To investigate the contribution of BNP promoter DNA methylation to the risk of rheumatic heart disease (RHD) and the influence of warfarin anticoagulant ...
BIOSCIENCE REPORTS
ACCEPTED MANUSCRIPT Hypermethylation of brain natriuretic peptide (BNP) gene is associated with the risk of rheumatic heart disease Ni Li, Dawei Zheng, Lebo Sun, Huoshun Shi, Xiuying Zhu, Guodong Xu , Qinning Wang, Caimin Zhu, Guofeng Shao To investigate the contribution of BNP promoter DNA methylation to the risk of rheumatic heart disease (RHD) and the influence of warfarin anticoagulant therapy on BNP methylation levels for RHD patients after surgery.BNP methylation levels were determined by bisulfite pyrosequencing from plasma samples of RHD patients compared with healthy controls. Several factors influencing the RHD patients were included age, smoking, and cholesterol levels. A fragment of 5 CG sites (CpG1‐5) in the promoter region of BNP gene was measured. BNP gene hypermethylation was found in CpG4 and CpG5 in RHD patients compared with non‐RHD controls. A significant difference was also observed between RHD patients with long‐term administration of warfarin and RHD patients who had recently undergone an operation. Moreover, single CpG4 and CpG5 analysis revealed a significant increase in methylation levels in men. BNP gene‐body hypermethylation is associated with the risk of RHD, and also influenced by the warfarin anticoagulant therapy of RHD patients after surgery, which could represent novel and promising targets for therapeutic development.
Cite as Bioscience Reports (2016) DOI: 10.1042/BSR20160408
Copyright 2016 The Author(s). This is an Accepted Manuscript; not the final Version of Record. You are encouraged to use the final Version of Record that, when published, will replace this manuscript and be freely available under a Creative Commons licence. All other rights reserved.
ϭ
+\SHUPHWK\ODWLRQRIEUDLQQDWULXUHWLFSHSWLGH%13 JHQHLVDVVRFLDWHG
Ϯ
ZLWKWKHULVNRIUKHXPDWLFKHDUWGLVHDVH
1L/L 'DZHL=KHQJ/HER6XQ+XRVKXQ6KL;LX\LQJ=KX*XRGRQJ;X4LQQLQJ:DQJ
ϯ
&DLPLQ=KX*XRIHQJ6KDR
ϰ ϱ
1LQJER0HGLFDO&HQWHU/LKXLOL+RVSLWDO1LQJER8QLYHUVLW\6FKRRORI0HGLFLQH1LQJER=KHMLDQJ
ϲ
&KLQD
ϳ
1LQJER8QLYHUVLW\6FKRRORI0HGLFLQH1LQJER=KHMLDQJ&KLQD
ϴ
&RUUHVSRQGHQFHVKRXOGEHDGGUHVVHGWR'U*XRIHQJ6KDRVJI#VLQDFRP
ϵ ϭϬ
$EVWUDFW
ϭϭ
7R LQYHVWLJDWH WKH FRQWULEXWLRQ RI %13 SURPRWHU '1$ PHWK\ODWLRQ WR WKH ULVN RI
ϭϮ
UKHXPDWLFKHDUWGLVHDVH5+' DQGWKHLQIOXHQFHRIZDUIDULQDQWLFRDJXODQWWKHUDS\RQ
ϭϯ
%13PHWK\ODWLRQOHYHOVIRU5+'SDWLHQWVDIWHUVXUJHU\%13PHWK\ODWLRQOHYHOVZHUH
ϭϰ
GHWHUPLQHG E\ ELVXOILWH S\URVHTXHQFLQJ IURP SODVPD VDPSOHV RI 5+' SDWLHQWV
ϭϱ
FRPSDUHG ZLWK KHDOWK\ FRQWUROV 6HYHUDO IDFWRUV LQIOXHQFLQJ WKH 5+' SDWLHQWV ZHUH
ϭϲ
LQFOXGHGDJHVPRNLQJDQGFKROHVWHUROOHYHOV$IUDJPHQWRI&*VLWHV&S* LQ
ϭϳ
WKH SURPRWHU UHJLRQ RI %13 JHQH ZDV PHDVXUHG %13 JHQH K\SHUPHWK\ODWLRQ ZDV
ϭϴ
IRXQG LQ &S* DQG &S* LQ 5+' SDWLHQWV FRPSDUHG ZLWK QRQ5+' FRQWUROV $
ϭϵ
VLJQLILFDQW GLIIHUHQFH ZDV DOVR REVHUYHG EHWZHHQ 5+' SDWLHQWV ZLWK ORQJWHUP
ϮϬ
DGPLQLVWUDWLRQ RI ZDUIDULQ DQG 5+' SDWLHQWV ZKR KDG UHFHQWO\ XQGHUJRQH DQ
Ϯϭ
RSHUDWLRQ0RUHRYHUVLQJOH&S*DQG&S*DQDO\VLVUHYHDOHGDVLJQLILFDQWLQFUHDVH
ϮϮ
LQPHWK\ODWLRQOHYHOVLQPHQ %13JHQHERG\K\SHUPHWK\ODWLRQLVDVVRFLDWHGZLWKWKH
Ϯϯ
ULVN RI 5+' DQG DOVR LQIOXHQFHG E\ WKH ZDUIDULQ DQWLFRDJXODQW WKHUDS\ RI 5+'
Ϯϰ
SDWLHQWV DIWHU VXUJHU\ ZKLFK FRXOG UHSUHVHQW QRYHO DQG SURPLVLQJ WDUJHWV IRU
Ϯϱ
WKHUDSHXWLFGHYHORSPHQW
Ϯϲ
Ϯϳ
.H\ZRUGV'1$PHWK\ODWLRQUKHXPDWLFKHDUWGLVHDVHEUDLQQDWULXUHWLFSHSWLGH
Ϯϴ
S\URVHTXHQFLQJHSLJHQHWLFV
Ϯϵ
ϯϬ
$EEUHYLDWLRQOLVW
ϯϭ
%13EUDLQQDWULXUHWLFSHSWLGH5+'UKHXPDWLFKHDUWGLVHDVH&*,&S*LVODQG7&
ϯϮ
6HUXPWRWDOFKROHVWHURO7*7ULJO\FHULGH+'/KLJKGHQVLW\OLSRSURWHLQ/'/ORZ
ϯϯ
GHQVLW\OLSRSURWHLQ$SR$$SROLSRSURWHLQ$$SR%$SROLSRSURWHLQ%$SR(
ϯϰ
$SROLSRSURWHLQ(
ϯϱ
ϯϲ
,QWURGXFWLRQ
ϯϳ
5KHXPDWLF KHDUW GLVHDVH 5+' LV SULPDULO\ DQ DXWRLPPXQH VHTXHOD RI DFXWH
ϯϴ
UKHXPDWLFIHYHUZKLFKRFFXUVDVDUHVXOWRIEHWDKHPRO\WLFVWUHSWRFRFFDOLQIHFWLRQ>@
ϯϵ
5+'FDQFDXVHFKURQLFLQIODPPDWLRQRIWKHHQGRFDUGLXPDQGP\RFDUGLXPOHDGLQJWR
ϰϬ
YDOYXODUG\VIXQFWLRQDQGKHPRG\QDPLFFKDQJHVDQGFRPPRQO\KHDUWIDLOXUHVWURNH
ϰϭ
RURWKHUVHULRXVUHODWHGFRPSOLFDWLRQV>@ 8QIRUWXQDWHO\EHFDXVHRIWKHODFNRI D
ϰϮ
VSHFLILF PHWKRG RI GHWHFWLQJ 5+' PDQ\ SDWLHQWV KDYH EHHQ GLDJQRVHG ZLWK
ϰϯ
LUUHYHUVLEOH YDOYXODU G\VIXQFWLRQ IRU ZKLFK YDOYXODU VXUJHU\ LV RQH RI WKH PDLQ
ϰϰ
WUHDWPHQWV >@ ,Q &KLQD 5+' UHPDLQV D VLJQLILFDQW KHDOWK EXUGHQ DOWKRXJK WKH
ϰϱ
SUHYDOHQFH RI 5+' KDV EHHQ GHFOLQLQJ LQ UHFHQW \HDUV 2ZLQJ WR D ODFN RI HDUO\
ϰϲ
GHWHFWLRQ 5+' SDWLHQWV FDQ VXIIHU IURP VHULRXV FRPSOLFDWLRQV DQG LUUHYHUVLEOH
ϰϳ
YDOYXODU G\VIXQFWLRQ 7KH LGHQWLILFDWLRQ RI D ELRPDUNHU RI FKDUDFWHULVWLF 5+'
ϰϴ
SDWKRSK\VLRORJ\ZLOOEHYDOXDEOHWRDLGHDUO\GHWHFWLRQDQGHQDEOHSDWLHQWVWRDYRLG
ϰϵ
VXUJHU\E\VWDUWLQJHIIHFWLYHWUHDWPHQWDWDQHDUO\VWDJH
ϱϬ
'1$ PHWK\ODWLRQ RIWHQ RFFXUV LQ D &S* GLQXFOHRWLGH FRQWH[W DQG SURPRWHU '1$
ϱϭ
PHWK\ODWLRQ FDQ UHJXODWH WKH H[SUHVVLRQ OHYHO RI WKH JHQH >@$EHUUDQW '1$
ϱϮ
PHWK\ODWLRQKDVEHHQH[WHQVLYHO\VWXGLHGLQFDQFHUOXQJFDQFHUDQGOHXNHPLD>@
ϱϯ
,WLVRIWHQUHODWHGWRWKHUHJXODWLRQRIJHQHH[SUHVVLRQ>@'1$PHWK\ODWLRQSOD\V
ϱϰ
D PDMRUUROHLQUKHXPDWLFGLVHDVHV>@+RZHYHURQO\DIHZVWXGLHVKDYHLQGLFDWHG
ϱϱ
WKH LQYROYHPHQW RI '1$ SURPRWHU PHWK\ODWLRQ LQ WKH VXVFHSWLELOLW\ RI 5+' DQG
ϱϲ
VWXGLHVRIWKHHSLJHQHWLFPHFKDQLVPLQ5+'DUHVFDUFH
ϱϳ
$QWLFRDJXODWLRQ LV D NH\ WUHDWPHQW IRU SDWLHQWV ZLWK 5+' DIWHU YDOYH UHSODFHPHQW
ϱϴ
ZLWKWKHDLP RISURORQJLQJWKHSDWLHQW¶VSURWKURPELQWLPHSUHYHQWLQJWKURPERVLVLQ
ϱϵ
WKH DUWLILFLDO KHDUW YDOYH DQG SUHYHQWLQJ DUWLILFLDO YDOYH G\VIXQFWLRQ 7KHUHIRUH
ϲϬ
DQWLFRDJXODWLRQ WKHUDS\ LV WKH SULQFLSDO PHWKRG IRU IROORZXS WUHDWPHQW DIWHU YDOYH
ϲϭ
UHSODFHPHQW:DUIDULQLVDFRPPRQDQWLFRDJXODQWGUXJLQWKHFOLQLFDQGWKHLQKLELWLRQ
ϲϮ
RI YLWDPLQ . HSR[LGH UHGXFWDVH DFWLYLW\ SUHYHQWV YLWDPLQ .GHSHQGHQW DFWLYDWLRQ RI
ϲϯ
FORWWLQJIDFWRUVWRH[HUWDQDQWLFRDJXODQWHIIHFW&OLQLFDOSUDFWLFHVKRZVWKDWWKHVDIHW\
ϲϰ
RI ZDUIDULQ LQ WKH WUHDWPHQW RI QDUURZ VFRSH DQG DQ LPSURSHU GRVDJH ZLOO OHDG WR
ϲϱ
LQHIIHFWLYHWUHDWPHQWRUEOHHGLQJ>@$ODUJHQXPEHURIVWXGLHVVKRZWKDWLQGLYLGXDO
ϲϲ
ZDUIDULQ GRVDJH IOXFWXDWLRQV GHSHQG RQ GLIIHUHQFHV LQ LQGLYLGXDO GUXJ PHWDEROLVP
ϲϳ
LQFOXGLQJ QRQJHQHWLF DQG JHQHWLF IDFWRUV >@ ,W LV XQFOHDU ZKHWKHU ORQJWHUP
ϲϴ
ZDUIDULQ DQWLFRDJXODWLRQ WKHUDS\ FRXOG LQIOXHQFH WKH JHQHWLFVOHYHO LPSDFW LQFOXGLQJ
ϲϵ
'1$IRU5+'SDWLHQWVXQGHUJRLQJPHFKDQLFDOKHDUWYDOYHUHSODFHPHQW
ϳϬ
$W SUHVHQW VHYHUDO JHQHV DUH UHSRUWHG WR EH DVVRFLDWHG ZLWK 5+' SDWKRJHQHVLV
ϳϭ
LQFOXGLQJWKH%13EUDLQQDWULXUHWLFSHSWLGH %035DQG*&.JHQHV>@%13
ϳϮ
LV Ă FDUGLDF KRUPRQH V\QWKHVL]HG DV D SUHSURSHSWLGH PDLQO\ H[SUHVVHG LQ WKH
ϳϯ
YHQWULFOHZKHQOHIWYHQWULFXODUIXQFWLRQLVLQVXIILFLHQF\,WLVDOVRUHSRUWHGWKDW%13LV
ϳϰ
D KDOOPDUN IRU PDODGDSWLYH UHPRGHOLQJ RI WKH OHIW YHQWULFXODU EHFDXVH P\RFDUGLDO
ϳϱ
H[SDQVLRQ DQG UDSLG V\QWKHWLF UHOHDVHG LQWR WKH EORRG FDQ KHOS UHJXODWH FDUGLDF
ϳϲ
IXQFWLRQ>@%13JHQHHQFRGHGE\%13FRQVLVWVRIWKUHHH[RQVDQGWZRLQWURQV
ϳϳ
ZKLFKLVORFDWHGLQWKHVKRUWDUPRIFKURPRVRPHSURGXFHGE\WKHFDUGLRP\RF\WHV
ϳϴ
LQ WKH FDSDFLW\ RI RYHUORDGHG VWUHVV %13 JHQH H[SUHVVHG LQ DWULDO P\RF\WHV DQG
ϳϵ
YHQWULFXODU P\RF\WHV PDLQO\ IURP YHQWULFXODU P\RF\WHV HVSHFLDOO\ LQ SDWKRORJLFDO
ϴϬ
VWDWH,WLVILUVWV\QWKHVLVHGDVSUR%13KRUPRQHSUHFXUVRULQWKHP\RFDUGLDOFHOODQG
ϴϭ
WKHQUHPRYHGE\O\VLV$DPLQRDFLGVLJQDOSHSWLGHILQDOO\VHFUHWHGWRWKHFHOOWKH
ϴϮ
IRUP RI SUHSUR%13 7KH ELRORJLFDO KDOIOLIH RI %13 LQ FLUFXODWRU\ EORRG LV
ϴϯ
DSSUR[LPDWHO\ PLQXWHV0DQ\ UHIHUHQFHV SURYHG WKDW SODVPD %13 OHYHOV IURP
ϴϰ
EORRG DUH NQRZQ WR EH HOHYDWHG LQ SDWLHQWV ZLWK V\PSWRPDWLF OHIW YHQWULFXODU
ϴϱ
G\VIXQFWLRQSODVPD%13FRQFHQWUDWLRQVFDQEHDGLDJQRVWLFSHUIRUPDQFHRIWKHKHDUW
ϴϲ
GLVHDVH PDUNHU %13 DFWHG PDLQO\ DV FDUGLDF KRUPRQHV DQG LV SURGXFHG
ϴϳ
SUHGRPLQDQWO\ LQ WKH KHDUW WKDW LV LQYROYHG LQ WKH UHJXODWLRQ RI QDWULXUHVLV GLXUHVLV
ϴϴ
DQGEORRGÀRZ%13JHQHH[SUHVVLRQLQFUHDVHVGUDPDWLFDOO\LQUHVSRQVHWR
ϴϵ
K\SHUWURSKLFVWLPXOLDQGSODVPD%13OHYHOVDUHXVHGFOLQLFDOO\WRGHWHFWDQGJXLGHWKH
ϵϬ
PDQDJHPHQW RI K\SHUWURSK\ DQG KHDUW IDLOXUH LQ KXPDQV >@ 6LQFH %13
ϵϭ
H[SUHVVLRQ LQFUHDVH LQ UHVSRQVH WR HOHYDWHG KHPRG\QDPLF ORDG SUHGLFWLQJ FOLQLFDO
ϵϮ
VHYHULW\DQGSURJQRVLVLQSDWLHQWVZLWKKHDUWIDLOXUHZHDQDO\]HGPHWK\ODWLRQSDWWHUQV
ϵϯ
LQ WKH SURPRWHU UHJLRQV E\ ELVXOIDWH S\URVHTXHQFLQJ %13 JHQH H[SUHVVLRQ DQG LWV
ϵϰ
TXDQWLWDWLYH H[SUHVVLRQ ORFXV PLJKW EH DVVRFLDWHG ZLWK 5+' ,Q OLJKW RI SUHYLRXV
ϵϱ
ILQGLQJVZHK\SRWKHVL]HGWKDWSURPRWHU'1$PHWK\ODWLRQRI%13JHQHLQSHULSKHUDO
ϵϲ
EORRGPLJKWFRQWULEXWHWRWKHULVNRI5+'7KXVWKHJRDORIWKLVVWXG\ZDVWRDVVHVV
ϵϳ
ZKHWKHU %13 JHQH SURPRWHU '1$ PHWK\ODWLRQ LV DVVRFLDWHG ZLWK WKH ULVN RI 5+'
ϵϴ
2XU ZRUN PD\ LGHQWLI\ QRYHO '1$ PHWK\ODWLRQ PDUNHUV DQG HQKDQFH FXUUHQW
ϵϵ
XQGHUVWDQGLQJRI5+'SURJUHVVDIWHUVXUJHU\
ϭϬϬ ϭϬϭ ϭϬϮ
0DWHULDODQG0HWKRGV
ϭϬϯ
3DWLHQWV
ϭϬϰ
$WRWDORIVXEMHFWVZHUHVHOHFWHGIRUWKHVWXG\IURPWKHLQSDWLHQWFOLQLFRI 1LQJER
ϭϬϱ
0HGLFDO&HQWHU/L+XLOL+RVSLWDO1LQJER&KLQD EHWZHHQ0DUFKDQG2FWREHU
ϭϬϲ
2I WKHVH VXEMHFWV PHQ DQG ZRPDQ 5+' SDWLHQWV FDVH JURXS DQG WKH
ϭϬϳ
UHPDLQLQJZHUHQRUPDOKHDOWK\DGXOWVFRQWUROJURXS ZLWKQR PHGLFDOKLVWRU\RI
ϭϬϴ
FRQJHQLWDO KHDUW GLVHDVH FDUGLRP\RSDWK\ OLYHU RU UHQDO GLVHDVHV 7KH LQFOXVLRQ
ϭϬϵ
FULWHULD RI WKH 5+' JURXS ZHUH DV IROORZV L HYHU\ SDWLHQW GLDJQRVHG ZLWK PLWUDO
ϭϭϬ
YDOYH SURODSVH EHFDXVH RI PLWUDO FKRUGDH WHQGLQDH IUDFWXUH DQG PLWUDO LQVXIILFLHQF\
ϭϭϭ
DQG VFKHGXOHG IRU PLWUDO YDOYH UHSODFHPHQW LL OHIW YHQWULFXODU HMHFWLRQ IUDFWLRQ
ϭϭϮ
() ! LLL OHIW YHQWULFXODU HQGGLDVWROLF GLDPHWHU /9('' PP 5+'
ϭϭϯ
FDVHVDQGWKHLUFRQWUROVZHUHZHOOPDWFKHGEDVHGRQWKHIROORZLQJGHWDLOVLY VDPH
ϭϭϰ
VH[Y GLIIHUHQFHRIDJH\HDUVROGYL RWKHUSK\VLRORJLFDOLQGH[HVIURPSK\VLFDO
ϭϭϱ
FKHFN $OO KXPDQ PDWHULDOV ZHUH REWDLQHG E\ WKH KRVSLWDO¶V UHJXODWLRQV DQG KHQFH
ϭϭϲ
ZHUH DSSURYHG E\ WKH HWKLFV FRPPLWWHH RI /LKXLOL +RVSLWDO :ULWWHQ LQIRUPHG
ϭϭϳ
FRQVHQWZDVDOVR REWDLQHGIURPDOOVXEMHFWVLQDGYDQFH
ϭϭϴ ϭϭϵ
6DPSOHFROOHFWLRQ
ϭϮϬ
%ORRGVDPSOHVZHUHFROOHFWHGLQ('7$WXEHVIRUSODVPDFROOHFWLRQIURPWKH5+'
ϭϮϭ
FDVHV 3HULSKHUDO EORRG ZDV FRDJXODWHG DW URRP WHPSHUDWXUH IRU PLQ WKHQ
ϭϮϮ
FHQWULIXJHG DW USP IRU PLQWRFRPSOHWHO\UHPRYH FHOOGHEULVDQGVWRUHG DW
ϭϮϯ
í& $OO SODVPDVDPSOHV RI FDVHV DQG FRQWUROV ZHUH FROOHFWHG E\ WKH VDPH
ϭϮϰ
LQYHVWLJDWRUV
ϭϮϱ ϭϮϲ
%LVXOIDWHWUHDWPHQW
ϭϮϳ
%LVXOIDWHWUHDWPHQWZDVSHUIRUPHGRQQJJHQRPLF'1$ZLWKWKH(SL7HFW'1$
ϭϮϴ
ELVXOIDWH.LW4LDJHQ*HUPDQ\ DFFRUGLQJWRWKHPDQXIDFWXUHU¶VLQVWUXFWLRQV
ϭϮϵ ϭϯϬ
'1$PHWK\ODWLRQDQDO\VLVS\URVHTXHQFLQJ
ϭϯϭ
3&5 RI ELVXOILWHWUHDWHG '1$ ZDV DPSOLILHG LQ D WRWDO YROXPH RI ȝO 3UH0L[
ϭϯϮ
SPRO RI HDFK SULPHU IRUZDUG SULPHU $**$77$*7$**7$**7$***7*7$7$
ϭϯϯ
DQG UHYHUVH SULPHU &&&&&77&77&&777&&7$&$$$7$7&&$$ DQG ȝO RI
ϭϯϰ
ELVXOILWH'1$F\FOHVZHUHFDUULHGRXWWKH3&5FRQGLWLRQVDUHVKRZQLQ7DEOH
ϭϯϱ
3&5SURGXFWVZHUHYLVXDOL]HGRQDJDURVHJHOV3\URVHTXHQFLQJZDVFDUULHGRXW
ϭϯϲ
XVLQJWKHVHTXHQFLQJSULPHU*7$**7$***7*7$7$*DQGWKH3\UR0DUN4.LW
ϭϯϳ
DFFRUGLQJWRWKHPDQXIDFWXUHU¶VLQVWUXFWLRQVRQD3\UR0DUN46\VWHP4LDJHQ ,Q
ϭϯϴ
WRWDO &S*V RI %13 LQWURQ ZHUH DQDO\]HG LQ WKH S\URVHTXHQFLQJ GHWHFWRU
ϭϯϵ
3\UR0DUN4,' XVLQJ3\UR4&S*VRIWZDUH
ϭϰϬ ϭϰϭ
'DWDHYDOXDWLRQ
ϭϰϮ
)RUS\URVHTXHQFLQJ'1$TXDOLW\ZDVFRQWUROOHGXVLQJ%L4$QDO\]HUVRIWZDUH%RFN
ϭϰϯ
HWDO 'DWDDUHVKRZQDVPHDQV6'6366YHUVLRQZDVXVHGIRUVWDWLVWLFDO
ϭϰϰ
HYDOXDWLRQ S ZDV UHJDUGHG DV VLJQLILFDQW 6WXGHQW¶V WWHVWZHUH XVHG WR WHVWIRU
ϭϰϱ
GLIIHUHQFHV LQ PHWK\ODWLRQ OHYHOV IRU FDWHJRULFDO YDULDEOHV 0DQQ:KLWQH\ WHVW ZDV
ϭϰϲ
XVHGE\FKHFNLQJWKUHHRSWLRQER[HVIRUWKHLQIOXHQFHRIZDUIDULQ
ϭϰϳ ϭϰϴ
5HVXOWV
ϭϰϵ
'1$PHWK\ODWLRQOHYHOVRI%13
ϭϱϬ
$V VKRZQ LQ )LJ WKH ELVXOILWH S\URVHTXHQFLQJ DVVD\ ZDV FDUULHG RQ D IUDJPHQW LQ
ϭϱϭ
WKHSURPRWHUUHJLRQRIWKH%13JHQH7KLVIUDJPHQWFRQWDLQHG&*VLWHVWKDWFRXOG
ϭϱϮ
EH PHDVXUHG WR HYDOXDWH WKH PHWK\ODWLRQ OHYHOV RI WKH %13 JHQH SURPRWHU '1$
ϭϱϯ
PHWK\ODWLRQ RI WKH %13 JHQH LQ WKH 5+' FDVHV ZDV VLJQLILFDQWO\ KLJKHU WKDQ LQ WKH
ϭϱϰ
QRQ5+' FRQWUROV &RUUHODWLRQ FRHIILFLHQW RI WKH '1$ PHWK\ODWLRQ OHYHOV ZDV
ϭϱϱ
PHDVXUHGDPRQJWKHVH&S*V7RGHWHUPLQHWKH'1$PHWK\ODWLRQOHYHORI5+'ZH
ϭϱϲ
FKRVH &*, RI 5+' DQG FRQWUROV :H IRXQG VLJQLILFDQW GLIIHUHQFHV DW &S* DQG
ϭϱϳ
&S*XVLQJS\URVHTXHQFLQJVKRZQLQ)LJ
ϭϱϴ
ϭϱϵ
:DUIDULQWKHUDS\RI'1$PHWK\ODWLRQOHYHOVRI%13
ϭϲϬ
:H QH[W LQYHVWLJDWHG WKH HIIHFW RI %13 '1$ PHWK\ODWLRQ OHYHOV RQ ZDUIDULQ GRVH
ϭϲϭ
UHTXLUHPHQWV DIWHU YDOYH UHSODFHPHQW $V VKRZQ LQ )LJXUH ZHIRXQG D VLJQLILFDQW
ϭϲϮ
GLIIHUHQFH RQ WKH &S* SRV VLWH DQG &S* VLWH SRV LQ FRPSDULVRQ ZLWK
ϭϲϯ
PRQWK 5+' 0 \HDUV 5+' < DQG WKH FRQWURO JURXS :LWK VHTXHQFLQJ
ϭϲϰ
PHWKRGVWKHKLJKHUPHWK\ODWLRQOHYHOVZHUHGHWHFWHGDW&S*DQG&S*DIWHU\HDUV
ϭϲϱ
< RIWDNLQJZDUIDULQFRPSDUHGZLWKPRQWK0 ,WLVDOVRDQDO\]HGWKHGDWDRI
ϭϲϲ
&S*˄SRV˅ WKH GLIIHUHQFH EHWZHHQ 0 DQG FRQWURO JURXS LV YHU\ VLJQLILFDQW
ϭϲϳ
S DQGWKHVLJQLILFDQFHRI&S*˄SRV˅EHWZHHQ0DQGFRQWUROJURXSZDV
ϭϲϴ
DOVR IRXQGS WKH GLIIHUHQFHV RI RWKHU JURXSV ZHUH QRW VLJQLILFDQW WKH
ϭϲϵ
VLJQLILFDQFH RI &S*SRV EHWZHHQ @5+'
ϭϵϳ
FDVHV ZHUH REVHUYHG WR KDYH VLJQLILFDQWO\ KLJKHU JHQRPLF '1$ PHWK\ODWLRQ LQ
ϭϵϴ
SHULSKHUDO EORRG LQ FRPSDULVRQ WR QRQ5+' FRQWUROV ,Q DGGLWLRQ FDQGLGDWH
ϭϵϵ
HSLJHQHWLFV DQDO\VLV VKRZHG WKDW DOWHUHG %13 SURPRWHU '1$ PHWK\ODWLRQ ZDV
ϮϬϬ
DVVRFLDWHG ZLWKWKH ULVN RI FDUGLRYDVFXODU GLVHDVH ,QWKH SUHVHQW VWXG\ZH UHFUXLWHG
ϮϬϭ
5+'FDVHVDQGKHDOWK\FRQWUROVWRWHVWWKHDVVRFLDWLRQEHWZHHQ'1$PHWK\ODWLRQRI
ϮϬϮ
WKH %13 JHQH DQG WKH ULVN RI 5+' &XUUHQWO\ WUHDWLQJ 5+' XVXDOO\ LQYROYHV
ϮϬϯ
FRQVHUYDWLYH WUHDWPHQW DQG LQWHUYHQWLRQDO WKHUDS\ ZKLOH VXUJLFDO WUHDWPHQW LV
ϮϬϰ
FRQVLGHUHG WR EH WKH PRVW HIIHFWLYH PHWKRG $QWLFRDJXODWLRQ LV D NH\ WUHDWPHQW IRU
ϮϬϱ
SDWLHQWV ZLWK 5+' DIWHUYDOYH UHSODFHPHQW ZLWK WKH DLP RI SURORQJLQJ WKH SDWLHQW¶V
ϮϬϲ
SURWKURPELQWLPHSUHYHQWLQJWKURPERVLVLQWKHDUWLILFLDOKHDUWYDOYHDQGSUHYHQWLQJ
ϮϬϳ
DUWLILFLDO YDOYH G\VIXQFWLRQ >@ 7KHUHIRUH ZDUIDULQ ZKLFK LV FRQVLGHUHG D
ϮϬϴ
FRPPRQ DQWLFRDJXODWLRQ GUXJ ZLWK ORQJWHUP WKHUDS\ PD\ LQIOXHQFH WKH
ϮϬϵ
JHQHWLFVOHYHOLPSDFWLQFOXGLQJ'1$IRU5+'SDWLHQWVXQGHUJRLQJPHFKDQLFDOKHDUW
ϮϭϬ
YDOYH UHSODFHPHQW +HUHLQ ZH VWXGLHG WKH FDUGLRYDVFXODUVSHFLILF JHQH %13 '1$
Ϯϭϭ
PHWK\ODWLRQOHYHOVWRDQDO\]HWKHLUHSLJHQHWLFIDFWRUV
ϮϭϮ
:H IRXQG VLJQLILFDQWO\ KLJKHU '1$ PHWK\ODWLRQ OHYHOV RI WKH %13 JHQH LQ WZR &*
Ϯϭϯ
VLWHVQDPHO\&S*SRV DQG&S*SRV LQWKH5+'FDVHVWKDQLQWKHQRQ5+'
Ϯϭϰ
FRQWUROV7KLVLQGLFDWHGWKDW%13JHQHERG\K\SHUPHWK\ODWLRQLVDVVRFLDWHGZLWKWKH
Ϯϭϱ
ULVNRIUKHXPDWLFKHDUWGLVHDVH
Ϯϭϲ
$VLJQLILFDQWGLIIHUHQFHZDVDOVRREVHUYHGEHWZHHQ5+'FDVHVZLWKDORQJWHUPGRVH
Ϯϭϳ
RI ZDUIDULQ DQG 5+' FDVHV WKRVH ZKR KDG UHFHQWO\ XQGHUJRQH RSHUDWLRQ &OLQLFDO
Ϯϭϴ
SUDFWLFH VKRZV WKDW WKH VDIHW\ RI ZDUIDULQ LQ WKH WUHDWPHQW RI QDUURZ VFRSH DQG DQ
Ϯϭϵ
LPSURSHU GRVDJH ZLOO OHDG WR LQHIIHFWLYH WUHDWPHQW RU EOHHGLQJ )OXFWXDWLRQV RI
ϮϮϬ
LQGLYLGXDOZDUIDULQGRVDJHVFDQLQIOXHQFHWKHVHYHULW\RI5+'LQJHQHWLFIDFWRUV$W
ϮϮϭ
SUHVHQW UHVHDUFKHV VKRZHG XVDJH RI ZDUIDULQ RQ VWDEOH GRVHV RQ 5+' FDXVLQJ
ϮϮϮ
&͕ ŝE͕>ŝĂŶ:͕ŚĂŽ^͕ŚĞŶŐ͕zĂŶŐy͕,ƵĂŶŐy͕^Śŝy͕^ƵŶ>͕ŚŽƵY͕^Śŝ,͕yƵ'͕/ŶĐŽŽŵ͕ƌĂŚŵĂĐŚĂƌŝs ĂŶĚ ^ĞŶŐƵƉƚĂ ^ ;ϮϬϬϴͿ ĞƚĞĐƚŝŽŶ ŽĨ ĂůƚĞƌĞĚ ŐůŽďĂů E ŵĞƚŚLJůĂƚŝŽŶ ŝŶ ĐŽƌŽŶĂƌLJ ĂƌƚĞƌLJ ĚŝƐĞĂƐĞ ƉĂƚŝĞŶƚƐ͘EĞůůŝŽůϮϳ;ϳͿ͗ϯϱϳͲϲϱ͘ĚŽŝ͗ϭϬ͘ϭϬϴϵͬĚŶĂ͘ϮϬϬϳ͘Ϭϲϵϰ͘ ϭϮ͘ sĂŶsůŝĞƚ:͕KĂƚĞƐEĂŶĚtŚŝƚĞůĂǁ;ϮϬϬϳͿƉŝŐĞŶĞƚŝĐŵĞĐŚĂŶŝƐŵƐŝŶƚŚĞĐŽŶƚĞdžƚŽĨĐŽŵƉůĞdž ĚŝƐĞĂƐĞƐ͘ĞůůDŽů>ŝĨĞ^Đŝϲϰ;ϭϮͿ͗ϭϱϯϭͲϴ͘ĚŽŝ͗ϭϬ͘ϭϬϬϳͬƐϬϬϬϭϴͲϬϬϳͲϲϱϮϲͲnj͘ ϭϯ͘ dƌĞŶŬŵĂŶŶD͕ƌŽĐŬD͕KƐƉĞůƚĂŶĚ'ĂLJ^;ϮϬϭϬͿƉŝŐĞŶĞƚŝĐƐŝŶƌŚĞƵŵĂƚŽŝĚĂƌƚŚƌŝƚŝƐ͘ůŝŶZĞǀ ůůĞƌŐLJ/ŵŵƵŶŽůϯϵ;ϭͿ͗ϭϬͲϵ͘ĚŽŝ͗ϭϬ͘ϭϬϬϳͬƐϭϮϬϭϲͲϬϬϵͲϴϭϲϲͲϲ͘ ϭϰ͘ EĞŝĚĞĐŬĞƌD͕WĂƚĞů͕EĞůƐŽŶttĂŶĚZĞĂƌĚŽŶ';ϮϬϭϮͿhƐĞŽĨǁĂƌĨĂƌŝŶŝŶůŽŶŐͲƚĞƌŵĐĂƌĞ͗ ƐLJƐƚĞŵĂƚŝĐƌĞǀŝĞǁ͘D'ĞƌŝĂƚƌϭϮ͗ϭϰ͘ĚŽŝ͗ϭϬ͘ϭϭϴϲͬϭϰϳϭͲϮϯϭϴͲϭϮͲϭϰ͘ ϭϱ͘ >ĞƌƚŬŝĂƚŵŽŶŐŬŽů W͕ ƐƐĂǁĂŵĂŬŝŶ ͕ tŚŝƚĞ '͕ ŚŽƉƌĂ '͕ ZŽŶŐŶŽƉĂƌƵƚ W͕ ^ĂŵƵĚƌĂůĂ Z ĂŶĚ dŽŶŐƐŝŵĂ^;ϮϬϭϯͿŝƐƚĂůĞĨĨĞĐƚŽĨĂŵŝŶŽĂĐŝĚƐƵďƐƚŝƚƵƚŝŽŶƐŝŶĐLJƉϮĐϵƉŽůLJŵŽƌƉŚŝĐǀĂƌŝĂŶƚƐĐĂƵƐĞƐ ĚŝĨĨĞƌĞŶĐĞƐ ŝŶ ŝŶƚĞƌĂƚŽŵŝĐ ŝŶƚĞƌĂĐƚŝŽŶƐ ĂŐĂŝŶƐƚ ;ƐͿͲǁĂƌĨĂƌŝŶ͘ W>Ž^ KŶĞ ϴ;ϵͿ͗ ĞϳϰϬϱϯ͘ ĚŽŝ͗ ϭϬ͘ϭϯϳϭͬũŽƵƌŶĂů͘ƉŽŶĞ͘ϬϬϳϰϬϱϯ͘ ϭϲ͘ ^ŚŝŬĂƚĂ͕/Ğŝƌŝ/͕/ƐŚŝŐƵƌŽ^͕dĂŬĂŶĞ,͕KŚŐŝ^ĂŶĚKƚƐƵďŽŝŚƵĂ,͕WĞŶŐ͕tĂŶͲ>ĞDĂŶĚzĂŶŐ'W;ϮϬϭϲͿ/ŶĨůƵĞŶĐĞŽĨĂƉŽĞ ŐĞŶĞ ƉŽůLJŵŽƌƉŚŝƐŵ ŽŶ ŝŶƚĞƌŝŶĚŝǀŝĚƵĂů ĂŶĚ ŝŶƚĞƌĞƚŚŶŝĐ ǁĂƌĨĂƌŝŶ ĚŽƐĂŐĞ ƌĞƋƵŝƌĞŵĞŶƚ͗ ƐLJƐƚĞŵĂƚŝĐƌĞǀŝĞǁĂŶĚŵĞƚĂĂŶĂůLJƐŝƐ͘ĂƌĚŝŽǀĂƐĐdŚĞƌ͘ĚŽŝ͗ϭϬ͘ϭϭϭϭͬϭϳϱϱͲϱϵϮϮ͘ϭϮϭϴϲ͘ ϭϴ͘ 'ŽůďĂƐLJ͕hĐĂƌK͕zƵŬƐĞů'͕'ƵůĞůK͕LJĚŽŐĚƵ^ĂŶĚhůƵƐŽLJs;ϮϬϬϰͿWůĂƐŵĂďƌĂŝŶŶĂƚƌŝƵƌĞƚŝĐ ƉĞƉƚŝĚĞ ůĞǀĞůƐ ŝŶ ƉĂƚŝĞŶƚƐ ǁŝƚŚ ƌŚĞƵŵĂƚŝĐ ŚĞĂƌƚ ĚŝƐĞĂƐĞ͘ Ƶƌ : ,ĞĂƌƚ &Ăŝů ϲ;ϲͿ͗ ϳϱϳͲϲϬ͘ ĚŽŝ͗ ϭϬ͘ϭϬϭϲͬũ͘ĞũŚĞĂƌƚ͘ϮϬϬϰ͘Ϭϰ͘Ϭϭϴ͘ ϭϵ͘ yƵ>͕ŚĞŶŐ͕tĂŶŐ>͕:ŝĂŶŐ͕>ŝƵ,͕yƵ>͕>ŝĂŽY͕ŚĂŶŐ>͕>ŝƵW͕^Śŝy͕tĂŶŐ͕^ƵŶ>͕ŚŽƵY͕>ŝ E͕,ƵĂŶŐz͕>Ğz͕zĞD͕^ŚĂŽ'ĂŶĚƵĂŶ^;ϮϬϭϰͿ'ĐŬŐĞŶĞͲďŽĚLJŚLJƉŽŵĞƚŚLJůĂƚŝŽŶŝƐĂƐƐŽĐŝĂƚĞĚ ǁŝƚŚƚŚĞƌŝƐŬŽĨĐŽƌŽŶĂƌLJŚĞĂƌƚĚŝƐĞĂƐĞ͘ŝŽŵĞĚZĞƐ/ŶƚϮϬϭϰ͗ϭϱϭϳϮϯ͘ĚŽŝ͗ϭϬ͘ϭϭϱϱͬϮϬϭϰͬϭϱϭϳϮϯ͘ ϮϬ͘ >ŝŵƐƵǁĂŶ͕ŚŽƵďƚƵŵ>ĂŶĚtĂƚƚĂŶĂƐŝƌŝĐŚĂŝŐŽŽŶ;ϮϬϭϯͿϱΖƵƚƌƌĞƉĞĂƚƉŽůLJŵŽƌƉŚŝƐŵƐŽĨƚŚĞ ďŵƉƌϮŐĞŶĞŝŶĐŚŝůĚƌĞŶǁŝƚŚƉƵůŵŽŶĂƌLJŚLJƉĞƌƚĞŶƐŝŽŶĂƐƐŽĐŝĂƚĞĚǁŝƚŚĐŽŶŐĞŶŝƚĂůŚĞĂƌƚĚŝƐĞĂƐĞ͘ ,ĞĂƌƚ>ƵŶŐŝƌĐϮϮ;ϯͿ͗ϮϬϰͲϭϬ͘ĚŽŝ͗ϭϬ͘ϭϬϭϲͬũ͘ŚůĐ͘ϮϬϭϮ͘Ϭϵ͘ϬϬϰ͘ Ϯϭ͘ ĂĐŚĂƌŝĂŚ:W͕ůŝŬƵd͕^ĐŚĞĞů͕,ĂƐĂŶ^͕>ǁĂďŝW͕^ĂďůĞĂŶĚĞĂƚŽŶ;ϮϬϭϲͿŵŝŶŽͲƚĞƌŵŝŶĂů ƉƌŽͲďƌĂŝŶŶĂƚƌŝƵƌĞƚŝĐƉĞƉƚŝĚĞŝŶĐŚŝůĚƌĞŶǁŝƚŚůĂƚĞŶƚƌŚĞƵŵĂƚŝĐŚĞĂƌƚĚŝƐĞĂƐĞ͘ŶŶWĞĚŝĂƚƌĂƌĚŝŽů ϵ;ϮͿ͗ϭϮϬͲϱ͘ĚŽŝ͗ϭϬ͘ϰϭϬϯͬϬϵϳϰͲϮϬϲϵ͘ϭϴϬϲϲϴ͘ ϮϮ͘ 'ŝĂŶŶŽŶŝ͕dĂŶŝ͕ůĞƌŝĐŽ͕WĂƐƐŝŶŽ͕dĂǀŽŶŝ͕ΖĂƐĐĂŶŝŽ͕ŽŵďĂƌĚŝĞƌŝ^ĂŶĚŵĚŝŶD;ϮϬϭϭͿ tŚĞŶ ƚŚĞ ŚĞĂƌƚ ŝƐ ďƵƌŶŝŶŐ͗ ŵŝŶŽͲƚĞƌŵŝŶĂů ƉƌŽͲďƌĂŝŶ ŶĂƚƌŝƵƌĞƚŝĐ ƉĞƉƚŝĚĞ ĂƐ ĂŶ ĞĂƌůLJ ŵĂƌŬĞƌ ŽĨ ĐĂƌĚŝĂĐ ŝŶǀŽůǀĞŵĞŶƚ ŝŶ ĂĐƚŝǀĞ ĂƵƚŽŝŵŵƵŶĞ ƌŚĞƵŵĂƚŝĐ ĚŝƐĞĂƐĞ͘ /Ŷƚ : ĂƌĚŝŽů ϭϰϴ;ϮͿ͗ ϭϲϭͲϳ͘ ĚŽŝ͗ ϭϬ͘ϭϬϭϲͬũ͘ŝũĐĂƌĚ͘ϮϬϬϵ͘ϭϬ͘Ϭϰϴ͘ Ϯϯ͘ ůŽŶĚĞͲLJŶŽďĞƌ&͕DŽƌŝŶĞĂƵ'͕ƐƚƌƵŐŽ͕&ŝůůŝĞ͕ƵƐƐĞůĂŶĚsŝŶĐĞŶƚ:W;ϮϬϭϭͿŝĂŐŶŽƐƚŝĐĂŶĚ ƉƌŽŐŶŽƐƚŝĐ ǀĂůƵĞ ŽĨ ďƌĂŝŶ ŶĂƚƌŝƵƌĞƚŝĐ ƉĞƉƚŝĚĞ ;ďŶƉͿ ĐŽŶĐĞŶƚƌĂƚŝŽŶƐ ŝŶ ǀĞƌLJ ĞůĚĞƌůLJ ŚĞĂƌƚ ĚŝƐĞĂƐĞ ƉĂƚŝĞŶƚƐ͗^ƉĞĐŝĨŝĐŐĞƌŝĂƚƌŝĐĐƵƚͲŽĨĨĂŶĚŝŵƉĂĐƚƐŽĨĂŐĞ͕ŐĞŶĚĞƌ͕ƌĞŶĂůĚLJƐĨƵŶĐƚŝŽŶ͕ĂŶĚŶƵƚƌŝƚŝŽŶĂů ƐƚĂƚƵƐ͘ƌĐŚ'ĞƌŽŶƚŽů'ĞƌŝĂƚƌϱϮ;ϭͿ͗ϭϬϲͲϭϬ͘ĚŽŝ͗ϭϬ͘ϭϬϭϲͬũ͘ĂƌĐŚŐĞƌ͘ϮϬϭϬ͘ϬϮ͘ϬϭϬ͘ Ϯϰ͘ 'ƵĞĂŶƚ ZŽĚƌŝŐƵĞnj ZD͕ ^ƉĂĚĂ Z͕ WŽŽLJĂ ^͕:ĞĂŶŶĞƐƐŽŶ ͕ DŽƌĞŶŽ 'ĂƌĐŝĂ D͕ ŶĞůůŽ '͕ ŽƐĐŽ W͕ ůŝĂD͕ZŽŵĂŶŽ͕ůďĞƌƚŽ:D͕:ƵŝůůŝĞƌĞzĂŶĚ'ƵĞĂŶƚ:>;ϮϬϭϯͿ,ŽŵŽĐLJƐƚĞŝŶĞƉƌĞĚŝĐƚƐŝŶĐƌĞĂƐĞĚ ŶƚͲƉƌŽͲďŶƉ ƚŚƌŽƵŐŚ ŝŵƉĂŝƌĞĚ ĨĂƚƚLJ ĂĐŝĚ ŽdžŝĚĂƚŝŽŶ͘ /Ŷƚ : ĂƌĚŝŽů ϭϲϳ;ϯͿ͗ ϳϲϴͲϳϱ͘ ĚŽŝ͗ ϭϬ͘ϭϬϭϲͬũ͘ŝũĐĂƌĚ͘ϮϬϭϮ͘Ϭϯ͘Ϭϰϳ͘
ϯϰϴ ϯϰϵ ϯϱϬ ϯϱϭ ϯϱϮ ϯϱϯ ϯϱϰ ϯϱϱ ϯϱϲ ϯϱϳ ϯϱϴ ϯϱϵ ϯϲϬ ϯϲϭ ϯϲϮ ϯϲϯ ϯϲϰ ϯϲϱ ϯϲϲ ϯϲϳ ϯϲϴ ϯϲϵ ϯϳϬ ϯϳϭ ϯϳϮ
Ϯϱ͘ WĂƌŬz,͕WĂƌŬ,:͕͕,ƵĂŶŐz͕>ŝƵ,͕yƵ>͕>ŝĂŽY͕>ŝƵW͕^Śŝy͕tĂŶŐ͕^ƵŶ>͕ŚŽƵY͕>ŝE͕yƵ>͕ >Ğ z͕ zĞ D͕ ^ŚĂŽ ' ĂŶĚ ƵĂŶ ^ ;ϮϬϭϯͿ ůĞǀĂƚĞĚ ƉůĂϮŐϳ ŐĞŶĞ ƉƌŽŵŽƚĞƌ ŵĞƚŚLJůĂƚŝŽŶ ĂƐ Ă ŐĞŶĚĞƌͲƐƉĞĐŝĨŝĐŵĂƌŬĞƌŽĨĂŐŝŶŐŝŶĐƌĞĂƐĞƐƚŚĞƌŝƐŬŽĨĐŽƌŽŶĂƌLJŚĞĂƌƚĚŝƐĞĂƐĞŝŶĨĞŵĂůĞƐ͘W>Ž^KŶĞ ϴ;ϯͿ͗ĞϱϵϳϱϮ͘ĚŽŝ͗ϭϬ͘ϭϯϳϭͬũŽƵƌŶĂů͘ƉŽŶĞ͘ϬϬϱϵϳϱϮ͘ Ϯϵ͘ DĂƌŐĂŐůŝŽŶĞ D͕ ŽůĂŝnjnjŽ ͕ ΖĂŶĚƌĞĂ '͕ ƌĂŶĐĂĐĐŝŽ s͕ ŝĂŵƉĂ ͕ 'ƌĂŶĚŽŶĞ ĂŶĚ ŝ DŝŶŶŽ ' ;ϮϬϬϬͿ'ĞŶĞƚŝĐŵŽĚƵůĂƚŝŽŶŽĨŽƌĂůĂŶƚŝĐŽĂŐƵůĂƚŝŽŶǁŝƚŚǁĂƌĨĂƌŝŶ͘dŚƌŽŵď,ĂĞŵŽƐƚϴϰ;ϱͿ͗ϳϳϱͲϴ ϯϬ͘ ΖĂŶĚƌĞĂ '͕ ΖĂŵďƌŽƐŝŽ Z>͕ ŝ WĞƌŶĂ W͕ ŚĞƚƚĂ D͕ ^ĂŶƚĂĐƌŽĐĞ Z͕ ƌĂŶĐĂĐĐŝŽ s͕ 'ƌĂŶĚŽŶĞ ĂŶĚ DĂƌŐĂŐůŝŽŶĞD ;ϮϬϬϱͿ ƉŽůLJŵŽƌƉŚŝƐŵ ŝŶ ƚŚĞ ǀŬŽƌĐϭ ŐĞŶĞ ŝƐ ĂƐƐŽĐŝĂƚĞĚ ǁŝƚŚ ĂŶŝŶƚĞƌŝŶĚŝǀŝĚƵĂů ǀĂƌŝĂďŝůŝƚLJ ŝŶ ƚŚĞ ĚŽƐĞͲĂŶƚŝĐŽĂŐƵůĂŶƚ ĞĨĨĞĐƚ ŽĨ ǁĂƌĨĂƌŝŶ͘ ůŽŽĚ ϭϬϱ;ϮͿ͗ ϲϰϱͲϵ͘ ĚŽŝ͗ ϭϬ͘ϭϭϴϮͬďůŽŽĚͲϮϬϬϰͲϬϲͲϮϭϭϭ͘ ϯϭ͘tĂŬĂŵŝLJĂd͕,ŽŬŽƐĂŬŝd͕dƐƵũŝŵŽƚŽ^/͕