13( )-22(ma)24(l)-8(e)24(s)-20( aged 25\226)24(44)24( )-32(y)24(ear)24(s)-20(.)]TJ 1.333 -1.222 TD 0.001 Tc -0.068 Tw [(I)12(n)1( )-23(19)23(97,)23( )-33(o)12(v)23(e)-10(r)23(a)-9(l)23(l)-21( l)12(i)-10(f)23(e)-9( )-23(e)24(xpec)23(tancy)23( )-33(\(L)23(E)-10(\))23( )-33(at bi)23(rth was)23( )-11(76.)23(5)-9( ye)23(a)-10(r)-10(s)23( )-11(\(Fi)23(g)7(u)7(r)23(e)-9( 1\))-10(.)23( )-33(The over)23(a)-9(l)23(l)12( )-33(L)24(E)]TJ -1.333 -1.2 TD 0.002 Tc 0.042 Tw [(inc)24(r)13(eas)24(ed b)-9(y)25( )-11(0)-8(.)24(4)-8( yea)24(r)-20(s)24( )-11(f)-9(r)24(o)7(m)7( the 19)24(96 LE pr)24(i)13(mar)24(i)-20(l)24(y)-8( b)13(e)24(caus)24(e)-8( of dec)24(r)13(eas)24(e)-9(s)24( )-11(i)13(n)2( m)24(o)-20(r)13(tal)24(i)13(t)2(y)]TJ 0 -1.222 TD 0 Tc 0.1 Tw [(from )33(H)-11(I)11(V)-11( )33(infe)22(c)-11(t)-11(i)22(o)6(n)6(,)22( hear)22(t)-11( )11(di)22(s)11(eas)22(e)-10(,)22( c)11(ance)22(r)78(,)11( s)11(t)-11(r)22(oke,)22( )22(and )11(homic)22(i)11(de.)22( Whi)22(te )11(f)22(emal)22(e)-11(s)22( c)11(o)-11(n)11(-)]TJ T* 0.004 Tc 0.307 Tw [(t)-19(i)10(n)10(u)-18(e)-18( )-11(t)15(o)-18( )-11(h)-7(a)5(v)-18(e)-6( t)15(h)-18(e)-6( h)-7(i)15(g)26(h)-18(est LE )-22(at birth \()-19(79.)26(9)-6( years\),)26( )-33(foll)26(o)-7(w)15(e)15(d)-18( )-11(by )-22(blac)26(k)-18( f)9(e)9(m)-18(a)-6(l)26(e)-7(s)]TJ 0 -1.2 TD -0.001 Tc 0.023 Tw [(\(74.)21(7)-11( year)21(s)10(\))-12(,)21( )-33(whi)21(t)-6(e)-6( mal)21(e)-12(s)-12( \(7)21(4)-11(.)21(3)-11( )-22(y)22(e)-6(a)-6(r)21(s)10(\))-12(,)-12( and bla)21(c)-23(k)21( )-11(mal)21(e)-12(s)-12( \(67)21(.)10(2)-11( )-22(y)22(e)-6(a)-6(r)21(s)10(\))-12(.)-12( Al)21(l)-23( four)21( )-33(r)10(a)-12(c)21(e)-7(-)-7(s)21(ex)]TJ 0 -1.222 TD -0.021 Tw [(g)-12(r)10(oups had )-22(i)21(n)-1(c)21(r)-12(e)21(a)-6(s)-6(e)21(s)-23( i)10(n)-12( )-11(LE )-20(dur)21(i)10(n)21(g)-23( )-11(19)21(9)-6(6)-6(\226)21(199)21(7)-11( and )-19(a)21(c)-7(h)-6(i)21(eve)21(d)-12( )-11(r)10(e)-12(c)21(ord hi)21(g)21(h)-23( )-11(l)10(i)10(f)-6(e)-6( expec)21(tan-)]TJ T* -0.004 Tc 0.115 Tw [(c)-26(i)18(e)-15(s)18(.)7( )-33(The gap between the whi)18(t)-9(e)-9( and )-22(bl)18(a)-15(c)18(k)7( )-33(popul)18(a)-9(t)-9(i)18(o)18(n)-26( )-11(i)7(s)7( )-11(6)-14(.)18(0)-14( )]TJ 29.489 0 TD 0.003 Tc [(year)25(s)14(,)-19( )]TJ 3.222 0 TD -0.007 Tc 0.14 Tw [(down f)-18(r)15(om )22(6)-17(.)15(6)]TJ -32.711 -1.2 TD -0.001 Tc -0.021 Tw [(year)21(s)10( )-44(i)21(n)-1( )-22(1)21(996.)21( )-11(T)-12(he gap )-17(be)21(t)9(w)-23(e)22(en )-19(me)21(n )-22(a)21(n)-12(d women )-18(i)21(s)10( )-11(5)-11(.)21(8)-11( year)21(s)10(,)10( )-18(down )-18(f)21(rom 6)-11(.)21(0)-11( yea)21(r)-23(s)21( )-11(i)10(n)]TJ 0 -1.222 TD [(1996)21(.)]TJ 9.6 0 2.041 9.6 88.08 262.08 Tm -0.005 Tc 0.08 Tw [(Repor)20(t)8(e)7(d)-30( )28(b)12(y)-30(: )25(M)-8(o)-8(r)20(tality S)12(t)6(a)6(t)-30(is)20(tics B)12(r)84(, )25(Div o)6(f)6( V)12(ital S)12(t)0(atistics)20(, National C)12(e)12(n)-30(ter)20( )28(f)-22(o)-5(r)20( )28(Health S)12(tatistics,)]TJ 0.239 -1.125 TD 0.011 Tc [(CD)36(C)6(.)]TJ /F4 1 Tf 10.8 0 0 10.8 88.08 237.12 Tm 0.009 Tc 0.046 Tw [(Ed)9(i)31(t)20(ori)31(al)31( N)9(o)9(t)31(e:)]TJ /F2 1 Tf 6.867 0 TD 0.001 Tc 0.043 Tw [( )-11(T)23(h)-21(i)12(s)12( )-11(r)-10(e)23(p)-10(o)1(r)23(t)-10( i)12(s)-21( bas)23(ed o)7(n)7( )-23(a)24(l)-21(l)23( )-11(the d)12(e)23(ath r)12(ecor)23(ds)23( )-11(r)-10(e)23(g)-10(i)12(s)12(ter)23(ed i)12(n)1( the U)23(n)-10(i)12(t)1(e)23(d)]TJ -6.867 -1.222 TD [(States)23( )-11(in 1997)23( )-11(a)12(n)12(d)-21( )-11(i)12(n)7(d)7(i)23(c)-5(a)-4(t)23(e)-10(s)-10( that dec)23(r)12(eas)23(e)-10(s)23( )-11(h)-10(a)24(ve o)-5(c)-5(c)23(ur)23(r)-10(e)23(d)-10( )-11(i)12(n)1( the r)-21(i)23(s)12(k)-21( for)23( )-11(death f)-10(r)23(o)-10(m)]TJ T* -0.001 Tc -0.043 Tw [(the top three)21( )-10(c)-12(a)21(u)-12(s)10(e)-12(s)21( )-10(and f)-12(r)21(o)21(m)-23( )-10(HI)21(V)-12( i)10(nfec)21(t)-12(i)21(o)-12(n)-1(.)21( )-10(Pr)21(o)21(g)-23(r)10(e)-12(s)21(s)10( )-10(i)-6(n)-6( pr)21(eventi)21(ng and t)-12(r)21(eat)21(ing thes)21(e)]TJ 0 -1.2 TD -0.002 Tc 0.069 Tw [(condi)20(tions)20(,)9( )-33(howeve)20(r)76(,)9( )-11(i)9(s)-24( offs)20(e)-7(t)-7( by i)9(n)-8(c)-8(r)20(ea)20(s)-13(e)20(s)-24( i)9(n)-2( m)20(o)-24(r)9(t)-7(a)-7(l)20(i)9(t)-7(y)-7( f)-13(r)20(om s)-13(e)20(p)-13(t)20(i)-24(c)20(emi)20(a)-12(,)20( )-11(k)9(i)9(d)-13(n)9(e)20(y)-12( di)20(s)-13(-)]TJ 0 -1.222 TD 0 Tc 0.089 Tw [(eas)22(e)-10(,)22( )-33(and d)-11(r)11(ug-i)22(n)22(d)-22(uc)22(ed )-22(c)11(aus)22(e)-11(s)22(.)-22( The )-22(di)22(ffer)22(enc)22(e)-11(s)22( )-33(i)11(n)0( )-22(LE by r)-11(a)22(c)-11(e)22( )-33(a)23(n)-11(d s)11(ex nar)22(rowed i)11(n)]TJ 9.6 0 0 9.6 88.08 161.04 Tm -0.007 Tc 0.107 Tw [(*)5(*)-107(I)-12(C)18(D-)-32(9, cod)-32(es 6)5(3)-32(0\22667)-32(6.)]TJ 7.2 0 0 7.2 90.96 153.6 Tm 0.011 Tc (\206\206)Tj 9.6 0 0 9.6 99.6 150.96 Tm -0.005 Tc -0.022 Tw 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All Rights Reserved.Univers is a registered trademark of Linotype-Hell AG and/or its subsidiaries.) readonly def /FullName (Univers 55 Oblique) readonly def /FamilyName (Univers) readonly def /ItalicAngle -12 def /isFixedPitch false def /UnderlinePosition -100 def /UnderlineThickness 50 def /Weight (Regular) def /BaseFontName (Univers) def end def /Encoding StandardEncoding def currentdict end currentfile eexec 2$}sڍmڔ6uO&q9M!n-XkVxU=g4`[D>M?W{AMFIz@ow ,,Fe$ظER¸|l010sr>?Ȏy a8ڲdC-51YeUK-9 )_q aY?4TSn ]3#f ݨV|e0j4 JXv첐G:}BIG%8-X SޚK}jVؾcUpo:e(k7 $ut~\\t*wGK>δͣ/2j>P*[f An'Z/-wRZ5]69hGˬ8?Z6|%>zSr4C€im&UAC;8IXIpe:?ɰg. 3#eALuPhѐ5#H)Ģbf2JJ{B^G._:\q#%ZSoDm|eE&r\bB42Da6g[ ZI@- M?fF-`aШ wFRU +"&%bKum`/\ALv1Dٌ#_Ω@ӑGxwz+YƂC.+hޞR# \Ņّ۪2zl'A+s8{"*X.fҋcJ $?{hzvb%pJ<;G(PϜ0T)}*D6HIwA k掠ּ-\z<9e.&g<|J̊Gaʧ,%rac-g=&6A|%<ޓbs-@2cHRGӿvGͽOJ5r7׏y{sF,;>BC)"5cfNRUJ]ҞnUo9US5 \Qɭd.0n&>l lվT?Z#?ݿ9yCeAX!'779nj0Z89hTvn=Wx~:E /M 9Z VE|.v{CNe|[FTm<q"GR܍0g19N ɦ#>:_D&[_ɘ@:V 6Qs>]kCE]D.gl^ _W".rAp)q Q],{R8 |N7/17"q74)giOmkqDpdI+[cBcx, Lt\yI!p3;ŒpCmkٿq8 ɶ0]&'W-Y+x͢0bR|uu!lOPҍ4אxj˯򟹧 .')W\W&!Ұ8OHRK~0 aEe s+cYbB"/Ͳ}z:VdPRAȰ~ySۀ^26|pZtF^4"!6d2T}ZIp '45!QiѨ!_%rfqX a72SOɔ jѡ~!MjUv)3p:ηۜbπ1C1%͏.8aGl:H(,r >w;y1"d5xXV~ttU}}mYV6AWƢx8ݹvzeْm ڵ)mta?=de)(S\nmQt|'nd0)ǐ5ΰv,J04b9y'S:|!NUEZ6⒙q[X{pl~lPm/QDz+*|zw{r CXƐ;"NF})ɳeY 6T!2y`ʙ8nۊĥ7~'v,\jyOh!&i2+c %}Pq_ԂDTta_fk^*_-n4/Ckvl ]0ű”pj%mmN Kdaz˜jHSl-a3չWbNІe^od#k(%l8h Yl{a P*Dx`c(g .Ae8;ll D"jgWAj2Zi.98/0yxJ/[ Yl`{fMr{9w[v;e.CiՔ(`;jzyD۷ ٙ,'3h?W(Gʊ p9O 7ہ"?&E[#g. 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All Rights Reserved.Univers is a registered trademark of Linotype-Hell AG and/or its subsidiaries.) readonly def /FullName (Univers 65 Bold) readonly def /FamilyName (Univers) readonly def /ItalicAngle 0 def /isFixedPitch false def /UnderlinePosition -100 def /UnderlineThickness 50 def /Weight (Bold) def /BaseFontName (Univers-Bold) def end def /Encoding StandardEncoding def currentdict end currentfile eexec 2$}sڍmڔ6uO&q9M!n-XkVxU=g4`[D>M?W{AMFIz@ow ,,Fe$ظER¸|l010sr>?Ȏy a8ڲdC-51YeUK-9 )_q aY?4TSn ]3#fRs+@6w!Uwp)k K2+u`8ЉgxoS_Kg\ O#bxi6\N֌8pZ/ApݔVN0@h8?_ ;pM֪r ܓc3? 8urwG溊` F6Y(*)! 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"_O"RkJ%n0sY##jwE"(5f( ˑu!7ayum6Ĺgw:tv+>b͎!ѳeb(u} UI@hFw[=嶜&6y! qmEa;k$ox>}/3hY?aCl?!^UI倜N`]%(#ZV~'A9QW a2̣%}c'MЁfHV ceXPPh8=bQwNdf(4nΉnڂ*AESpuQM<ǁ ئb L`{g""lyXKD/.b82~'TPceUxL(re3R}–;ls ޥOr֧U;@B =zw\Fp*dZ2/v)~(k{[6eZLsGV.]4S9@b{Pz!%Xj,ï:tf`IK;~r*>#PDew+}{dEEbY*i%=vo;1/moqR =TgB}䊺p")yxu,?3fz#Hu3lNB}}:$;,`ˣiλ͜$rc*z}9L<4bJU$x=^:>Իd [K"ȳӉ *.>"Y43;3]n˪@,fWNcZn2J1ݡѷỢ.2_C݋Fj9us.t E_"hytM0X"E%a}. 2žl"3hT?[лjwR @`cJ|r8|faנl?l!:'f^vush;m}ebo[޿qܷS6uÛ"eT)S͚k n L+h+2Ο'z{Ԉ#4OsC(ObA[Ĭh殫b b2 MoC62nm(OBeXv!ႌJ8ߴUid$d^@.I:V^e;N)PWP6i-sYz1V$4twn|JҭݟIʬuR؏M3]o`@G! 693LϷ[^v_~)W7S^×n~~׋6}3)QmhޢrjA>. 8|mnS%ɲm"|VC)ԢII$-AOGfP"eAp!x/u8_ͫ5zojaj (>ܪkɴ(":g8ݳ쳾qBݴ7մr9<y&X]<(<ܪe_`۔$;Rkr)ˆ ɋ N`栣a9L(PK6 _K-y@}|A晳AlxWWA'_%3e/% ߭JsF]±fJ/0;sNH6OM&" $^x^Ƿg< +ƴg`!֛= (ߞ7Ԋ4!RV!VeNU:UgN'!.xz1jfJŝD:*1\^3V(Yog7}"A2DzYhMV. > stream %!FontType1-1.0: AADCMI+Univers-Black 1 13 dict begin /FontName /AADCMI+Univers-Black def /FontType 1 def /FontBBox {-153 -250 992 986} readonly def /FontMatrix [0.001 0 0 0.001 0 0] readonly def /PaintType 0 def /FontInfo 12 dict dup begin /version (001.001) readonly def /Notice (Copyright (c) 1987, 1991 Adobe Systems Incorporated. All Rights Reserved.Univers is a registered trademark of Linotype-Hell AG and/or its subsidiaries.) readonly def /FullName (Univers 75 Black) readonly def /FamilyName (Univers) readonly def /ItalicAngle 0 def /isFixedPitch false def /UnderlinePosition -100 def /UnderlineThickness 50 def /Weight (Black) def /BaseFontName (Univers-Black) def end def /Encoding StandardEncoding def currentdict end currentfile eexec 2$}sڍmڔ6uO&q9M!n-XkVxU=g4`[D>M?W{AMFIz@ow ,,Fe$ظER¸|l010sr>?Ȏy a8ڲdC-51YeUK-9 )_q aY?4TSn ]3#fRs+@6w!Uwp)k K2+u`8ЉgxoSkr'0Zߴ(VQ1D Jچ;UV;Oզ4sȤЄg1~o=lF9.DCz'hCpKhʐ֢2[#~H[Ct$j:0hϏ-ܖ U3d %2zYVvgȈo:.d$vhȓfc?fU= #Zxb#1" %Qňώ3e%'kg|~ExXR<D!IYr' 9~#(59.Tؔ)FUNHWW% ̅Œ^uӪy&E,rwX>j!=Rt@ҽnouBPn쵊ڟ!3ULowBf AOF胩n\bJne%@+V<9"D̈I(dbEkqӔ&L!Nɑqp }%33L:[ƱؿRB%$<')ȭ sk(*J!l.ΤZ<]M^"A!"p''6'h8roy ۫uA=;Puf&Ad%xL N (Y3 \bUbk3/|aMA,B  `tЈVhK#A{|/)n0m~X5éPm&Y[x"qez /fuOH7 n-FEp&ýk0i\ڢla m} 9aK+"6YԻ"?rEQ͇#vxY{Np68z] Yr4PJPȗoa'C%ѻO=]#of>Xܺ2To$SSJ Bדu momf߅~r22^.Nvu~g`;uzMi%}*6sncMfس9{׺`jSk\P9Љx?u8*ZO'`2a) ^rK: H, 4:fb_jp:C{"Qgs8eicdV4f䜼:_qeyw8[F¶L""PjѳZr(.ü !Y-(퓀?@d0)f:G5U 2̤}SIѐ9[cL2=vԼ:ǩ9BfTj"y;C 4oA]AH F5Q#Jg3k;KlyV~9 w,;8.-RxI ;smTp.CO'IIA$Q `F?E-x(s/fg]//LTOʼ֏8;ݱZ!p{s{  a˿+[Bm@6^X =lt%LOtYe.:Bm`M+GMLF0lHG0Zxy$W/겒ply,/wJټ..D`]ev)z ٲ̣D/ F >ڤ0NS#D^_:\,/}!p*R9E&e{y/) ɎnH%#F1(v`rxج:xŕ$Ȧ$EU 4Z0e$4S>Κ8ũ'$ę3Q#Е־Ӝ]?⸸b?3?q]6ܢŚ mB] `GLf_PseH f0d/[<ψ /qZ߯ z[;۸hrA9i?a Ia#*OȢ|Y&-.nCNl;ۤng^Rq]4 6OL Cgoa )79hIwLdXZ];!TB X#_hTӫ<CVRtfC`b1#Ԑ&OjXx֣0]N8HyQFY4?Ǯ+H+ Q Z][D2ߣɑ$S櫽›3y,xJ6 hm f ֝#z1bBp,>S'}ʖw%8XOf\kֈkS>1߄K((mf9`ۼLRS |BQ~V9 )H:(ع;P]5_bd56A;YƘBKhpmŤAh9X* &'82,q蘿ñjFF:5c ZE `B,̼%_!o jXgCl9Y#U?yGH/dlEGo}Sc\gX!u/H4e3y Ѽ@ MұFyr kܒ,7xǔS]]m(1(b_ۗ$Er=XKb~uB|l% G&&D4A i6vT/+ P8.*#e\lIPXS1sC.z> jSY, XТ ?=B KV'?)ri Mj\V&Mfz?-Fu3F"TYbݫHOuu])~ö]*BiڀSj+cA7jU*AŶ֝ hktS $Ҡrշwd*X| <=v7??ut*nw!r 뉕\HB\ U?RmHk{LobfdNz/bCJo8uI~r׮B#;/F^֠f?EriV΃;5dy7H;N>, kpwfZۿp4Ԡsr'x>X<Ӷc@M5BI?L{L=ca:JyS}R.`I8BWH`LBl~_MT_hҕM y&i1bG#hڇD\.57 MʗG8f]: cfs)Z!HZcmϿŤ⼂{avM V/o;NUz}oSSF!]*~ y֛g4kfܛvH1 װʝ`k_+mXH* Ɏ}N$M7YM*{u8&coZ[ѐrN[ZE1vꈛGG515^QGysf"&B M􁄠sߟ,_W &/JC2I>Wl^HR?lBڒ;UWrqQ F=o)$ށe)R83Є~hK"#5~f!.Nha{PòiE=( rR_kqk ;:_@'BԺC?L'e ]XnoťW!Ѡ5.Ht?Ů1E><ϑ׸d|DSp6jٍ]~ϴ+DŃP탥8%䵄*'h!*Ѷ. b&⾣,؟eR17_?'E[YfX"s2vx-Ƭǭ|eaiϨ9G _oo/ Ž j'־Ӝ]?ⳲЈfIs.pk^KN%7>(,w\ [0|Ϯ[D;cxv( m5 1ulNRΓUNJ&Rݧ39}~#@5yp}7A z>ڰ-Gа`{<=6γoZC 1aTV{8FK扠|CGC?k [‹?"Uoy5ZAݟĩXcg+<8FcT# endstream endobj 124 0 obj << /Length 5798 /Length1 754 /Length2 5042 /Length3 0 >> stream %!FontType1-1.0: AAHJBI+ArialMT 1 13 dict begin /FontName /AAHJBI+ArialMT def /FontType 1 def /FontBBox {-222 -250 1006 922} readonly def /FontMatrix [0.001 0 0 0.001 0 0] readonly def /PaintType 0 def /FontInfo 12 dict dup begin /version (001.000) readonly def /Notice (Copyright (c) 1991 Adobe Systems Incorporated. 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