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Levy JM, Duszak RL, Akins EW, Bakal CW, Denny DF, Martin LG, Van Moore A, Pentecost MJ, Roberts AC, Vogelzang RL, Kent KC, Perler BA, Resnick MI, Richie J, Becker G. Thrombolysis for lower extremity arterial and graft occlusions. American College of Radiology. ACR Appropriateness Criteria. Radiology 2000; 215 Suppl:1041-54. [PMID: 11037530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Van Moore A, Levy JM, Duszak RL, Akins EW, Bakal CW, Denny DF, Martin LG, Pentecost MJ, Roberts AC, Vogelzang RL, Kent KC, Perler BA, Resnick MI, Richie J, Dawson S. Percutaneous biliary drainage in malignant biliary obstruction. American College of Radiology. ACR Appropriateness Criteria. Radiology 2000; 215 Suppl:1055-66. [PMID: 11037531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Levy JM, Duszak RL, Akins EW, Bakal CW, Denny DF, Martin LG, Van Moore A, Pentecost MJ, Roberts AC, Vogelzang RL, Kent KC, Perler BA, Resnick MI, Richie J, Spies J. Inferior vena cava filter placement. American College of Radiology. ACR Appropriateness Criteria. Radiology 2000; 215 Suppl:981-97. [PMID: 11037526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Greenwald LM, Levy JM, Ingber MJ. Favorable selection in the Medicare+Choice program: new evidence. HEALTH CARE FINANCING REVIEW 2000; 21:127-34. [PMID: 11481751 PMCID: PMC4194679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Historically, studying the Medicare managed care favorable-selection issue has been difficult because direct data on managed care enrollees have been unavailable. In this study, we analyzed the first year of Balanced Budget Act (BBA)-mandated inpatient encounter data. Based on this comparison of actual managed care and fee-for-service (FFS) beneficiaries, it appears that there are significant differences between these populations. The most striking differences are found in the comparison of average risk factors, indicating a clear bias in the managed care populations toward beneficiaries predicted to be less costly.
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Greenwald LM, Esposito A, Ingber MJ, Levy JM. Risk Adjustment for the Medicare program: lessons learned from research and demonstrations. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 1998; 35:193-209. [PMID: 9719787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The Balanced Budget Act (BBA) of 1997 requires numerous changes in Medicare. Medicare's managed care program has been reinvented as "Medicare + Choice," offering an expanded range of delivery system options for beneficiaries and a schedule of payment changes that will dramatically affect managed care plans. Preceding some of these BBA-legislated changes to Medicare were years of research and demonstrations. Risk-adjusted payment in the Medicare + Choice program, which is mandated for implementation in 2000, is one example of a longstanding developmental initiative. This paper provides a brief overview of risk adjustment-related research and demonstration activities carried out by the Health Care Financing Administration (HCFA) since the 1980s, and describes a possible technical approach for the implementation of risk-adjusted Medicare managed care payments in 2000.
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Ardito M, Botuck S, Freeman SE, Levy JM. Delivering home-based case management to families with children with mental retardation and developmental disabilities. JOURNAL OF CASE MANAGEMENT 1997; 6:56-61. [PMID: 9335725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To meet the needs of individuals with mental retardation and developmental disabilities (MR/DD) and their families living in urban setting, a noncenter-based model of case management was implemented. In contrast to traditional case management in which families and consumers come to the case manager and most service coordination is done by telephone or in meetings at the case manager/social worker's worksite, the case manager in a noncenter-based model is mobile and able to meet the consumer and family in their domains. In this model, case management is provided in conjunction with in-home residential habilitation and funded by Medicaid under the Home and Community Based Services Waiver. This funding stream provides monies for nontraditional services delivered in noncertified settings. Case managers used the Family Resource Scale to get an immediate indication of the resources and needs of each family. The scale highlights the adequacy of a person's basic and caregiving resources, as well as financial needs. The findings from this study suggest that an understanding of both disability and entitlements is essential for case managers who may have to help advocate for consumers around services and benefits. Moreover, to build and maintain an egalitarian and supportive relationship with families, the importance of caregiver-specified resources and needs must be recognized by case managers. Access to resource information and the ability to engage the family in problem-solving depends on a well-trained staff with the ability to respond to individuals with different needs and from a variety of circumstances. These essential skills prepare a case manager to assist families with their immediate requirements as well as to mobilize them to plan for future needs.
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Levy JM, Dern TA, Botuck S, Altomonte JM. A new era of at-home health care services for private people with developmental disabilities. HEALTHCARE INFORMATION MANAGEMENT : JOURNAL OF THE HEALTHCARE INFORMATION AND MANAGEMENT SYSTEMS SOCIETY OF THE AMERICAN HOSPITAL ASSOCIATION 1997; 10:49-56. [PMID: 10157648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Levy JM. Pharmaceuticals: FDA labeling time line. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 1997; 25:75-76. [PMID: 11066483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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34
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Bauer J, Johnson RF, Levy JM, Pojman DV, Ruge JR. Tuberculoma presenting as an en plaque meningioma. Case report. J Neurosurg 1996; 85:685-8. [PMID: 8814176 DOI: 10.3171/jns.1996.85.4.0685] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Intracranial tuberculomas generally present as either solitary or multiple lesions in the brain parenchyma. They are characterized by a ring-enhancing area on either computerized tomography scans or magnetic resonance images. A case is presented in which an intracranial tuberculoma was dural based and had an appearance similar to an en plaque meningioma.
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Botuck S, Levy JM, Rimmerman A. Gender-related differences in placement rates of young adults with mental retardation and severe learning disabilities. Int J Rehabil Res 1996; 19:259-63. [PMID: 8910128 DOI: 10.1097/00004356-199609000-00007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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36
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Levy JM, Jessop DJ, Rimmerman A, Levy PH. Employers' attitudes towards persons with disabilities: a comparison of national and New York State data. Int J Rehabil Res 1995; 18:103-14. [PMID: 7665254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This paper compares the results of two large-scale studies conducted as part of an ongoing research programme on employers' attitudes towards the employability of persons with severe disabilities--a study of Fortune 500 corporations and a study of employers doing business in New York State. The results indicated that both groups of employers were favourable towards the employability of persons with disabilities. Executives from large national corporations were more favourable than those from the predominantly small companies doing business in New York State. Prior contact with persons with disabilities that was positively evaluated appeared to differentiate those more and less favourable in both study groups, especially in the smaller companies of the New York State study group. Employers' characteristics associated with differences in attitudes in the literature (e.g. education, work experience) also appeared to be confirmed by data from New York State companies more than from the corporations of the Fortune 500.
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Levy JM. Article 81 and the dentist. THE NEW YORK STATE DENTAL JOURNAL 1994; 60:67-70. [PMID: 7808721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Levy JM, Botuck S, Levy PH, Kramer ME, Murphy BS, Rimmerman A. Differences in job placements between men and women with mental retardation. Disabil Rehabil 1994; 16:53-7. [PMID: 8043884 DOI: 10.3109/09638289409166012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Thirty-three men and women with mental retardation living in the New York metropolitan area (USA), who entered a supported employment programme were followed during their first 9 months in competitive employment. Differences in placement outcomes were consistently associated with gender differences. The implications of these findings are discussed in terms of providing employment services to men and women with mental retardation and developmental disabilities.
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Augé B, Satgé D, Sauvage P, Lutz P, Chenard MP, Levy JM. [Retroperitoneal teratomas in the perinatal period. Review of the literature concerning a neonatal, immature, aggressive teratoma]. ANNALES DE PEDIATRIE 1993; 40:613-21. [PMID: 8129332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A neonate with an immature, poorly demarcated retroperitoneal teratoma invading the aorta-vena cava space died immediately after surgery. Among 34 cases of retroperitoneal teratoma discovered during the first postnatal month, including one renal case and ours, eight can be considered malignant on the basis of histology in two cases and clinical course in six. Five of these tumors exhibited a significant immature component. In neonates, the proportion of malignant teratomas is greater for retroperitoneal tumors than for other sites: sacrum and coccyx, heart, neck, mediastinum, and abdomen. Evaluation of chemotherapy in teratomas with significant immature components is difficult because few of the patients of this small sample received such treatment. As in other sites, regardless of the degree of maturity, exeresis must be as complete as possible.
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Levy JM. C-arm film changers add diagnostic flexibility. DIAGNOSTIC IMAGING 1993; 15:86, 95. [PMID: 10146351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Levy JM, Borowitz M, McNeill S, London WJ, Savord G. Understanding the Medicare Fee Schedule and its impact on physicians under the final rule. Med Care 1992; 30:NS80-94. [PMID: 1434969 DOI: 10.1097/00005650-199211001-00007] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
On January 1, 1992, the Medicare program unveiled a new method for paying physicians known as the Medicare Fee Schedule (MFS). The new fee schedule is a complex system of administrative pricing based on the resource inputs used in producing physician services. The MFS consists of three parts: 1) a Relative Value Scale, which assigns to each medical service a value relative to all other services; 2) a conversion factor, which converts the relative values into dollars; and 3) a geographic adjustment factor, which adjusts payments based on geographic differences in the cost of producing physician services. In this article, the following are addressed: how the relative values were determined; how the geographic adjustment factor was constructed; and how the conversion factor was calculated. In addition, balance billing limits and the Medicare Volume Performance Standards (MVPS) are described. Computer simulations of the impact of the MFS on payments to physicians are presented. The authors found that the MFS will 1) redistribute payments away from surgeons, radiologists, and other procedure-based specialties toward the primary care specialties; 2) redistribute payments away from urban areas toward rural areas; and 3) redistribute payments away from invasive procedures and diagnostic tests toward evaluation and management services. The authors conclude with a discussion of the future refinements of the MFS, its applicability to other payers, and whether it will accomplish its intended purposes.
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Lutz P, Gallais C, Albert A, Falkenrodt A, Cazenave JP, Levy JM. Use of intravenous immunoglobulins (IVIg) to treat a child with pancytopenia and hypoplastic marrow. Ann Hematol 1992; 65:199-200. [PMID: 1420509 DOI: 10.1007/bf01703116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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43
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Abstract
On January 1, 1992, the Medicare program unveiled a new method for paying physicians known as the Medicare Fee Schedule (MFS). The new fee schedule is a complex system of administrative pricing based on the resource inputs used in producing physician services. The MFS consists of three parts: (1) a Relative Value Scale (RVS) which assigns to each medical service a value relative to all other services; (2) a Conversion Factor (CF) which converts the relative values into dollars; and (3) a Geographic Adjustment Factor (GAF) which adjusts payments based on geographic differences in the cost of producing physician services. In the paper we explain: how the relative values were determined; how the GAF was constructed; and how the CF was calculated. In addition, we explain balancing billing limits and the Medicare Volume Performance Standards (MVPS). We then present computer simulations of the impact of the MFS on payments to physicians. We find that the MFS will: (1) redistribute payments away from surgeons, radiologists, and other procedure-based specialties toward the primary care specialties, (2) redistribute payment away from urban areas toward rural areas, (3) redistribute payments away from invasive procedures and diagnostic tests toward evaluation and management services. We conclude with a discussion of the future refinements of the MFS, its applicability to other payors, and whether it will accomplish its intended purposes.
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Botuck S, Levy JM, Kramer ME, Levy PH, Rimmerman A. A one year follow-up of urban young adults with mental retardation in supported employment. Int J Rehabil Res 1992; 15:103-14. [PMID: 1526699 DOI: 10.1097/00004356-199206000-00002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There is little information available about the provision of supported employment services for individuals from diverse cultural, ethnic and economic backgrounds. To fill this gap, in relation to the specific experiences of urban youth with mental retardation, we initiated an agency based longitudinal study of our employment training programmes. Data from the first year follow up of 45 young adults with mental retardation is presented. Information regarding all phases of the job training and job placement process was examined. The major findings are that 71% of the trainees were employed during the first nine months post-training, with approximately 30% of the trainees working for six months or more. Overall, 75% of the trainees' placements were in service industries and the amount of direct support the trainees required decreased over time. Additional findings and their implications for programme development are discussed in relation to the unique needs of urban young adults with developmental disabilities.
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Rao PS, Wilson AD, Levy JM, Gupta VK, Chopra PS. Role of "buttoned" double-disc device in the management of atrial septal defects. Am Heart J 1992; 123:191-200. [PMID: 1729825 DOI: 10.1016/0002-8703(92)90765-n] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sixteen patients seen over a 9-month period ending in August 1990 were offered transcatheter closure of their ASD with a custom-made "buttoned" double-disc device. The study was approved by the Institutional Review Board and informed consent was obtained in each case. The device consists of an occluder, a counteroccluder, and a loading wire and is delivered to the ASD site via an 8F sheath. Parents of two children elected surgical closure. In five children the stretched diameter of the ASD was too large (greater than 20 mm) and transcatheter closure was not attempted. These seven children underwent elective surgical closure without incident. In one child the defect measured 5 mm and the Qp:Qs was 1.4:1 and therefore ASD closure was not recommended. In the remaining eight children transcatheter closure was attempted. In two of the children the occluder pulled through the ASD and was successfully retrieved and the children later underwent uneventful elective surgical closure. The device was implanted across the ASD in six children. In one child the device dislodged from the ASD site within minutes after implantation and the child was sent to emergency surgery, where the device was removed and the ASD was closed. In the remaining five patients, aged 7 months to 45 years (weight 3.6 to 50 kg), with a Qp:Qs range of 1.3 to 2.3 and a stretched diameter of 10 to 19 mm, the ASD closure was successful with 25 to 40 mm size devices. Repeat echo-Doppler studies 2 weeks and 3 months after the procedure in all patients and 6 months later in two children did not reveal any residual shunt. It is concluded that (1) the custom-made "buttoned" double-disc device can be implanted across the ASD safely and effectively via an 8F sheath, thus making transcatheter ASD closure feasible even in very young infants; (2) measurement of stretched diameter of the ASD in the catheterization laboratory is a useful guide for selection of an appropriate-sized device; and (3) additional clinical trials are warranted to confirm the efficacy and safety of the device.
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Levy JM, Jessop DJ, Rimmerman A, Levy PH. Employment of persons with severe disabilities in large businesses in the United States. Int J Rehabil Res 1991; 14:323-32. [PMID: 1838362 DOI: 10.1097/00004356-199112000-00005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A mail survey of the largest businesses in the US, the Fortune 500 industrial and service corporations, examined the attitudes of personnel and human resource executives towards the employability of persons with severe disabilities and actual corporate practices regarding the employment of persons with disabilities. The 341 executives who responded are found to be favourable to the employment of persons with disabilities, especially if the executives work in corporations that have hired persons with disabilities within the past three years, and/or have had personally good contact with persons with disabilities in the past. Almost two-thirds of the corporations have a policy regarding hiring persons with disabilities; over one-half have hired such persons within the past three years; and over one-third have supported work programmes.
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Lutz P, Lehmann C, Veillon F, Moises A, Chaigne D, Flamant F, Levy JM. [Iconographic rubric: ORL non Hodgkin's lymphoma disclosed by bilateral blindness and anterior hypopituitarism]. ARCHIVES FRANCAISES DE PEDIATRIE 1991; 48:567-8. [PMID: 1768197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Abstract
Clinical, echo-Doppler, and pathologic data of a rare case of tricuspid atresia in association with truncus arteriosus are presented. There are only six patients (including the patient reported here) with this anomaly in whom detailed pathologic and/or clinical descriptions are available in the literature. An additional six cases were mentioned in the literature but without any details. A prevalence rate of 1.4% among tricuspid atresia cases is estimated. All infants presented with symptoms of cyanosis and/or congestive heart failure within a few days to 2 months after birth and died shortly thereafter. Cardiomegaly and increased pulmonary vascular markings on the chest x-ray film and left axis deviation with left ventricular hypertrophy on the ECG are usually present. Echocardiographic, catheterization, and angiocardiographic studies are helpful in documenting anatomic and physiologic features of this anomaly. Pathologically, the muscular type of tricuspid atresia, type I or II truncus arteriosus, a large subtruncal VSD, and a hypoplastic right ventricle are present. It is concluded that coexistence of tricuspid atresia and truncus arteriosus is rare; clinical, laboratory, and pathologic features are distinctive; the clinical presentation early in life with rapid demise is common; and prompt palliative surgery immediately after recognition of this anomaly should be undertaken.
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Aslamy W, Danielson K, Hessel SJ, Levy JM. A 3-year-old boy with neck pain after motor-vehicle accident. Pseudospread of the atlas. West J Med 1991; 155:301-2. [PMID: 1949791 PMCID: PMC1003000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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50
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Lutz P, Chaigne D, Levy JM. Isolated intention tremor: a sign of metastatic neuroblastoma. Eur J Pediatr 1991; 150:686-7. [PMID: 1915528 DOI: 10.1007/bf02072638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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