scieee AI-readable full text Open interactive document viewer

Funcionamiento cognitivo en el trastorno por acumulación: estudio de un caso

Becerra García, Juan Antonio; Robles Jurado, Manuel Javier

Abstract

El trastorno por acumulación (TA) se caracteriza por la adquisición de objetos, la incapacidad para tirarlos y la acumulación. Este trastorno ha sido conceptualizado como un síntoma o un subtipo de trastorno obsesivo compulsivo y actualmente su clasificación es controvertida. Nos proponemos realizar un estudio cognitivo en un caso de TA y comentar las alteraciones que se presentan en este caso e identificar las características que lo diferencien de otros trastornos que presenten acumulación patológica. Las diferentes alteraciones encontradas y las características distintivas del TA se comentan en los apartados de resultados y conclusiones. Estos estudios pueden ser una buena estrategia para conocer más sobre este tipo de trastorno.

Full text

01234568596 3516 !!" #5$%8596850382$8534 &3'568885#8(&3'568885#)8* &3'568885+25',&3'568885!5' -./011.23450647/.80/49:;</=4>5145348596#126?6?2366@3A8%#BC2()3D EF3G<//0<40601;/23.1<=4H*55I2H5356 J01.K.5<=H24L107;95<=43'5*5 MNOPQROSTQUOVRWPRXOQVQYRWUOWUZWV[S\VR[ORW ]R[WSPNTNZSPQ^O_WU\VN`QRW`UWNOWPS\R abcdefdghdihejklkmmfenfmlof p3.q0/r.5954504s9t3 ucdbvweacxivyemzj{k|ea}mf~z Lr<1.91.234LL4s9t3 J0r:803 A4643122)306545(1826)385*H546 3188146,22)3A64546436835142(8 236342362*41854643*656'126',42534562 6%)35634'548"6113565(235642834'5323 6850,53464535625651565343535645658534% 64564625855353854646436251565345322)3 14)?6855345645356533486,64564686434'685 0655343536148685562486,326356A646564286125853 6523*2535644513566*5564541854643 969K/9r4169q0=4643122)33)356428856 LKr;/91;4 +838685+>645(58*,5566'5264316656636 3*4,486816656636385566'52445686856*553 35142(5866,1462*4,15*6566'5126'5868538 2534,4666%43634'565642856'5535834'5 8%2456615%,664584+>$25565(534'5 6428,365+>3845344545436156534634665384 8534,456464465145445868564415653414 8358553423845436384586434'54564645+> 5534583562463832636654365656428564665564*5 86445,435464,158685 04</5r=4+83>685#343#656428, 010 23536787993237 8787799988 5778 !"!#3 $%79&'3()&*($ 3 +,-./012.3,-,.2425,1/6,-78-.,6,.3869: ;,-</6-5,-,.2425,.9=0-18-/>?83/7@-./0-/-790- A,5/6-BC/-</6-5,-90.,<,.91,1-<,6,-396,6-5/7- D28-E,0-558F,1/-,-786-90G39587-HI6/73-B-J,635@- KLLMNO-P73,-./012.3,-<687803,-20-./03902/- 18718-5,-0/64,591,1-H./58..9/0974/N-E,7: 3,-20-8Q3684/-18-,.2425,.9=0-<,3/5=F9.,O- R,6,-./079186,6-5,-./012.3,-,.2425,1/6,- ./4/-<,3/5=F9.,-87-08.87,69/-D28-78-,.2: 42580-80-8Q.87/-/>?83/7-90G39587@-D28-8Q973,- 20-0G486/-18-87<,.9/7-A93,587-187/6180,: 1/7-E,73,-85-09A85-18-19S.253,6-5,-,.39A91,1- 0/64,5-B-D28-3/1/-855/-.,278-20-183869/6/- 185-T20.9/0,49803/-<867/0,5-18-D2980-5/-<,: 18.8@-./4/-</6-8?84<5/@-<6/>584,7-18-<,: 68?,@-,975,49803/-7/.9,[email protected]+,E86,@-U,9;@- V,63W0@-RX68;-B-Y,.,@-Z[[MNO-+,-./012.3,- ,.2425,1/6,-<,3/5=F9.,-<2818-<687803,-19: T8680387-T/64,7-.5W09.,7\-UW016/48-18-]9=: F8087@-./012.3,-,.2425,1/6,-./4<2579A,- /-36,73/60/-</6-,.2425,.9=0-H^_N@-./012.: 3,-,.2425,1/6,-873868/39<,1,-B-./012.3,- ,.2425,1/6,-18-,094,587-/-UW016/48-18- `/XO-P73,-./012.3,-3,4>9X0-<2818-<68780: 3,678-T/64,01/-<,638-18-/36,7-80T86481,: 187-./4/-36,73/60/7-/6Fa09./7-.868>6,587@- <79./797@-36,73/60/7-18-5,-,594803,[email protected] Hb=48;:I869,@-Z[[LNO _5F20/7-873219/7-E,0-187.693/-,5-^_- ./4/-20-72>39</-18-36,73/60/-/>7879A/- ./4<2579A/-H^cdN-.,6,.3869;,1/-</6-5,- ,1D2979.9=0-18-/>?83/7@-5,-90.,<,.91,1-<,6,- 187E,.8678-18-873/7-B-5,-,.2425,.9=0O-R86/- .2,36/-.,6,.386W739.,7-5/-19T8680.9,0-18- /36/7-72>39</7-18-^cd\-72-87.,7/-09A85-18- 9036/7<8..9=0@-5,-,2780.9,-18-68797380.9,-,- 5,-./4<2579=0@-5,-87.,7,-4/39A,.9=0-<,6,- 85-36,3,49803/-B-5,-</>68-687<2873,-,5-36,: 3,49803/-./0-90E9>91/687-7858.39A/7-18-5,- 68.,<3,.9=0-18-786/3/090,-HeUfUN-H_>6,: 4/g93;@-I6,[email protected],63;-B-I266@-Z[[ij- +,E86,@-V,63W0:Y,5587386/7-B-U,9;:f29;@- Z[[0NO- _.32,548038@-873,-79801/-/>?83/-18- 873219/-5,-2>9.,.9=0-0/7/5=F9.,-185-^_O- ]9T8680387-873219/7-./0.8<32,59;,0-5,-,.2: 425,.9=0-./4/-20-F62</-18-./012.3,7-D28- T68.2803848038-,<,68.80-./4=6>91,7-80-85- ^cd@-4a7-D28-./4/-20-79F0/@-7W03/4,-/- 72>39</-18-X738-H_>6,4/g93;@-kE8,3/0-B- U3/6.E@-Z[[lj-c5,320?9@-k9559,47@-J,75,4@- _>6,4/g93;-B-^/590@-Z[[lj-U,42857@-Y980: A802@-b6,1/7@-d25580@-f91158@-+9,0F@-P,3/0- B-`873,13@-Z[[lNO-R,6,-<68.97,6-72-2>9.,.9=0@- 78-873219,0-5,7-.,6,.386W739.,7-19T8680.9,587- 185-^_-80-685,.9=0-,-5,-./012.3,-18-,.242: 5,.9=0-<6/<9,-185-^cdO-P0-85-^_-5,-./012.3,- ,.2425,1/6,-/.2668-</6-85-,<8F/-84/.9/0,5- ,-5/7-/>?83/7-/-</6-72-A,5/6-9036W078./-B-87- A9A91,-./4/-8F/7903=09.,-HR86327,@-I255,0,@- U90FE@-_5/07/@-V80.E=0-B-V,3,9Q:d/57@- Z[[lN@-498036,7-D28-5,-./012.3,-,.2425,: 1/6,-<6/<9,-185-^cd-78-.,6,.3869;,-</6-5,- <68780.9,-18-918,7-/>7879A,7-685,.9/0,1,7- ./0-5,-,.2425,.9=0-H<807,49803/7-4aF9./7- 18-D28-,5F/-4,5/-72.8186a-79-78-187<680180- 185-/>?83/N@-</6-5,7-,..9/087-18-./4<6/>,: .9=0-7/>68-5/7-/>?83/7-B-</6-786-A9A91,-./4/- 8F/1973=09.,-HR86327,-73@-Z[[lNO-P0-8738- 873219/-5/7-,23/687-428736,0-D28-5,-./012.: 3,-,.2425,1/6,-<6878038-80-85-^_-87-5,-4a7- ./4G0-B@-,20D28-<,68.8-786-20,-80391,1-78: <,6,1,-185-^cd@-<687803,-,53,-./4/6>9591,1- ./0-8738O- _20D28-85-^_-0/-,<,68.8-./4/-3,5-80- 5,7-.5,79S.,.9/087-0/7/5=F9.,7-,.32,587@-87: 3/7-E,55,;F/7-68T8680387-,5-^_-./4/-20-7W0: 16/48-.5W09.,48038-1973903/-,5-^cd@-,</: B,0-5,-E9<=38797-18-19T8680387-,23/687-7/>68- 5,-./079186,.9=0-8738-36,73/60/-./4/-20,- 028A,-.,38F/6W,-19,F0=739.,-80-85-]UV:m- HV,3,9Q:d/57@-I6/73@-R86327,@-d5,6h@-U,Q8: 0,@-+8.h4,0@-U3890@-V,3720,F,-B-k95E854@- Z[K[j-R86327,@-I6/73@-I255,0,@-U,42857@-U38: h8388@-^/590@-U,Q80,@-+8.h4,0-B-V,3,9Q: d/57@-Z[K[NO-P5-^_-3,4>9X0-<687803,-.,6,.: 012 346478984348 9898899 6889 !"#" $4!% &8' (4)*'+)%!4 ,-./0,12304516-.-72138-042974-84:/75.9;-45-4 <1=>-7-0?4@84AB40-4171213434C734-5354;D04 ,-;E.373F489049GH-,9040-432C;C83745-4;3I 7-.3432,1J3F40-438;32-7374E.1721E38;-7,-4 9GH-,90429;94.9E3F4E3E-8F4G98030F4-8-2,.959I ;K0,12904L4;C-G8-0M4;1-7,.304NC-4-840/75.9I ;-45-4<1=>-7-040C-8-40-.4;D046.-2C-7,-4NC-4 0-417121-4-74E-.097304;3L9.-045-4O243P904 NC-4E35-2-74C734-76-.;-5354;-7,384946/01I 234E.1;3.134NC-488-J3434C7347->81>-721345-84 3C,92C153594-4Q1>1-7-F4894NC-4E.9E12134NC-4 0-432C;C8-74G30C.304L4.-015C9049.>D71290F4 79403G1-759453.4C734-RE812321=745-4E9.NC-4 32C;C8374ST3Q-.3484F4UVVOW? @84;95-89429>71,1J9I2975C2,C3845-4 32C;C8321=745-4X.90,4SX.90,F4L4Y.900F4Z[[\M4 X.90,4L4]3.,8F4Z[[OW4E90,C834NC-483432C;CI 8321=74-0,3./345-,-.;173534E9.42C3,.94-8-I ;-7,90^4 ZW4<K_21,4-74-84E.92-03;1-7,945-41769.;3I 21=7^48904E321-7,-04NC-432C;C8374,1-7-74 51_2C8,354-74834,9;345-45-210197-04L4>.374 E.-92CE321=74E9.479429;-,-.4-..9.-0F4 ,3;G1K74;C-0,.3745K_21,4-7483423,->9.1I `321=74L49.>371`321=7F4C74-02309471J-845-4 5102.1;17321=74-7,.-49GH-,9041;E9.,37,-04 L47941;E9.,37,-0F435-;D045-4C745K_21,4 -74;-;9.134L45-483042.--72130409G.-4834 23E3215354;7K0123F4L34NC-40C-8-74>C3.I 53.48304290304E9.4014830498J1537?4 UW4a.9G8-;304-74834J172C8321=74-;9219I 738^4E.-0-7,374C734J172C8321=74-;9I 2197384Q3213489049GH-,904NC-46C72197374 29;94.-29.53,9.19045-40C2-09041;E9.I ,37,-045-84E30359?4 \W4b-0EC-0,34-J1,3,1J3^4-0,904E321-7,-04 32C;C8374E3.34-J1,3.4-84;38-0,3.4NC-4 8-04E.95C2-4,9;3.45-210197-0409G.-4NC-4 ,1.3.F4E9.4;1-59434-NC1J923.0-? 0W4c.--721304.-0E-2,943483473,C.38-`345-4 8304E-.,-7-72130^4;C-0,.374C734-R2-01I J34E.-92CE321=74E9.48904-..9.-0F409G.-4 8347-2-0153545-4297,.9845-48304E-.,-7-7I 213049409G.-4834;3L9.4.-0E9703G1815354 NC-4,1-7-74.-0E-2,943483047-2-01535-04 6C,C.304S>C3.537489049GH-,904E9.40148-04 Q121-.374638,3W? <-432C-.5942974-0,-4;95-8945-432C;CI 8321=74SX.90,F4L4Y.900F4Z[[\M4X.90,4L4]3.,8F4 Z[[OWF40-4EC-5-4176-.1.4NC-48904E321-7,-04NC-4 0C6.-74C74AB4EC-5-74E.-0-7,3.4E.9G8-;304 -74-84E.92-03;1-7,945-41769.;321=74L4-748304 D.-3045-43,-721=7F423,->9.1`321=7F4;-;9.134 L4,9;345-45-210197-0?4a92904-0,C51904Q374 -R3;173594830438,-.32197-0429>71,1J304NC-4 0-4E.-0-7,374-7483432C;C8321=7429;EC801J34 -74>-7-.384L4-74-84AB4-74E3.,12C83.F4L48904NC-4 894Q374Q-2Q940974.-83,1J3;-7,-4.-21-7,-0?4 a3.3429..9G9.3.4-0,343_.;321=7F4.-381`3;904 C734Gd0NC-534-74e@<Tfg@429;G1737594 8304E383G.304hij4k4h89i+ j4L4hij4k4h98j?4T34E.1;-.34 29;G17321=7451945904.-0C8,3590M4;1-7,.304 NC-48340->C7534;90,.=4C74,9,3845-4U14.-0C8I ,3590?4:174,-7-.4-742C-7,348904-0,C51904.-3I 81`359042974371;38-0F40CH-,90479428/712904L4 .-J10197-0F48904-0,C5190409G.-438,-.32197-04 29>71,1J3046C-.9742C3,.9?4@74-0,90F4d7123I ;-7,-4,.-04-0,C51374-84AB429;94,384516-.-7I 21D7598945-84Alc4L4-72C-7,.374NC-4-74-84 AB40-4E.-0-7,37438,-.32197-04-749.>371`3I 21=74L4.-2C-.594.-,3.535945-4;3,-.1384J10C384 S]3.,8F4X.90,F4B88-7F<-2m-.0G32QF4:,-m-,--F4 <C6637L4L4:3J3>-F4UVV0WF4-749.>371`321=74 L423,->9.1`321=745-41769.;321=74Sn172`-F4 :,-m-,--4L4X.90,F4UVV1W4L4-743,-721=74SY.10I Q3;F4o.9p7F4:3J3>-F4:,-m-,--4L4o3.89pF4 UVV1W?4@84-0,C51945-4T3p.-72-F4n995-.097F4 e3,31RIc980F4<3J15F4:E-2m-704L4aQ1881E04 SUVVOW4-72C-7,.34C74;3L9.45K_21,4-74834 ,9;345-45-210197-04-74E321-7,-04Alc42974 2975C2,3045-432C;C8321=74NC-4-74E321-7,-04 Alc40174-0,3042975C2,30? a-703;904NC-432,C38;-7,-4-84-0,C5194 L45-02.1E21=745-423090428/712904EC-5-40-.4 012 346478984348 9898899 6889 !"#" $4!% &8' (4)*'+)%!4 ,-./0122.341-5./6547/8.2./.829:43.2-9;/.7/ <9-9<4341-59/=1/7.;/.7512.<49-1;/<9>-454?.;/ 821;1-51;/1-/1;51/52.;592-9@/A9;/82989-1B 39;/1;5,=4.2/,-/<.;9/=1/CD/<931-5.-=9/ <9-/=15.771/7./-.5,2.71E./=1/7.;/.7512.<49-1;/ F,1/821;1-5./17/<.;9G/1;81<HI<.31-51/,-/ 824312/9JK154?9/1;/?12/;4/0.L/,-./.M1<5.B <4N-/>79J.7/9/1;81<HI<./=1/=4M121-51;/O21.;/ <9>-454?.;/F,1/;1>6-/79;/21<41-51;/1;5,=49;/ ;9-/2171?.-51;/1-/1;51/52.;592-9/<939/1-/7.;/ <.8.<4=.=1;/=1/.51-<4N-G/313924./L/1K1<,B 54?.;G/.=13O;/=1/1;5,=4.2/7./.M1<5.<4N-/=1/ 952.;/O21.;/<939/7.;/0.J474=.=1;/?4;9<9-;B 52,<54?.;G/?4;91;8.<4.71;/L/=1/71->,.K1/F,1/ -9;/.89251-/,-./?4;4N-/3O;/<938715./;9J21/ 7.;/<.8.<4=.=1;/<9>-454?.;/F,1/8,1=1-/1;5.2/ .M1<5.=.;@/P-/;1>,-=9/9JK154?9G/51-41-=9/ 1-/<,1-5./7./74512.5,2./21?4;.=.G/1;/?12/;4/0.L/ <.2.<512H;54<.;/=4;54-54?.;/1-/1;51/<.;9/F,1/ 812345.-/<7.;4I<.279/<939/CD/L/=4M121-B <4.279/=1/9529;/52.;592-9;/<.2.<5124E.=9;/892/ <9-=,<5.;/=1/.<,3,7.<4N-/8.597N>4<.@ QRSTUT VWXYZ[ \1/52.5./=1/,-./3,K12/=1/0]/.^9;/F,1/ ?4?1/<9-/;,/1;89;9/L/;,/04K9/=1/_/.^9;/L/F,1/ 541-1/-4?17/=1/1;5,=49;/8243.249;/`<938715N/ 7./a=,<.<4N-/b1-12.7/cO;4<.d@/e21;1-5./,-./ <9-=,<5./.<,3,7.=92./8.597N>4<./=1/=4M1B 21-51;/5489;/=1/9JK159;/1-/<.;.@/a-521/;,;/ .-51<1=1-51;/M.3474.21;/=1;5.<./,-/0123.-9/ F,1/;,M24N/,-/2152.;9/3.=,2.54?9@/A9/821B ;1-5./-4->6-/.-51<1=1-51/M.3474.2/=1/8;4B <98.5979>H.@/a-/7./.<5,.74=.=/821;1-5./,-./ =4.J151;/5489/ff/L/-9/541-1/9529;/.-51<1=1-51;/ 31=4<9F,4262>4<9;/=1;5.<.J71;@/g939/.-51B <1=1-51;/8;4F,4O524<9;/812;9-.71;/=1;5.<./ ,-./=1821;4N-/89;58.259@/h./8.254<48.-51/0./ ;4=9/=4.>-9;54<./21<41-5131-51/=1/Cig/<9-/ 821=934-49/=1/.<59;/<938,7;4?9;/`<N=4>9/ =1/g7.;4I<.<4N-/f-512-.<49-.7/=1/a-M1231B =.=1;j/gfak]G/l0m@kdG/3,1;52./=4I<,75.=/ 1-/17/.221>79/=1/7./<.;./L/1-/17/<,4=.=9/=1/ ;,/04K9/L/,-./.<54?./<9-=,<5./.<,3,7.=92./ =1/=4M121-51;/9JK159;@/a-/7./67543./;13.-.G/ .=13O;/=1/21<4J42/1;51/=4.>-N;54<9G/;1/71/ 0./4-;5.,2.=9/52.5.341-59/M.23.<97N>4<9/ <9-;4;51-51/1-/f\n\/L/J1-E9=4.<184-.;@/a7/ <9-9<4341-59/=1/1;51/<938925.341-59/L/7./ .<<1;4J474=.=/39;52.=./892/7./8.<41-51/39B 54?N/-,1;529/4-512o;/892/17/1;5,=49/=17/<.;9@ pqrZsWtYqZ[ruvutYwxwyr \1/.=34-4;52.29-/=4;54-5.;/82,1J.;/8.2./ 1?.7,.2/=4M121-51;/M,-<49-1;/<9>-454?.;@/h./ ?.792.<4N-/=1/7./.51-<4N-/L/?179<4=.=/=1/ 829<1;.341-59/;1/21.74EN/31=4.-51/79;/;,JB 51;5/=1/zH>459;/L/g7.?1/=1/A63129;/=1/7./ a;<.7./=1/f-5174>1-<4./{1<0;712/8.2./D=,7B 59;Bfff/`|89}86~889898+ ~~~G/{Df\Bfffj/{1<0;712G/m]]kd@/h./3139B 24./?12J.7/4-31=4.5./L/=1392.=./;1/34=4N/ 31=4.-51/17/;,J51;5/h4;5./=1/e.7.J2.;/=1/7./ a;<.7./=1/13924./=1/{1<0;712Bfff/`|89}+ 8898+~~~G/{\Bfffj/{1<0;712G/ m]]0d@/e.2./7./?.792.<4N-/=1/7./313924./?4B ;,.7/;1/,5474EN/7./l4>,2./g93871K./=1/n1L/ `n1LG/m]]d@/h./1?.7,.<4N-/=1/7.;/<.8.<4=.B =1;/1K1<,54?.;/;1/21.74EN/31=4.-51/79;/;,JB 51;5/=1/\131K.-E.;/L/h152.;BA63129;/=17/ {Df\Bfff/`{1<0;712G/m]]kd/L/31=4.-51/17/ 51;5//=1/g97921;/L/e.7.J2.;/`b97=1-G/ m]]1d@/h./0.J474=.=/?4;9<9-;52,<54?./;1/?.B 792N/31=4.-51/7./<984./=1/7./l4>,2./g93B 871K./=1/n1L/`n1LG/m]]d@/e92/,75439G/8.2./ 7./?.792.<4N-/=17/71->,.K1/;1/,5474E.29-/79;/ ;,J51;5/=1/9<.J,7.249/1/f-M923.<4N-/=17/ {Df\Bfff/`{1<0;712G/m]]kd@ e.2./17/829<1=4341-59/=1/.=34-4;52.B <4N-/L/<9221<<4N-/=1/7.;/=4M121-51;/82,1J.;G/ ;1/0.-/;1>,4=9/7.;/-923.;/4-=4<.=.;/1-/79;/ 3.-,.71;/=1/7.;/34;3.;@/h.;/8,-5,.<49-1;/ 011 23536787993237 8787799988 5778 !"!#3 $%79&'3()&*($ 3 +,-./0123450.6,+12374-381371-0,/,7160.3.63 /1+137-9.51:3;9.-4630-162;4-<1+12313796= 091/,46.23.2/181-.2:37.-/.60,8.23>3796091= /,46.23?@ ABCDEFGHGEIJC K837-4/.243040183+.3.L1891/,M63+9-M3+423 2.2,46.2@3N1371-0,/,7160.3;9.3.L1891+1374-3 813<,2<137.-24613.63813124/,1/,M63+.3.6;.-= <42313813O9.31/9+.@3K638137-,<.-132.2,M632.3 7,+,M3293/462.60,<,.604371-1371-0,/,71-3.63 .837-.2.60.3.209+,43+.3/124:32.3-.18,PM39613 .60-.L,201371-13813-./4Q,+13+.3+1042324/,4+.= <4Q-RS/42:3160./.+.60.23;1<,8,1-.23>37.-= 24618.23<.+,/4=72,O9,R0-,/423>371-13.L1891-3 8123/1-1/0.-T20,/123/8T6,/123+.3293/46+9/013+.3 1/9<981/,M6371048MQ,/1@3U//.+.301<5,V6313 O9.36423.60-.L,20.<423/463.83<1-,+4@3K83 +,1Q6M20,/43>30-101<,.6043O9.32.3+.2/-,5.3 ;9.3-.18,P1+4374-3.8372,O9,10-13O9.38130-1013 .63963+,2742,0,L43+.32189+3<.6018@3K638132.= Q96+132.2,M6:32.3178,/1516381237-9.512371-13 813.L1891/,M63+.38123+,;.-.60.23/171/,+1+.23 /4Q6,0,L12@ WXYZ[\]^_Y N123/1-1/0.-T20,/123/8T6,/123+.3813/46= +9/0131/9<981+4-1:32.3+.2/-,5.6313/460,= 691/,M6@3`63-.29<.63+.3.201232.3-./4Q.3.63 813015813a@3 N423+,;.-.60.23<10.-,18.23>345b.0423O9.3 1/9<98132463-471:3717.83c7.-,M+,/42:3-.= L,2012:3717.8.23>317960.2:3;1/09-12:3/1-0123>3 ;488.0423+.37958,/,+1+d3>3548212@3K63/916043 138131+O9,2,/,M63+.3.2042:3/4<7-1318Q96123 /42123O9.318<1/.613/4<43813-471:3-.L,20123>3 7.-,M+,/423>35482123+.3813/4<7-1e3<,.60-123 O9.340-1238123-./4Q.3+.3813/188.3c548212:3/1-= 0123>3;488.0423+.37958,/,[email protected]= <1/.61+13.63.831-<1-,4:3/916+43.201388.64:3 Q91-+13813-4713.635482123,6+.7.6+,.60.<.6= 0.3+.32,3.201329/,13438,<7,1:3+,20,6Q9,.6+43 f6,/1<.60.3.60-.3-4713921+13>369.L1@3K63 /916043183717.83>38123548212:3643g1/.36,6Qf63 0,743+.3/812,S/1/,M6:384231/9<9813+.24-+.= 61+1<.60.3<.0,+423.635482123.63/918O9,.-3 89Q1-3+.3813/121@3 h9.20-139613-.81/,M63/463842345b.0423 5121+13.63293L184-3,60-T62./43c6./.2,+1+3 i"33j-,6/,718.23/1-1/0.-T20,/123/8T6,/123+.3813 /46+9/0131/9<981+4-13+.381371-0,/,7160.@ kElDBGmDGnIoFEopqloDqBqDJEBrlJGDqloEIoEpoDqlC 798 s471:3717.83>3548212@ 9t83 u4<7-R6+48423>3-./4Q,V6+48423+.3813/188.@ v97788 w43g1>34-+.63.631/9<981/,M63+.3717.83>3548212@ u10.Q4-,P1/,46.23/1M0,/123.63813-471@ x9ty8z3 j40.6/,18390,8,+1+3+.3842345b.042@ 788{7 |45-.,<78,/1/,M63.<4/,4618@3 N.37-474-/,46163/460-483>32.Q9-,+1+@ v97883 w43813/462,+.-13/4<4371048MQ,/1@ K23L,L,+13/4<43.Q42,60M6,/1@ 77987}973 h1813-.81/,M63+.371-.b1@ j4/13/4<96,/1/,M63>310.6/,M6313293g,b4@ w43g1>3-.81/,M63/46340-423;1<,8,1-.23c71+-.2:3 g.-<1642:3.0/@d@ 77987873 U,281<,.604324/,18@ KL,01/,M63+.32,091/,46.2324/,18.2@ U92.6/,13+.3-.81/,46.2324/,18.23.~0-1;1<,8,1-.2@ v99779873 60.-L.6/,M63+.32.-L,/,42324/,18.2@ 012 346478984348 9898899 6889 !"#" $4!% &8' (4)*'+)%!4 ,-./0121345267.-8.-2.9/0/56:.;.<6871,-54.=/-. 0-8-5.42>4<-84,67.267.,19-5-80-7.>40-514? 2-7.2-.@56@65<1684.<680562.;.7-A/51,4,.480-. @671B2-7.8-<-71,4,-7.9/0/547C.D6.<6871,-54. 7/.<6>@6504>1-806.<6>6.42A6.@4062EA1<6. ;.F1F-.24.<68,/<04.4</>/24,654.,-.965>4. -A67180E81<4C.G1<[email protected]/45? ,45.-7067.6BH-067.;.=/-.86.@/-,-.01545.247.<6? 747.I>481J-704.=/-K.L71.247.<6747.-70M8.4NOP. [email protected]:C.S4.@60-8<142./0121,4,.,-. 06,67.267.6BH-067.-7.24.543E8.=/-.,[email protected]? >4<-845267C.T65.-H->@26P.-8.-2.<476.,-2.@4? @-2.,1<-.=/-.01-8-.=/-.0-8-526.71->@5-.<-5<4. @454.@6,-5./74526.-8.21>@145.24.<6<184P.24. </42.-704.71->@5-.7/<14.7-AU8.-2.>451,6C.V8. </4806.4.247.B62747P.,1<-.8-<-71045247.<6>6. 965>4.,-.<2471J<45.267.,17018067.6BH-067P.@65. 26.=/-.86.@/-,-8.9420452-C.W-.>/-7054.48? 71674P.155104B2-.;.4A5-71F4.</48,6.7/.>451,6. 01-8-.=/-.<6A-5.56@[email protected][email protected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email protected].<2454>-80-.187/J<1-80-P.42. 1A/42.=/-.-8.247.<68,1<168-7.,-.T424B54.;. \6265C.T65.U201>6.-8.247.@5/-B47.,-.`6<4B/? 24516.-.a8965>4<1E8.04>B1X8.7-.-F1,-8<14./8. 5-8,1>1-806.<2454>-80-.,-0-51654,6C bcdefghicdjh V8.-70-.-70/,16.,-.<476.@6,->67.6B? 7-5F45.=/[email protected].@518<1@42-7. <454<0-5O701<47.=/-.267.5-<1-80-7.-70/,167. 7-k4248.<6>6.,1701801F47.,-2.lYP.-7047.768. 24.<68,/<04.4</>/24,654.F1F1,4.<6>6.-A6? 7180E81<4.;.=/-.6</[email protected]@-A6.42.F4265. 1805O87-<6.,-.267.6BH-067.=/-.7-.4</>/248C. V8.5-24<1E8.<68.26.480-5165P.24.@4501<1@480-. >/-7054./8.,14A8E701<6.,-.lm\P.26.=/-.7-? AU8.18F-701A4<168-7.5-<1-80-7.IYB54>6n103. 84P.[oo2p.m240/8H1.84P.[oo2p.T-50/74.8 4P.[oo2p.W4>/-27.84P.[oo2:.-7.95-</-80-. =/-.7-.-8</-805-.</48,6.7-.@5-7-804./8.lYP. ;4.=/-.-7067.-70/,167.,-J-8,-8.-2.lY.<6>6. 012 346478984348 9898899 6889 !"#" $4!% &8' (4)*'+)%!4 ,-./012/30-3.24510163.647.89:;.9/012.<101<= /40>2/?<12.@,-<?3-1742.A,4.24.50424-/1-.4-.47. 8B.C.A,4./1DE?F-.24.3E240G1-.4-.42/4.<123. 23-.71.50424-<?1.64.<3-H?</32.@1D?7?1042I. 1?271D?4-/3.23<?17.C.A,4.42.47.64/40?303.64. 2,.G?61.54023-17.73.A,4.D3/?G1.71.<3-2,7/1. 4-.217,6.D4-/17.JK1L401.84I.MNNOP;.81D= E?F-.24.4G?64-<?1-.4-.47.<123.3/012.<101</4= 0>2/?<12.6?2/?-/?G12.647.8B.<3-.04254</3.1.71. <3-6,</1.1<,D,716301.A,4.24.50424-/1E1.4-. Q!4.R42,7/1632.64.71.4G17,1<?S-.<3T-?/?G1; UVWXYZ [X\W]^Z_` abc6defg36hggi d8j kl.mn1</?/,6o.MpqrO;.k:.s.tN 8?53o.uv;.k:.w.tN 8?4D53o.r=0.D?-,/32;.k:.s.Mp 8988x8y kl.mn1</?/,6o.tpqrO;.k:.s.tN 8?53o.uv;.k:.s.tN 8?4D53o.r=0.D?-,/32 zc7QgzQfazQ6hg6f676zhgf6{z+aaa 8988 klo.MqtM;.k4o.0 8988 klo.Mpq0|;.k4o.p 8988 klo.|qtM;.k4o.tN 8998 klo.MtqM0;.k4o.O QgzQhgzQee  klo.ON;.k8o.MN d klo.pt;.k8o.rN +d klo.t0;.k8o.MN zc7QgzQhgf6gzd6f6{6az+aaa h klo.1;.k4o.0 d88}&8 klo.pO;.k4o.2 z88~ klo.tr;.k4o.| f8+}&8 klo.O;.k4o.1 $9 klo.Mp;.k4o.1 a9 klo.1;.k4o.O .k40<4-/?7;..k,-/,1<?S-.l?04</1;..k,-/,1<?S-.m2<1710.J46?1..l42G?1<?S-.8>5?<1o.tN..rP;. .k,-/,1<?S-.8.J46?1..l42G?1<?S-.8>5?<1o.pN..tNP;m2<171.64.u-/47?T4-<?1.4<L2740. 5101.B6,7/32=uuu.J{8986a8898z98+aaaI.Bu=uuu.4<L2740I.MNNtP;.. m2<171.64.4D30?1.64.4<L2740=uuu.J{8988z98+aaaI.=uuu.4<L2740I.MNN0P; 012 346478984348 9898899 6889 !"#" $4!% &8' (4)*'+)%!4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email protected],<,37434.,1.-=.3,<,1>781.2,.5=<,I 37=-.C7:@=-E.Q=:.R=G7-72=2,:.C7:4>41:<3@><7I C=:.<=5G7K1.5@,:<[email protected]>7<.75?43<=1<,E. S=B.@1=.?4G3,.>=?=>72=2.2,.71R7G7>781.2,. 3,:?@,:<=;.D@,.<=5G7K1.7127>[email protected],<,37434. 2,.-=.=<,1>781.:,-,><7C=;.=-<,3=>741,:.,1.=G:I <3=>>781.D@,.,C72,1>7=1.37972,M.>4917<7C=.B. 2KL>7<.,1.5,5437=.2,.<3=G=H4.D@,.7127>=1. 27L>@-<=2.,1.,-.5=1<,1757,1<4.B.5=17?@-=I >781.2,.71A435=>781.?3,:,1<=2=E.F1.>@=1<4. =-.-,19@=H,.:,.5@,:<3=.@1=.>45?3,1:781.B. R=G7-72=2.C,3G=-.2,L>7,1<,E F1.G=:,.=.-=.-7<,3=<@3=.3,C7:=2=;.-4:.2=<4:. 4G<,1724:.,1.,:<,.>=:4.,:<J1.,1.>41:41=1>7=. ?43.-4.,1>41<3=24.?43.,:<@274:.>454.-4:.2,. T37:R=5.84.UV22WX;.S=3<-.84.UV220X.B. Y71>M,;./<,Z,<,,.B.N34:<.UV22WX.:4G3,.=-<,I 3=>741,:.>4917<7C=:.2,-.[\E.]1724.=.-=.,C7I 2,1>7=.,5?037>=.R=--=2=.,1.-=.-7<,3=<@3=;.-4:. R=--=M94:.4G<,1724:.,1.,:<,.,:<@274.2,.>=:4. ,C72,1>7=1.-=.75?43<=1>7=.2,.-=.,C=-@=>781. >4917<7C=.>[email protected],=.5J:.=.,C=-@=3.,1. ,:<,.<3=:<4314.B=.D@,.-=:.27L>@-<=2,:.?@,2,1. <,1,3.71^@,1>7=.,1.27A,3,1<,:.>=3=><,30:<7>=:. >-017>=:.2,-.<3=:<4314E.\@1D@,.>454.:,.<3=<=. 2,-.,:<@274.2,.@1.:4-4.>=:4.R=B.D@,.<,1,3. ,1.>@,1<=.-4:.71>41C,17,1<,:.2,37C=24:.2,. -4.?,D@,_4.2,.-=.5@,:<3=.B.=@1D@,.-=.?=3I <7>7?=1<,.R=--=.:724.27=914:<7>=2=.B.,:<,.<4I 5=124.-=.5,27>=>781.2,:2,.R=>,.:4-4.@14:. 20=:;.A=><43,:.>454.-=.5,27>=>781.4.,-.17I ..#4.=X.O4?7=.2,.-=.N79@3=.O45?-,H=.2,.P,BE.GX.P,?342@>>781.,1.5,5437=.2,.-=.N79@3=. O45?-,H=.2,.P,BE 012 346478984348 9898899 6889 !"#" $4!% &8' (4)*'+)%!4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`4;QG/a@b@G/S286c.46G/d@e@G/bBN`82;QG/ b@K@/7/S922G/a@d@/fghhij@/b7<1;?</12-3C -6;8;4?6/860/?9;B?<-/?D/B?H64;4,-C=-C N8,4?28./;N-2817/D?2/?=3-334,-CB?<19.C 34,-/043?20-2@/3kl l99m *#G/2h0nC2hop@ K=28<?`4;QG/a@b@G/qN-8;?6G/d@r@/7/b;?2BNG/ e@K@/fghh1j@/JN-/3;8;93/?D/N?82046H/83/8/ 37<1;?</?D/?=3-334,-CB?<19.34,-/043C ?20-2@/78m889msm8  )tG/2hguC2hii@ S2?3;G/v@T@/7/r2?33G/v@w@/f2nnij@/JN-/ N?82046H/?D/1?33-334?63@/78m8+ 89msm8 '#G/iupCi12@ S2?3;G/v@T@/7/x82;.G/J@/f2nnuj@/K/B?H64;4,-C =-N8,4?28./<?0-./?D/B?<19.34,-/N?820C 46H@/78m889msm8  ')G/i02Cioh@ r?.0-6G/w@a@/fghhpj@/y4s8898 4/d80240z/JeK/e04B4?6-3@ r5<-QCS-248/{@/fghhnj/S?2<83/B.I64B83/0-/ .83/B?609B;83/8B9<9.80?283@/| 79 #tG/2ggC2ih@ r243N8<G/a@v@G/}2?`6G/J@K@G/b8,8H-G/w@v@G/ b;-c-;--G/r@/7/}82.?`G/A@x@/fghhpj@/~-9C 2?137BN?.?H4B8./4<1842<-6;/833?B48;-0/ `4;N/B?<19.34,-/N?82046H@/78m 889msm8 )G/20p2C201i@ x82;.G/J@P@G/S2?3;G/v@T@G/K..-6G/r@a@G/A-BcC -23=8BNG/J@G/b;-c-;--G/r@G/A9DD867G/b@v@/ 7/b8,8H-G/w@v@/fghh0j@/KB;98./860/1-2C B-4,-0/<-<?27/0-MB4;3/46/4604,4098.3/ `4;N/B?<19.34,-/N?82046H@/88 68 !"G/onCun@