ࡱ> nN(2J&JC{DLBhPNG  IHDRT:ָ&1sRGB pHYs  LPLTEu653975885986/ONKSQNSRNSRPcb^tsohfbzwsyxsggbhgdzyv}gBҵQǿȿ.&IDATxH75VGIDn˦:v\2oZwyTnc?%%š*"n?E P! TB TB TB TB TB TBTBTBTBTB4ɓ9D@qwi2JCq8M]DljDNS<_Ei@#mQ1W*GR&EUE߈UT:)C $do_ R nNfTD'瑈HOd_@~ұXq>5c8/*ЪTT۟`Bo~ ?/Pֆ//?ӻ/oo9/P;_#ϛw̤y:TapM+,*& 6woGc2@eVclCӿ<*T[/zsf??hf@ZĿaHoߘ?Npi@kxK?*~XMM_5O~۷Ϛ~ОPTʰ/?)N2 TQoOqPPPPUmP/U*"" 6C_/PPPP;" 6CjJ.P T*jG8N*d$B*kF$ȭ:ܷ7?n6*uґ:sJݻ~ *}F A-zOtEg?7UQAH';BXETE *_J?_}?/:;=דN'\\~yun89x/U {5IMg>Fe $?y/.Έ7s'zof~=xAjs:S${9ħ չ.=>VU ZUlRH|A "%{rruJ%5*yI?_ޟ_h1xIr:ybmJC=RTV*ڢM-Txɹ]bbqr^Ht!ENN>8f{S9 UAէgY}s*k-:/8E1Sv\g껝^:j=O)?2Nٟ8R8__ZeZUI/ RST*Cgޟ,yx߼\S#ս?Ӆ!ZeT/Ӫ Dӫ 5ijg(<ܟeo:'\jTOrK])|ZGV:ZUlRA&Vm ե:4{MMYy6%8WGgʴ.g[ON0J.lN.M]oUoã:]TWܶjH?jS~0]:FT&E;rU#r"S^8 ;oPmAkwΏwy$UEjR&\Ueq*hTj7VR?M53IO^Ymm0A>ʓ$\Y*KOHz W+ ^irM3fzM (rczf )Vڶs5xsUyCPSZ[{r*_%[*?iHaQZmEPIT$'DT B`U:v+n\[rjkT۞PjxePՋzQz͸a@U+T]z7:rNUPPPPUQ凢MFB*jBkj~n;'z[IȬ܊ծQ &3aFaej*ԭbO뛘p:׏"@"FDҞ}z-jZyM&효ZG#uy۷QG_wSwJ0n5S_ŊП^ѢłI7Z*WsTܶkfɷ]s3qC\ǝO]Rdli ' *fiRU&z_qH5 -bEZKEosI /|^Q Iv۔?yci;Oe-UieKz`tRəYjżn'N?=\:俖VZ+“[۔ڷyuG%ʠ^ۀ jc Mez=V⾟7"-OR,X~fEx"9ڢp]ټڪݠj/6h5Wan FΖj/͆m~Y5QMdtJEyE5H"Ӌ.1I!Hmb^QErTRӔ}A17SirrW4x_GNiakVX?|XӚ2K%WoJ'ÿ3⟼N^VoNkDW6zu{]⎷y^rv-HάfQdςSM+}ǩH;0kO]Ra[Ϥ66쪜Z a37G[Uk~ AM^+bEV7_=(RUa֍)in;-kBQB24k䜦m0P?ɎZjOݬ*o弨sۚY+τ AٝZgzT|^TKOqIͼڣ҃HQ52*EK&@Tr*=ր*[QpPCQv^S!j9v|h"S!j-ꈦJ T@T@T@1*YT@eBV /ܟ'QKT9!U݌=@TPɬ*Ϯ lʮP-Ti VWPz*DQ%q&@TQ />KB?Ss ֣tG+[۹ÌdPSzr ַ;uWFt̃*"E0H Psw(3PzY&\Ue`uFgޙ>Ł?y1!QSu1V^PȨ8IGŕT@#YF>ۢ>JD ^դPv##t̞O [`~TՔe D}`@5nN=PmY")nyW$'DT@,qHih(kLJ!'F:Pb2PAQ G5 ,*@Tk}@e ՀHP-T ePB]O@TPޘÈ jA~ULNL T'7*?@køn,/z;?GFk]_h jw9U`h'2ZVQI"mT9- C%$ *jTBTQS CU~ۯ[mip_KF뉊p_DC*7WGӒ*7WZEUz&Ъ/r~m^O!b}Q~5FZj/jlUz<U={TjAF*OT㛈ʕ_Y TGK-AZ TGxXN-^PI__T$5EUuZE𯮨Ui@YE@U#TUI*Zơ:8MCX'm#79Bu@Z5EkM_ `n n{wճ[?T㛙S4HYg/ID4)=D%J KIpU4jo{p%r̈́l5U@*17izjj)UQ-hTQI&OR4Ul٢Ui 0r~\ F*"c(Ґ+nJG( FeVMQŎCR_E=*m̞T$'DT%[@ԦN41x%%!9q][L ר.htTv@5C6@Ud w(UY[@e2q2Pܡ T@jT CQw(՞?KPPP_^qTYTr]wi8K$0֊2ʣm=Uݜ*خI?ac慨U]T ՔO:|E9r{TS:Z& ʢ-zr縣*ӵZ Fh5U ~;TuxTz`nh/u[\OE$Mh-hmѤ'_lUnkv%cTMuHT:jAϩ@R2Z^ X?Ъ,y|u۩@(PUu::T-Wh7V]QՒ֑Plz I}z֝UAxmUNꨫr:NZE5q]P@"uAu;CD1V[EhOBʣZ*q:0Sz*h TvQ^=Cӏ\=ϮyV[F Vqn!1w" :VO=^l:Zռ&#U4+;=Py(Q4:j1 ufj7ok旺tf.٪/=fߍ4{#\J҄*SuU;cT[4Q{!1zhu.)([B\z')|$7+j9S*j^fC[M5F]@*TFJjp*AS$^:*j9mkfXJET.TUPUZ5jU߭DT.Ɯ'=E&ILsMM;;5?sUӜ* UN^DD٤e(\Cuw{6u`vbKЪџGP$_7'bO7\CDUOٌ==`lET^UHHDi$'DrkͼDѴG.c;tlH-j/(סJRLC5UYyۨso6eTku<89MmhA$%+/U @ePuZ@TiPYT@eVQ%q&G\@DXyT|):iH:24*uґTO.P-T2ԨBT@e UQ@UIT%*_^8XAT۰(*ҪbݪO#giUEՊxB i֟@TVQmP̾Q1P(:=#Bu,G5PcU|$]^Ubta/G5PY(f;ZrEOze1EAvK_E+DNHT!qHꔊɨڴRO񨞡UA$j_9A T@&*@T@T@T@(*T ,T@eG2?MK_[?J*ۨx#TVQ^_#PYB I@TPI_?8*{p:Pʣz)+CGoN~T@U/nԻ;*ھjas=E^8@m#{'HH-2V\RJPզ/J #IO \NQJ=bT@T@U=TfG4*Ә! UHaQP T@U"sH mr%%݉ѢT)@e*ۨ007PYG:* TQv**G< "*;g;S_A3jj@$`T5N[d9@U?T2%^YΞfa㧹!pwJSP_Yܞ0,.T5P5ծt ^:MBӗ^ r *"uAqT@}Ge WUс XU@ޕOqy!QS(Vs*_]z6}#$רɱ\{=)YPkPhmsjc|RPS%z稪) j}HЍ7~:*JGQѕ㑢Ά4ټٰq@\ Q^jDBxB$GBZw=!*oT]~No׷@T%PͺgOjRƣr#-'E}N=z}]USTf`հswJdOfUUMQ-Pmjnnw▯&*MO3Mٓ*jBJځ 졚N:Ծlk|TPfn{ @TvP͆w69%Ta 6P***:*TyEPmv************$B?*UŸ@TQ(HbtסJU VJUPIQUcT"P~<$BM+TT,J* ?(*nNfHODuPCN|?RB@uallql͓6-f r'D&VG41Q$:9DF%P-H !(Q@ {ͪЌT^LǟZ:,-9+g R_GeJ}3omXSXSFeؕK?%gQٵ+uV=p/p/juT- +6%mT_jļOo/q"!DɵISUAoЁNˮ5GTr_P\v>:FC),\ҫzTpʸ EA"% ٢=ữcbMV |z-36{-Yzu Q*P! TP! TP! TP! TP! TP! TB T;w3*wL/嚻ƪ4,qe$9dIBbYens*@* {~ y^vI+ * kl_ HU^@I$BsѪ&Vκa)|sg͖Qóu7? kllY+Q|Ħ(P&P%:x,'Jc ȓʢIs+I\odٓd'x¼=TID}/yJ?yZ*^Lk;&ҏ R:~j=̊R*rO$?tm 9H%b"E:YHH^TJB *GH/Tu*'\.QSiFfѠJ<ޏ:B-}f2 x't82|jيDa,^PP*OzC2EӗS)M%4T\TOfc.{Kty-7*UHk˟iكoPƼ_1uRBu ,T;{ʨDiw{uUotI;lQyU/?1YFLR47:3ZAU}.1$ʐE#ҋ-mhl!^;Jt>F>٠UYj3I;VZ|EL%S_\SɥEs5b T!_X@}M-u5UBG"YMRDBg'9(߰K9tȋC#4PTߢzSz5*'u 9U1ȩlLjџ o8-̫t=GP.J\B5G|'0Mޏ@Ob%w.iҧ+R0Xz!+5Uu'R;U w^#O8ZmFO(8[2[Ⳇ-EU8v;.M7|/>[Ur&uǓ\ҋSŧ+;_ē8Ip]".*a&*1rx߃@*P!@*P!@*P!@*P!@*P!@*P! @*@*@*@*b%*jG~IENDB`F{ PI.I7%1CJFIFLEAD Technologies Inc. V1.01    "!#(3+#&0&,=-0569:9"+?C>8C3897 7$$77777777777777777777777777777777777777777777777777Z  }!1AQa"q2#BR$3br %&'()*456789:CDEFGHIJSTUVWXYZcdefghijstuvwxyzw!1AQaq"2B #3Rbr $4%&'()*56789:CDEFGHIJSTUVWXYZcdefghijstuvwxyzi ?(#Zp;]!^hݝUc`=1f Ԛ`5eՎ9?΀+[jr%ɲr; c_?p /[q%[cʳd$xqYK\9I]P1 W1GN+Zv/]x8%B̑S.RܐHjVМx4+?6s߷jו2\? FZ|19AQ*}J$|K}K³6<_q^ؘb'M5ȼ_%йy gOZMKʍ3󙧑C]݈g}^qoi]fv/늗^/- 7]LF#Ӂ~;Ts;}n-k~Ov洍y[>f_34~UT灏sG'{3Md-vs|ɎgNQXZ-;RF6`$hu94g:JWtj ~^<^0+|LGkOť۰xY0HqA^:iz^E I@4Ì'iKdդT ؎?|2*Z^GrFTdS-DT- )UqZJ{Qq ) 㰌Qqة" Y%v=DIԅk h"hxi1cVjMĂ=\,JI2.*xC,⡖@PqHb.4(6P-FOIy>¾GһݚEXۖw \SMp DIgqڱZ~٪UݓV|g45=kȋ:b&J"1fH秷^x#[ Ȼ=TP@*Tufǩ0<͖_AÖ&d\qLjlQpddcQ# + Ҟ+^(%ibZ!1U\uiEq 1zPm# v3g'ds͞s9}N?o'vt8ּ:监²TQ-Rb+ʄzksWw_ۋFPv}5T%FH @y4:۰;!w 2_-bS$c aaZwiE mQp"+ݾ4Zd3! t\BWqJFT )UqXMqXzRƉGH`;J;2kKvkF5;$J00+ pUIT9H63'p#փ9 h=+ +֏no5`| *U=-ƔyueN9i"2Hjr$wAFgwnG{XFuZSg>&D\as(P14:ʾBa33_)Y'\ W0UCH"29in(1@( Ҹ +VaZb40; EcRJey0BxdHRc TPPRz 3ak짰k-ʝG)+.+j ɠF>7nXi= dyvxdO\#S4 ;g+T/c9csdZ7#aLb!Sqv OX˺py 9ֽ$X3} +OW@H"fgS'epf7 +?ԯҀ%>|Bړ+?@YKJS< ~uُ/ n$dգMi^'W4:],ڠǥxU9"ӡ^,2 DҬF9ҪQ ̰\S ZZhbb4{_iW;8kiEF GcDmey$+Q<'Pu8zIzsV#7vpV |lI90L;עx3]sjW:sX]`|vߊ5I]-3n /Q V;*k%:ri=ГZ,뺤pjѵ$ 1vy'w^+7V6՚ʢгRY_cJ`dGQQFPFoVۙ6e^)% S7p *܁ӿn4SXiouAםZ5ztsHŭƹlQm M66s7Ϯ^ 9? xwz|w|&p>h7wAsYgK7=)져qIyO[0kafu]p{ޖn7_G-)"F^£ȧh=kS P@1X8 ?Z|F s h)ց b*@PMJ u>q{-ʩ^ڭ S>!ʹC3{oF̒HcלRifyekip7 Y۳rdGcF4*|vo=,4ЈnFOQr27\/4ZՍ[kv/2kl4{5$ 1G\Wj*Ԉ"kuxϵLJO?hBPZj^E~igVC3ߧѴW30 B as,K.䪞֢7Mm67kQw+dt\.>[yZ[ v谂^%eԑ׽)4x0ikL|"[y 35jpi>pTJKdD)e,4{%<[‘*$rՕ fkB8%s**<ЋC 3ٵ 啘g#{wڸXxU+#كHuԵ^rC݈AiBi4t ثu<ɥdA7+ t$m'{/ˣu|wj=~W~j6Fι@4" pJV8oEwĈщ 09'Wrq-DzϥI@ bI,=7`8mf1iX*L ;bo7h511@(8@&*F&){FyҺsSz3~M%ٖ=6>zsۨv4*N$KV3 i c <NKgKc+[\[C>ֽ 5Rof23-[Ɋ83%fTm }Wf.+KV} mEyBWz68ϵy4g#jn='mgY37cPwנl\Re:Yu-/O\Be@ӷň'Q5ء{WbY3PQ 3ȯJ0߭V虩kiZ+« #PQw}vdV" k\ >RU<Чi׺kG3asJ?N+Lt$⤶eCMPѷTgo1>oEmOEj2=|t-O=֜ZݓZx_ivC{o=3^<)>hj66t[xY.a'8?oȧ56Ki_ isi˓u}];r(ZvM{ 4_SLѤ?# ;G59'&M R_JrRL[.0iVɦ+客-2K Q%i\ͫH$NI8 549]6,jZxYbGT4OʴsV"5~qg8forYpz ]flb÷Ůo2OW>DPGQjcR;V!ck/jSAyp̮]Tʧ~$Vu(Sb>eE}\_<{—؀?3S\ԒYMj :QRAH#*8zէ;$]XH.)WxoFPIB s=i0(R޷ 1M^p66Dg^z\.RXx~5+cczռ[I#oTȓFzH0';f)T tǑ] kQaIXHwB zh,Llf]>Ű'x%hqWw9]_GQ%X S& pǯNnZф6d8[ռZR˧K9A|Ѽ6W0Ox$z-]|*-D,]x:@J`!a㊖0K*`U! aA#H6AdE);"^t;m/c2#e,85rJ79ɴkalK%l@`C;ggոB1ZvFN5M_ĚkiH7a8I(B)m$n<~e#9mX8BtiIZ{?c2FWlؠg=d*JqO͏Vف} wG{! %pZHr tdeUa[}֒27NnHQOfCiykjNppIE][V0amw,q@6LShKsk}jE !cvI$ƕↀVCu;xnC8"Ar*Wn3J.# xҷ._*"+xs" ?J֕eEs5t!6EvS6L4Y: ù_Qk(Xҙ)b95EfmEڪ-h@Aِ1ҪGKͲKB`~ lM^zB⬬n2dEh-"aA'I3D&-=o{yuGmUNkg1@p ܞLF8#bgEeH\!f)1ڥ(Z?XSBdg;XCiA$iڄ3LT.J8c>ۃ;-txP{f{A`T3~^J7vSҒAm.TG(e%Ct8+&ۙD}MEX_N%N^KS;CA][S|W^A%U\yOC dTߠ]Ktt6@7ÍL=Ua8Z"Q뙾&/4FP8P'PeI:߃]S+xĚŞ:D\۩-Z1 SKsI|%K&kQHe[k`k Wϋ!(<@au={^ɋ'%uK>ӱw68upsҮM^'Pԣ_*Wf6=5qqKRjKk%y #,1ʸ'+mԘCZޛg>Yѯ16ry^rA[oۗh#e%Q9%3:jl?*lo]NYSs OՑ  GK{C !g'qjڻIt=_GuanbH"H~wuf%h>8'dzswrc _zT]%Ynr'>X,T֘L}"RR\ә~JӥO{G8 NԇNH66woizѱ%*U dpz%j{2ڋI DVrm8\wN2R9My@-F!WpF+bYjĖ֠BKw@fF0)im5 ^Y.I,qq'j䛱vX(vBCl>bg~^$o4cmC=!x5CwX>nJi!# c=9徨~l'IBdH$l4MeOoqkG(M>H}N+X2c2X"厼X:tQ{WC.~p{}D2, TjᰨM=JGӆ.$PnƭnY 5<{d]"g8 n'=?!38.o1B*FhB9U[E($րG3M~꺅JeϵhJ)ZF0u5B9(q;.ƕ~3t_-j:O Ŧsܲ29'N8LGx?*(K!كgfm+-=A ҽ!k@B9vj3[R5IRFv}3qj]KFmq B(ҘR@z *@F5H w$VdP;A5q.VrdUie[`?R_J^Ice ~eGvs?}qOBQ* 4GIl5}H$P&A5RXQ]kɧ{(e !{u]Bd}NZ"\YJiu`Žy'攭Z1i]h$.$ImSn 3Krd~OƩ$VMS} U07{8V֤u΅ vvKB6Ӝ=G"Χ.⽛cp 1w Pn?y }j YۼXD`L œv`H>ZÿZ(;Ko5#! Đ1bBl@.7S$e<ttcWϧ4 ae j`z++EX񯉚=.bA1_ÿ\,g?X$}PUhU$p}iI܀C4-n$Q7 skC5 .Si- *z4gS݉$"F~B{8%hݛFh+J<s8i>Mg˷(yq1j^qd#Β.yP A)S7*.E+ıTdzԈ[kvk'w*ri `Զ9h9oglhQc+adop;9 ($R*CcOa}vѧt( Z0/O|>'z=W@PM-`2LPy|)7%'Դgƚgzz`#cgC8ukEb|Qya2a:gTGNz1q8 xaR{ )nt4BI\öo,H^W#Wp/,j(`"H4=0=ʚ3u$y#{>1K xj-ŶO4|ÀA|4v jZ*YsQqEZF7m|-amy%ŮvP>Oa?"mCm'%p@Դ]sZ_"ya1̭nAq8mRR]%ddJM]̓Ijr(Dxg[8?qVVatY[t%yn $p/+v? | YTd19]r~ֶwh# Zx{qg E#m?娮fB@ wSudc$Yn#0z`O:G[t&]\Kug #=\Vs]fwe=xaݴۀ?3ƀ6׉>Չ4&KO0QQ{jqjAӄ2o'3S*fiQ֘lZapsɚVC G%IXִ*3v<}\'镃-cXbLU5bJdeaF1BыcYui$)M:p8=ys y|>pze J}JkTp{R{kGa.wwgv[KFNkcJ RB"cMBG)<޵-Kv絇-l!Qk-`?>?:$b='9}Yڮ ɩaiaN&Jggn~ hO/1^bRbX)psA`j' [;[J~7ۂpO\mc[iM+f;YtPGӑ ke KIWk[nIqJ#O&JI2/ݷ4&Uym U!^Y5=V"+.i 'z -.R/-amIl,VIsc&U(N5;M^EҬ.8K9q >ƷŞ$ׅ˥ݾ#ӽg-I4E籺%d F=#VfucutrjC_MɽFT9pVyFtBICR.&C]<ܑ)G ǞVQ6$XK}Uk(e蚕3 SJ-;ܥz(#E`bEE$U۱9ɩ1DDBbU+hlUruJe(3&CkkFVg#mcuq4 'RJȓ5.]NsnQF}&ݍhuȸJ@PA+MJU :WT FyA4J C@(8`!&\gJVƆpd l?W9FnړL :F% 랿{=մۯ Xޤv7g C:m!?@28FmGaf}ZY%ɍb1FQ`'[ȵRKXD^k!$d{:Q+Xv.zA!qsUcZ\_}·rYamy 5F‡c5/Gom2x0Lc"g\}kA!F?*g׌lU񶓩2ru+G#T.&ӧm[J$oks8&!=@XmUjVE.O .csIۂyy+غsj]BZ$Vc6brH泦V5ʮƽnnc6ٖymsyݳZFg#*XZ9m|彲15l!kBsvz!V.,I+873r88Җ舾h>L5|I2O5{lkwᾫ=қ+c>b>'+lz@®zMZ!tiEV<25+K1EC9+8 !)\i&BlMjʢYpv=cH=1"3dԷep8@IH~km;y{\WnIvZ(r*@Q "sϵ`',@+ZU~2*TH-K*`oڬ=?)oG({{YI#c J>DU^f\ 榍qeYV7kL!\sպjHvZcn-ot#}2[3/sVݚ#BIeȪ#(NCJ|Z )=2qj[+II&'s;LX8u43OJЮWaͼ$r =N̨Wttq|jmCil3r3gT]/jjז:2bORqUQuЭfph+!e,p )aGRk[-id0I#8=3Uk ٣KQX|n3DatgZ6= D}h&LO7v+U,}%rUF=KBm#uhȌ`ZTN[PLۉ$7Wd;=6`sR(vP=—"M:H0a#E|*<>;ӱ60s\c0ٕi8is,r9A{H0RR[ #Wa0(JC L/T`D#Ah·=E|%IKVe+d= V"g_V"02DH$Ij4fEI FB:}G9oj ofkϨUQ8JʹrW kɵ;%ݽYH{wmd3H./5UbQUA98*~{cdLwd*/J@!c 0>z 譐`; BnĶGeO12qέ+l;X>;d^3n5<%/R߭a7skrp '^̷֫M=ɱ"FJ2:o ^Rm-Ak{8 ΧQּu ⅉT㩭cMdE]^Ԇ޵ PwNǦ:\ϔ3@$J*e23GjqġHWT!}Yqi|9e Qf/>Vr,m෎(T@Sv8qڞ!eP:P"@Si{4_@~mun`+q59?- Zsڹ[(Bi\I(" P[ntw v=@N9jU8صuBW D)una9=#L<]F¦:-tF\գkmrܐLOV5i2C8b BN[R͑QZkR}\iQnWΒ0<]*v|# V̭ʰ ;~u,;Rʏhǭ^Ƨ|K>E2cl+3 Dy`TpxK[o@pt4k0q=i{v=evws.™C$MK 6rc"(1-5(C r)5u{| yk%- )MHl⋀1@2i f:v vDN\xssq+aG=*ӱ=ds/~h3Hy:Uli=஖aGPi<δ72ee_^NpQ\=Uirx>JprivЯ?*sɫ4+Q!p6F3#`Ko& \Z !UMIa]Qfck(i&HBFӑYNJjș8X`6LWj[.wc5,IɸTS l9X]Si tBV69\s;y)]eY#5D6gLw`T&{ʂH*y\ *™[V8b?$ԬÄx$UBѱ%U6E3o~ﯭ#Hjr:a.dv6 q؎) 4oX֩χ=){d (9h6 X7Ȉ)Ŀ=-m,Z3;W#c4LѰ$ HUTkN;r\S9x)e0ǟ.a{ױOnmiP{VKչo"H7e3zgz  6VFCDQ.kmE@*b3\aY;(P0qҹ90PHc4FX"l$jqўe@ArSkwX!O֑v3!d0xc(͒O]@0 [4,lqYI cVuDf2!Qr~Z̸͖i30zOO1qT*2WvXvtuW5u5ZIM"[*I#~[S<ұאf" e$sP *N)LkpT RTeqR ֦< rp'ؑKM Y +;XF.!Gqt'Ԍ3Tk'󦍢h +(F#$ wsj'nWp8-JX$ ,`}q־_(\-hg\ $UJv1@9[3ci+박=&,]>&\ EEH$ob_DIz6a@P98OlbRN}T!p{S(EPPRIa}0~*o-F4E2.)8Cc q@ :)VD8aִʔLކ.ܼ_C_YByTbՆk w0rZG}cS%t&$աn1,X W#\N,!1W y +ZO6: ZKPں5h f#sI[CfNIc4]6])X16ڨX1@ h 2u 5gBvj%J78y4HX;qgEb6fk 5AfE;cPGzM#9M# X88#k'#T`j^c,XKVqT-r*NiN2IɪJ-xCx#J 4+98m~Mڣ.Tæ=ht!v.xmoy(E2YNPP3ғdc0$#|*.>E=V2tJƑ2㊰ڀ L" :zOa't8VMw`{*ޢ,E 깬b+31T\O&@oTq8,z]1XzD:q]<Ƒ+@+?J7Q[ɦHٱv4bր]Cu/0␯b'H#V{I!+&с䙍F0_iNɸVlq9ٓ%م>i2]{jOhlfUy]I5IXjbdq )6PI:.0)6hz҈NS""y/;jOZi5 :} SתFVLB<ΣN"VIP6Z*)z|FJu2F)0 p*dBQ4x=:_|'UkbQ\NQa{P@1 @Bc1G:T[X7#^Y]FN"hp633&!zEsҁX{MjZ4b5YnE!MenVgk GJV{P1 8+ J{4cҁXh, hX@Tdџ4 Jde[$Pi͛ R9'N@ ҭr#Lh9licQޥXĔ=I{$l5&|Msڬ _Nrx @ΛJyX P6G&6P9C4lgLրyّJ[x'!+JNosEV(qT@t!h4P@@[.A5'䤺 lhC׷}eʬVewQ])_f@=GKhP1@Px"n#4CG򞂒B8iGa@q@fLWRz؍' +Tfٟ4'Pكf]ĝqY2fpß҃)7'5H(سKf:ڤ q=L*+kC+S֮֠OȜ StJ( msѷD0 ;vFD4+L!ϖ3@Pgڀ8^1A_O_5ȴRbS3@P0{S0@ /M%DXmKr{R%\qf{hUd*kDN@= p@|b! b( R&`($pqڑ N)6T@FECfMCf-3T+~T6DqULlUB>RqґIXs!gaZDM^ZZ3GFI9={>AP!8⁊0Ȧms~HǶxlgE}!@qKu2zb*JSeΐǥ!9J)qC qLP)gq`p<*lG<ŕGZ$7cphP_R3zP2&j[ b7jW]1LWɩlLϒQRٓv)0fٓf|皆y\u斧Wb(H,LCh)"P>_OjE$2g6DɌZg^?$|sAJ>gX(~Њ`oi +jMi> ;y d,Jxr2oBL 浆I T R RhɩPPNEmJK"j uP4s$]iy[ nZpoU!-d;ƁҲoA-H$~:%Ĺ{Զfٕu!jͳ&ɯ)X5jrNeRK(9۸OvJ$yUsAhIH4sZ$rNF./J<ב9^{Jtʛ9GZL!V3W.ދڀJ1;sҴN܃CT%!b9KT#npS_=kh7Rb JC԰i0 C@EwQ<ִJЗbyJ.$FlrzWzEꔮ;wp\Ҹb&yr[*zȹR[TfBiPٔ4s HΞ#!Й%r< JX-GR4v(ٰR4Qe˶1ښEZȬ* *0H,VYJ)9kK$gxhTҰ,}9t:0%ǵҲm!1( ҵJ|7=@ H^9@ X3f qLf; *X " 6i+XbQa (Ɩf7T 0FE8 &'2WCݢc(X*MwFS^C&*=N ZirݟZNBl}s6w\(`=JWdj uNmHhكM&G#dHǓv:iIY45Ht׀^ 4sGAE-(w7.~H;&lpM"R#b:I,!T@%҂vg#qs"z5rf{4S"Xhj!-tֱIKmcVn{ |FJuj "ܱ&S*jolSQ 4ICH@1,qJXc&j R7T (oh6c}As^]dͫXB׺EvITbB))/.&NҎK8<%j0 O>xGM|Ȳ)).%j H3ED sSc&5"+E^?H-e#夊ZQ3@oi[VeاZD짱auV8Q1DtPXeHyGE0uϥ|"pq)nPb @1EDbbd,FƤ.0aa@ , w4P})l1A!K\E'M[Q-DI+캒FϚ`Bǵ10hA@k>k&P+Xd%I1@ bO/=4$q@g܅RI(nr^W GJˢ<؎Sk ūU͔dfjWiglCIԟ)Ėfvry'&;$KY\#Vnq[qg[\,DbGod]Y6C`]T椏Bǧ>EFxMOg%>Cӊ@qw.;yq F1WV>v:1sUq ;c=2nDNn"&oza|CdLLDeP1AH ҚYDkp=8Ȓb]0iGǭ!@)@ .: AI wCPKv*~lQ*ԎInROT†c=k6>e3JM#Ʃ7&WOQL Khݰrh֝9M+PRF8Uޓga*: KPX5WBu9[ j#TybPEFNJ/}@Icyg >hy= 3+8F"_I@ qa֦KF~̘ n;F6F]t6LUߊ.Uɸ ȚZ؛/W4 O(*-;nF^x47Rn⁉ԇqC( M f'^[^צD+@4jcd#O4{P 3@qcD\Igqf\wE ؍M֋ZKZW&)rKv2MK^Mۃ;&inqIe]E'ڡU0ny 78V7w$?.ids=JS\j()JQJ;GT%tBSAGSnz1_а+/Jo'k*ORIrDthr6&):R)+(Vl pilQkPdn *Rw=Z4=z?b@ bB$zz Q{YĶ1l/!3V>mGfF$[a*XX)sY{ĩunUPr ~RpzX)SޫlĶrJ"0rs/Kڼ.YCY}VJJ2مŖln0=ֿ@.&k&ݤ?*MbBEkZo  J֖ i+ Qdi[YX)F1Kdg q[\N-ɮ["I(]:{}sY 6Ҷ+o8(p 3vQ2y5ȳF_RO+h浅rGR.}AJxiv!ӗbf,TrA>iN/Gkٻći=8EnV2rI=$>/uƥI8*d]k&@hxnF:U4ek%̳HݞsMɤ7$WoIIXKOT;J+I˷@7?U<̗ =2/DpG>y=)(lH %0>L[^$֤OᙢRs]x+tu8V%PY+ wP2#MaY^TGII‰avЙRimZ%B@.v;+ &::,*{ӵG {]JݤeU- xM-P[f)RPT?BTiQݴPg>1T 8Wh_XFp#4}NK+ٴ(0_ (`{M9y[gz$TQVG?Pd^j{4#( (JqP|BPJ-` J:P@րE%(t<=!\PP\e5)4wP&8*Hߕ1t+gaҀ4{Bʀ  KS,R3Pˣ,@A,T3ʀ }[@ݕȍ*M>ߕ66ʀ-rPTQ{ll?=4;g8*s7>@qʀ~TCUϖ*H;Nʀ,5vLgoʀ[Iygt{g .P*X;t[P`;@ mP.q3Ps*t&txznZ5.?JUT Z( ?Ph2@a+THuP??*?Zʀ- ٔǖ?* -,~T<^qaPs~T<=j,~Tf lVV?*m=1Py%i!1P[B&ϖ\Z:m@_ʀ'O *cB|+n$P֬("Z:F($ų?*-Y0P~TC[H|PR?*lxR1@hNLc 6j@,?*P cXnA,~T\xR1POXZkPaO MWP ʀQ~T5kgk[Gl ,P@P@P@P@P@P@P@P@P@P@P@P@J( / 00DArialngsRomanlluׯ0DGaramondRomanlluׯ0 DTimes New Romanlluׯ00DWingdingsRomanlluׯ0@0.  @n?" dd@  @@``   Cs!     ,,>>() ,,()? @ ACD?$b$2J&JC{DLBhV(R$ PI.I7%1C%{V( 0AA@8  3ʚ;ʚ;g4GdGd( ׯ0ppp@ <4dddd8vS0lt 80___PPT10 ?  %rCHerbal Medicine6David Hilmers MLK Clinic Lecture Series March 31, 2008* ObjectivesTo discuss the efficacy and use of some common herbal remedies To learn about the regulation and safety of herbal medicines in the US To discuss some of the drug interactions and common side effects of herbal medicines BackgroundIn 1997, 12.1% of Americans used herbal medications with out-of-pocket costs of $5.1 billion In Europe there has been more regulation and more formal licensing of products than in the USA Many traditional remedies are not considered  medicines by patients and may be part of social norms (e.g.  azarcon or  greta for stomach ailments in Mexican infants contain high levels of lead),(GCase 1.A 65 year old male patient tells you that he is using saw palmetto for his  prostate problems . He tells you that the salesman at the health food store says that it is guaranteed to meet the same quality standards as any other drug. He asks your opinion. What do you tell him? Regulation of herbal remediesjHerbal remedies are exempt from rigorous regulation in the United States Must have some evidence for claims that are made on the packaging, but not asked to provide it before marketing begins May be considerable variation in the composition of an herbal remedy among manufacturers and lots, as well as discrepancies between label information and actual content. ! Manufacturing of herbal productsFor commonly used herbal remedies the U.S. Pharmacopeial Convention is developing standards for product quality and monographs that review chemical, pharmacologic, and therapeutic data. When an herbal product is labeled  U.S. Pharmacopeia or  National Formulary, the Dietary Supplement Health and Education Act of 1994 (DSHEA) requires that the product comply with the standards for product quality. System of standards is entirely voluntary and leaves the door open for inferior products. Z,+    Does it work?UThe patient asks you about whether saw palmetto really works. What is your response? Efficacy of saw palmetto'Double-blind trial randomly assigned 225 men over 49 years with symptoms of benign prostatic hyperplasia to one year of treatment with saw palmetto extract (160 mg twice a day) or placebo Primary outcome measures were changes in the scores on the American Urological Association Symptom Index (AUASI) and the maximal urinary flow rate. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, quality of life, laboratory values, and adverse effects. No significant difference between the saw palmetto and placebo groups in AUASI scores, maximal urinary flow rate, prostate size, residual volume after voiding, quality of life, or PSA during the one-year study. The incidence of side effects was similar in the two groups. N Engl J Med. 2006 Feb 9;354(6):557-566(Z(,S "Case 2You are seeing a 75 year old patient with history of a mitral valve replacement with a mechanical valve. He says that he would like to take some herbal medications that he was told would help increase his energy and his memory. His wife tells him all herbal medicines are safe. He asks your opinion. Are all herbal medicines safe? To what herbal medicines might he be referring? What might be some consequences of these in this patient?./ZZ/7{ Safety of herbal medicationsNProblems include: Adulteration of product during manufacturing Different formulations giving inconsistent doses Drug-drug interactions May contain other active ingredients (digoxin-like molecules in herbal teas, for example) Most herbal medications have not been adequately tested for long-term side effects (kava and hepatotoxicity) &==,"%Herbal remedies for memory and energy&&&Gingko biloba has long been thought to improve memory A well-designed double-blind trial investigated gingko for memory enhancement in cognitively intact elderly adults. Randomly assigned 230 community dwelling men and women over the age of 60 with MMSE scores greater than 26 to receive ginkgo biloba 40 mg three times daily or placebo for six weeks. There was no improvement in memory with ginkgo treatment as measured by standard neuropsychological tests, self-reported memory function, or global rating by spouses, friends, and relatives. Ginseng has been used for its alleged aphrodisiac, antidepressant, and diuretic activity. It is often recommended to improve stamina, concentration, vigilance, and well-being No evidence to support improved well-being in clinical trials t7ZZZ>ZZ7>, Case 3A 65 year old man presents to your office with complaints of fatigue, difficulty falling asleep, loss of appetite, and a loss of interest in his hobbies over the past 3 months. His current medications include coumadin, verapamil, HCTZ and glipizide. For the past week he reports having a URI for which he has been taking Vitamin C and Echinacea. His wife suggested he take St. John s Wort, ginseng root and ginkgo for his problems and general health. P  A  What should you advise him regarding the use of St. John s Wort? AB; St. John s Wort GThere are data, predominantly from Europe, that support the efficacy of standardized extracts of St. John's wort in the short-term treatment of mild to moderate depression. These data also suggest that St. John's wort is comparable in efficacy to tricyclic antidepressants and SSRIs. However, data from the US have not confirmed the benefits of St. John's wort for depression. There are only relatively limited data on the efficacy of St. John's wort for severe depression. A Cochrane systematic review concluded that the evidence on St. John's wort is inconsistent and confusing HPHlf KV`   _For what adverse events is he at risk with his combination of prescription and herbal remedies?  Side effects,St. John s Wort hastens the metabolism of verapamil and warfarin, resulting in lower levels of both Gingko biloba can cause platelet dysfunction leading to increased bleeding tendencies Ginseng has been noted to reduce the levels of warfarin, resulting in subtherapeutic INR s Z  +y He has read in a health magazine that ginkgo can help male impotence  what do you tell him? !Gingko biloba and sexual functionA small study of men with erectile dysfunction secondary to decreased blood flow found that those treated with ginkgo biloba extract had an improvement in penile blood flow in six weeks. After six months, 50 percent of patients treated were noted to regain potency. In an open trial, 37 male and female patients with selective serotonin reuptake inhibitor (SSRI) associated sexual dysfunction were treated with ginkgo biloba extract. Significant improvement was noted after four weeks in 86 percent of patients. A small randomized trial failed to show similar benefits. A proprietary combination product containing ginkgo biloba improved libido in a randomized trial of 108 women ages 22 to 73  P>v'C RWhat is the medical data regarding Echinacea in the treatment of the common cold? &Echinacea and URI sThere is controversy over the best echinacea species, plant part, active component(s), and dosage. In contrast to other herbal medicines, echinacea products are often not standardized. Several controlled trials of echinacea for URI prior to 2000 showed a decrease in symptom intensity and duration. These studies varied greatly in their quality and the type of echinacea used. Since then, several well-designed studies have found that it is no better than placebo for the treatment of URI Well-designed studies have not generally found it to be efficacious for the prevention of URI: Experimental studies have also generally not found that it is effective in preventing URI after challenge with rhinovirus BZ T b#  8 D  R"Problems studying effects of herbsRandomization and blinding are difficult; for herbs that have a distinctive taste or smell, concealing the treatment assignment can be problematic. Results obtained with one product may not apply to other preparations from the same herb; few trials have compared different preparations from the same plant source. In the case of products that contain a mixture of herbal ingredients, the relative contribution of each may not be known. Trial reports are often limited to the statistical significance of a mean difference between herb and placebo, whereas they could also present the number needed to treat for a minimal clinically important difference. Z#More problems with studiesIntermediate outcomes (e.g., the effects of hawthorn on cardiac performance in CHF) instead of hard end points (e.g., effects on cardiovascular mortality) are often reported. Most trials compare an herb with placebo but not with medications that have well-established safety and efficacy. When an herbal remedy is compared with an established compound, adequate doses of each are needed. Few trials have considered the combined use of an herbal medication and a conventional drug, but such use is common. Positive results may be reported more often than negative results, leading to an overestimate of the treatment effect (publication bias) $ZZ LWhat general advice should you give patients interested in taking remedies? Cautions for patientsSpeak with your physician before taking herbal remedies or even herbal teas Be sure to list all medications, including herbal remedies, on drug lists Choose reliable manufacturers of herbal meds There are many different formulations, use form and dose that has been tested in clinical trials Consider cost of herbal medications, sometimes can be much more expensive than conventional medication Cautions for doctors(Need to specifically ask patients if they are taking any herbs, teas or traditional medicine treatments. They might not consider these  medicines . Look carefully at side effect profile Look for drug-herb interactions Do not dismiss herbal medicine automatically as ineffective May have a strong placebo effect May damage patient-provider relationship Some herbs have been found to be very effective drugs (artemesins were Chinese herbs used for malaria and now have been shown to be most effective treatment available for malaria).ZZ s SummaryHerbal medicines are considered supplements and are not subject to strict regulation There are no standard formulations of many herbal medicines There is little conclusive clinical data supporting a benefit for most herbal meds Like conventional meds, herbals can have dangerous side effects and significant drug-drug interactions Randomized prospective trials are difficult to perform and are rarely done Z"Resources for herbal medicine data Cochrane reviews www.cochrane.org/reviews Physicians' Desk Reference for Herbal Medicines Up To Date The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines De Smet P. HERBAL REMEDIES N Engl J Med, Vol. 347, No. 25. December 19, 2002 vZZZ3>./  0` 3333ff3` 3333f33ff3` "3333̙ff3` Kf3̙` &e̙3g3f` f333̙po7` ___f3̙;/f9` ff3Lm` ff3LmNLm>?" dd@*?nAd@q<nAqFLK#M n?" dd@   @@``PR    M`2p>> &(    HҒ? ?" `}  X Click to edit Master title style!!  @  HՒ? ?" `  RClick to edit Master text styles Second level Third level Fourth level Fifth level!    S    6dܒ #" `] `}  ^*     6 #" ``   d*       6\ #" `] `}  d*       C @ABCDE FjJ@3"0`B  s *DjJ"0 `0H  0޽h ? ___f3̙;/f9___PPT10i.  +D=' = @B + Edge 0  (    H&? ?"@  X Click to edit Master title style!!    H)? ?"   [#Click to edit Master subtitle style$$    6. #" `] `}  ^*     62 #" `]}   d*       6|7 #" `] `}  d*       C @ABCDE F8c@3"@B  s *DjJ"  ,$0H  0޽h ? ___f3̙;/f9___PPT10i.  +ityD=' = @B +0 zr` (    0@B P    P*    0E     R*  d  c $ ?    0J  0  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S  6 _P   P*    6\Q _   R*  H  0޽h ? 3380___PPT10.a 0  (  x  c $B@  x  c $C   R  C *Aherbal2 @ H  0޽h ? 3380___PPT10.-@!0 0 0 0(   x  c $쑟 `}   x  c $Ē `  H  0޽h ? 3380___PPT10.-0 0 p0(  px p c $̗ `}   x p c $ `  H p 0޽h ? 3380___PPT10. 0 0 @0(  x  c $ܬ `}   x  c $ `  H  0޽h ? 3380___PPT10.-* 0 ,*(  ,x , c $ `}   r , S ` `  H , 0޽h ? 3380___PPT10.z$ 0 0$(  r  S  `}   r  S  `  H  0޽h ? ___f3̙;/f980___PPT10.UZ0 0 00(  0x 0 c $$ `}   x 0 c $ `  H 0 0޽h ? 3380___PPT10.Ƀ* 0 4*(  4x 4 c $ `}   r 4 S  00  H 4 0޽h ? 3380___PPT10.hq0 0 P0(  x  c $% `}   x  c $% `  H  0޽h ? 3380___PPT10.0`0 0 80(  8x 8 c $+ `}   x 8 c $+ `  H 8 0޽h ? 3380___PPT10.čdn0 (  K  05 `d uNews flash from last week: FDA Warns Against Unapproved Erectile Dysfunction Supplements The FDA is warning consumers not to take the Blue Steel or Hero dietary supplements, marketed over the Internet to treat erectile dysfunction, after a chemical analysis showed they contain undeclared ingredients that could adversely affect a person's blood pressure. The supplements, distributed by Active Nutraceuticals or the Marion Group, contain substances similar to sildenafil (Viagra). These ingredients may interact with nitrates in prescription medications and cause one's blood pressure to drop to unsafe levels. March 26, 2008&v0Y,4 H  0޽h ? ___f3̙;/f980___PPT10.T0QC]0 l](  lR l s *A l 0A0 { k9Difference in content of ginseng in various formulations.: 2:H l 0޽h ? 3380___PPT10.pOl* 0 d*(  dx d c $9 `}   r d S LF `  H d 0޽h ? 3380___PPT10.0 0  0(   x  c $pR `}   x  c $HS `  H  0޽h ? 3380___PPT10.ʊ7 0 $^(  $x $ c $d `   x $ c $e `   $ 6g  `   $ 0i  `& :  H $ 0޽h ? 33___PPT10i.ˊd+D=' = @B + 0 <0(  <x < c $l `}   x < c $q `  H < 0޽h ? 33___PPT10i.ƍ$+D=' = @B + 0 @0(  @x @ c $ `}   x @ c $\ `  H @ 0޽h ? 33___PPT10i.ȍ@[J+D=' = @B + 0 D0(  Dx D c $ `}   x D c $ `  H D 0޽h ? 33___PPT10i.ȍcAO+D=' = @B + 0  H0(  Hx H c $ `}   x H c $ `  H H 0޽h ? 33___PPT10i.ʍ^B+D=' = @B + 0 @P0(  Px P c $t `}   x P c $L00  H P 0޽h ? 33___PPT10i.ʍ`8s+D=' = @B + 0 0L0(  Lx L c $\ `}   x L c $  `  H L 0޽h ? 33___PPT10i.ʍ0BH+D=' = @B + 0 PT*(  Tx T c $D `}   r T S ` `P  H T 0޽h ? 33___PPT10i.ʍ=?+D=' = @B + 0 `*(  `x ` c $  `}   r ` S  `  H ` 0޽h ? 33___PPT10i.pİ+D=' = @B +} 0 @$(  r  S  `}   r  S X0  H  0޽h ? ___f3̙;/f9___PPT10i.+D=' = @B + 0 `X0(  Xx X c $ `}   x X c $ `  H X 0޽h ? 33___PPT10i.Qv<+D=' = @B + 0 p\0(  \x \ c $( `}   x \ c $ `  H \ 0޽h ? 33___PPT10i.2G+D=' = @B + 0 h*(  hx h c $ `}   r h S ` `P  H h 0޽h ? 33___PPT10i. [+D=' = @B + 0 (0(  (x ( c $(  `}   x ( c $  `  H ( 0޽h ? 33___PPT10i.ˊ+D=' = @B + 0 t0(  tx t c $ `}   x t c $T  `F  H t 0޽h ? 33___PPT10i. BS+D=' = @B +0 VNp(  X  C    N  S ^ 0    HERBALS AND DRUG INTERACTIONS Name of HerbSome Common UsesPossible Side Effects or Drug Interactions Cayenne External: used for muscle spasm and soreness Internal: GI tract disorders External: potential for skin ulceration and blistering with greater than 2 days of use. Internal: overuse may cause severe hypothermia. Echinacea Echinacea boosts the immune system and helps fight colds and flu. Aids wound healing. Echinacea may cause inflammation of the liver if used with certain other medications, such as anabolic steroids, methotrexate or others. Ephedra Ephedra is also called Ma-Huang. It is used in many over-the-counter diet aids as an appetite suppressant. It is also used for asthma or bronchitis. Ephedra may interact with certain antidepressant medications or certain high blood pressure medications to cause dangerous elevation in blood pressure or heart rate. It could cause death in certain individuals. Feverfew Feverfew is used to ward offf migraine headaches and for arthritis, rheumatic disease and allergies. Feverfew may increase bleeding, especially in patients already taking certain anti-clotting medications. Garlic Garlic is used for lowering blood cholesterol, triglyceride levels and blood pressure. Garlic may increase bleeding, especially in patients already taking certain anti-clotting medications. Ginger Ginger is used for reducing nausea, vomiting and vertigo Ginger may increase bleeding, especially in patients already taking certain anti-clotting medications. Ginkgo Ginkgo, also called ginkgo biloba, is used for increasing blood circulation and oxygenation and for improving memory and mental alertness. Ginkgo may increase bleeding, especially in patients already taking certain anti-clotting medications. Ginseng Ginseng increases physical stamina and mental concentration. Ginseng may cause decreased effectiveness of certain anti-clotting medications. Persons using ginseng see increased heart rate or high blood pressure. It may cause bleeding in women after menopause. Goldenseal Goldenseal is used aas a mild laxative and also reduces inflammation. Goldenseal may worsen swelling and/or high blood pressure. Kava-kava Kava-kava is used for nervousness, anxiety or restlessness; it is also a muscle relaxant. Kava-kava may increase the effects of certain anti-seizure medications and/or prolong the effects of certain anesthetics. it can enhance the effects of alcohol. It may increase the risk of suicide for people with certain types of depression. Licorice Licorice is used for treating stomach ulcers. Certain licorice compounds may cause high blood pressure, swelling or electrolyte imbalances. Saw Palmetto Saw Palmetto is used for enlarged prostate and urinary inflammations. People using saw palmetto may see effects with other hormone therapies. St. John's Wort St. John's Wort is used for mild to moderate depression or anxiety and sleep disorders. St. John's Wort may prolong the effect of certain anesthetic agents. Valerian Valerian is used as a mild sedative or sleep-aid. It is also a muscle relaxant. Valerian may increase the effects of certain anti-seizure medications or prolong the effects of certain anesthetic agents.V Pe k  O '  E T H  0޽h ? 3380___PPT10.prpdgrkrvn^˭<mr@txЖ?aҁm:i:JjVozw#1Oh+'0 hp  Herbal MedicineDavidEdgeanoopa24Microsoft PowerPoint@p@؆,/@Ghg  ,V'&" WMFCm( <8?@ABCDEFGHIJKLMNOPQSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~    Root EntrydO)Pictures{Current UserSummaryInformation(PowerPoint Document(ReDocumentSummaryInformation8