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The Department of Medical Informatics & Clinical Epidemiology (DMICE) is one of 27 academic departments in the School of Medicine at Oregon Health & Science University (OHSU). The mission of DMICE is to provide leadership, discovery and dissemination of knowledge in clinical informatics, clinical epidemiology, and bioinformatics / computation biology. This mission is fulfilled through programs of research, education, and service. DMICE programs are recognized internationally for their accomplishment and innovation. The OHSU Biomedical Informatics program is one of the largest of its kind in the world.  
 
The Department of Medical Informatics & Clinical Epidemiology (DMICE) is one of 27 academic departments in the School of Medicine at Oregon Health & Science University (OHSU). The mission of DMICE is to provide leadership, discovery and dissemination of knowledge in clinical informatics, clinical epidemiology, and bioinformatics / computation biology. This mission is fulfilled through programs of research, education, and service. DMICE programs are recognized internationally for their accomplishment and innovation. The OHSU Biomedical Informatics program is one of the largest of its kind in the world.  
  
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Clinfowiki is edited by [http://www.ohsu.edu/xd/education/schools/school-of-medicine/departments/clinical-departments/dmice/people/vishnu-mohan.cfm Vishnu Mohan, M.D., M.B.I.], and was created in 2005 by [http://www.uthouston.edu/sbmi/faculty-and-staff/dean-sittig.htm Dean F. Sittig, Ph.D.].
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Clinfowiki is edited by [https://www.ohsu.edu/people/vishnu-mohan/2BD88C7AE00A4A21861DFB0964974984 Vishnu Mohan, M.D., M.B.I.], and was created in 2005 by [https://en.wikipedia.org/wiki/Dean_F._Sittig Dean F. Sittig, Ph.D.].
  
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To begin a new article, or edit an existing article, you must first create an account and login to the ClinfoWiki. The site can be browsed by anyone.
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The site can be browsed by anyone.  To begin a new article, or edit an existing article, you must first create an account and login to the ClinfoWiki. The easiest way to create a new page is to edit an existing page where you want your article to link from, and then place your page's name within double square brackets, like so: <nowiki> [[Your page name here]] </nowiki> If you then save the page and click on that link, you will be taken to a screen with a box where you can begin to write your content.
  
 
[[Special:ActiveUsers|We]] are currently working on [[Special:Statistics|{{NUMBEROFARTICLES}}]] articles, and we '''[[Clinfowiki To Do|need your help]]''' to complete this study of Informatics. See [[Special:Statistics]] for more complete information on the site.
 
[[Special:ActiveUsers|We]] are currently working on [[Special:Statistics|{{NUMBEROFARTICLES}}]] articles, and we '''[[Clinfowiki To Do|need your help]]''' to complete this study of Informatics. See [[Special:Statistics]] for more complete information on the site.
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* [[EHR | What is the Electronic Medical Record]]
 
* [[EHR | What is the Electronic Medical Record]]
 
* [[EMR v. EHR]]
 
* [[EMR v. EHR]]
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* [[Interface Design of the EHR]]
 
* [[EHR-enabled Research]]
 
* [[EHR-enabled Research]]
 
* [[Security of the distributed electronic patient record: a case-based approach to identifying policy issues]]
 
* [[Security of the distributed electronic patient record: a case-based approach to identifying policy issues]]
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* [[Purpose of EMRs]]
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* [[Registries]]
  
 
==[[:Category: CPOE | Computerized Physician Order Entry (CPOE)]]==
 
==[[:Category: CPOE | Computerized Physician Order Entry (CPOE)]]==
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* [[Barcode medication administration]]
 
* [[Barcode medication administration]]
 
* [[E-prescribing | Electronic Prescribing (E-prescribing)]]
 
* [[E-prescribing | Electronic Prescribing (E-prescribing)]]
 +
* [[Medication Errors]]
  
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==[[:Category: CDS | Clinical Decisions Support (CDS)]]==
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==[[:Category: CDS | Clinical Decision Support (CDS)]]==
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* [[CDS | Clinical Decisions Support]]
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* [[CDS | Clinical Decision Support]]
 
* [[Timeline of the Development of Clinical Decision Support]]
 
* [[Timeline of the Development of Clinical Decision Support]]
 
* [[The Evolution of Clinical Decision Support]]
 
* [[The Evolution of Clinical Decision Support]]
 
* [[Decision Support Service]]
 
* [[Decision Support Service]]
 
* [[Effect of Computerized Clinical Decision Support on the Use and Yield of CT Pulmonary Angiography in the Emergency Department]]
 
* [[Effect of Computerized Clinical Decision Support on the Use and Yield of CT Pulmonary Angiography in the Emergency Department]]
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* [[Automated Clinical Decision Support (CDS) using Pattern Recognition/Temporal Relationships]]
  
 
==[[:Category: PHR | Personal Health Record (PHR)]]==
 
==[[:Category: PHR | Personal Health Record (PHR)]]==
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* [[i2b2 Informatics for Integrating Biology and the Bedside]]
 
* [[i2b2 Informatics for Integrating Biology and the Bedside]]
 
*  [[The Cloud and it's impact on Health IT]]
 
*  [[The Cloud and it's impact on Health IT]]
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* [[Teleconcussion - An Emerging Sports Concussion Management Model]]
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* [[The Blockchain in Healthcare]]
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* [[Robot Anesthesia]]
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* [[American College of Emergency Physicians:  InnovatED]]
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* [[Software-Guided insulin therapy]]
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* [[L1000 assay and the Connectivity Map dataset]]
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* [[5G and Healthcare]]
  
 
=[[:Category:Applications | Applications]]=
 
=[[:Category:Applications | Applications]]=
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==[[:Category:Evidence Based Medicine (EBM) | Evidence Based Medicine (EBM)]]==
 
==[[:Category:Evidence Based Medicine (EBM) | Evidence Based Medicine (EBM)]]==
 
* [[EBM | Evidence Based Medicine]]
 
* [[EBM | Evidence Based Medicine]]
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* [[Hierarchy of Evidence]]
 
*  Rationale, design,and implementation protocol of an electronic health record integrated clinical prediction rule (iCPR) randomized trial in primary care
 
*  Rationale, design,and implementation protocol of an electronic health record integrated clinical prediction rule (iCPR) randomized trial in primary care
 
* [[Efficacy of an Evidence-Based Clinical Decision Support in Primary Care Practices A Randomized Clinical Trial]]
 
* [[Efficacy of an Evidence-Based Clinical Decision Support in Primary Care Practices A Randomized Clinical Trial]]
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==[[:Category:Methodologies and Frameworks | Methodologies and Frameworks]]==
 
==[[:Category:Methodologies and Frameworks | Methodologies and Frameworks]]==
 
* [[Evaluation and Design Methodologies]]
 
* [[Evaluation and Design Methodologies]]
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* [[EHR Data Quality]]
 
* [[The Journey through Grief: Insights from a Qualitative Study of Electronic Health Record Implementation]]
 
* [[The Journey through Grief: Insights from a Qualitative Study of Electronic Health Record Implementation]]
 
* [[Sociotechnical systems]]
 
* [[Sociotechnical systems]]
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* [[Data Center Planning and Design Overview for Healthcare Organizations]]
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* [[EHR Participatory Deployment Vs Black box Deployment methods]]
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* [[Real-time automatic polyp detection system for colonoscopy using artificial intelligence]]
  
 
==[[:Category:Government, Public and Private Initiatives | Government, Public and Private Initiatives]]==
 
==[[:Category:Government, Public and Private Initiatives | Government, Public and Private Initiatives]]==
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* [[Assistant Secretary for Planning & Evaluation]]  
 
* [[Assistant Secretary for Planning & Evaluation]]  
 
* [[Office of the National Coordinator for Health Information Technology (ONC)]]  
 
* [[Office of the National Coordinator for Health Information Technology (ONC)]]  
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* [[Trusted Exchange Framework and Common Agreement (TEFCA)]]
 
* [[Council on the Application of Health Information Technology (CAHIT)]]  
 
* [[Council on the Application of Health Information Technology (CAHIT)]]  
 
* [[Agency for Healthcare Research and Quality (AHRQ)]]  
 
* [[Agency for Healthcare Research and Quality (AHRQ)]]  
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* [[Electronic Laboratory Reporting]]
 
* [[Electronic Laboratory Reporting]]
 
* [[Department of Education]]
 
* [[Department of Education]]
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* [[PMI | Precision Medicine Initiative (PMI)]]
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* [[Health Information and Management Systems Society (HIMSS)]]
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* [[Society for Participatory Medicine]]
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* [[Veteran’s Affairs Switch from VistA based Electronic Health Record to Cerner Millennium]]
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* [[Singapore NEHR]]
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* [[ORCATECH | Oregon Center for Aging and Technology (ORCATECH)]]
  
 
==[[:Category:Training and User Support | Training and User Support]]==
 
==[[:Category:Training and User Support | Training and User Support]]==
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* [[Learning Health Systems (LHS)]]
  
 
==[[:Category:Terminology and Coding | Terminology and Coding]]==
 
==[[:Category:Terminology and Coding | Terminology and Coding]]==
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*  [[Unified Medical Language System | Unified Medical Language System (UMLS)]]
 
*  [[Unified Medical Language System | Unified Medical Language System (UMLS)]]
 
*  [[Aggregated data]]
 
*  [[Aggregated data]]
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==[[:Category:Business and Organization | Business and Organization]]==
 
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* [[Medicare advantage]]
 
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Medicare Advantage
 
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'''History of Medicare:'''
 
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Original medicare is a fee for service program where the government pays health care providers directly for Part A (inpatient services) and Part B (outpatient) benefits.  It was established in 1966 to address the medical needs of Americans over age 65.  It also provides health insurance to younger individuals with disabilities.
 
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Medicare Advantage, or Part C benefits, are offered by private companies approved by Medicare.  Medicare plans administered by private companies have been around since the 1970’s, Medicare Advantage was formalized in 2003 through the Medicare Modernization Act.
 
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'''Segmental payment through 4 different programs:'''
 
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Medicare Part A is an entitlement, which means that those who are eligible do not have to pay for it.  This covers inpatient services at hospitals, nursing homes, home health and hospice care.
 
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Medicare Part B is not an entitlement, which means those that are eligible must pay for it.  Average premium is $100/ per month.  The premium covers outpatient services such as doctor’s visits, durable medical equipment, physical therapy and mental health.
 
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Medicare Part C (Medicare Advantage) covers both inpatient and outpatient services (C=A+B). 
 
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Medicare Part D, which is prescription drug coverage, is usually included in Part C programs.  This was established in 2003, also as a result of the Medicare Modernization Act.
 
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'''Payment structure of Original Medicare and Medicare Advantage:'''
 
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Both Original Medicare and Medicare Advantage will contract with approved medical providers.  These are medical doctors, osteopathic doctors, nurse practitioners and physician assistants.  The way providers are paid differ between the two programs.  Original Medicare is fee for service - each individual office visit must stand on its own and have supporting documentation in the medical record for that specific visit.
 
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Medicare Advantage pays on a risk adjustment basis.  This means more medically complex patients are paid higher premiums.  To collect payment on a diagnosis - for example diabetes - the patient must be seen at least one time a year.  It must be a face to face visit with one of the four types of providers listed above. 
 
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The Center for Medicare and Medicaid Services (CMS) has three risk adjustment structures for Medicare Advantage.  All three share a common basic approach of assigning a risk score.  The risk score represents the expected cost of the patient normalized to the expected average cost for the population.
 
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Part C will assign a “risk score” for chronic diseases such as diabetes, heart disease, HIV infection.  Acute catastrophic events such as a heart attacks, strokes or fractures are also assigned risk scores.
 
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End stage renal disease will pay for dialysis, kidney transplant and post transplant care.
 
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Prescription drug coverage.
 
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Reimbursement rates are set by the federal government on a county-by-county basis using formulas established by CMS. The reimbursement rate is linked to the average cost of caring for Medicare beneficiaries who are enrolled in Part A and Part B in the county. The government has estimated that the typical Medicare Advantage plan collects 12-14 percent more for each member than the cost of caring for a person enrolled in traditional Medicare.
 
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−
 
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'''Role of Electronic Health Records:'''
 
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Many EHR programs can be linked into Medicare formularies.  This will avoid searching in a separate source on whether a particular drug is covered.  It will also help patients avoid paying more for a non-formulary medications.
 
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Medicare patients tend to be older than that of the general population, thus there are more recommend preventative measures.  Examples include colon cancer screening, mammography, blood pressure check, vaccines, cholesterol and diabetes testing.  A structured data entry system based on recommendations from the US Preventive Services Task Force can give providers and patients guidance on timely best practice.
 
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Of particular challenge for providers who accept Medicare Advantage patients is collecting at a rate that is reflective of medical complexity.  Computerized patient support tools have been designed to capture chronic diagnosis.  To use the diabetes example above, the support tools are integrated into electronic health records such that all visits which address diabetes are flagged for billing.  At audit only one occurrence per year is needed to justify payment, the single best record to justify diabetes risk adjustment is sent.  A robust support tool will also send reminders to patients for chronic condition follow up.
 
−
 
−
 
−
'''References:'''
 
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Medicare.gov
 
−
 
−
Yvonne Zhou, James Wang, Marianne Turley.  Impact of Panel Support Tool Use on Quality Outcomes.  Kaiser Permanent Northwest. July 2008
 
−
 
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Medicarenewsgroup.com
 
  
 
==[[:Category:Workflow | Workflow]]==
 
==[[:Category:Workflow | Workflow]]==
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*  [[Software Test Documentation]]
 
*  [[Software Test Documentation]]
 
* [[Data Model to Enhance the Security and Privacy of Healthcare Data]]
 
* [[Data Model to Enhance the Security and Privacy of Healthcare Data]]
 +
 +
==[[:Category:Data Visualization | Data Visualization]]==
 +
* [[Clinically Relevant Data Visualization]]
  
 
=[[:Category:Reference | Reference]]=
 
=[[:Category:Reference | Reference]]=
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* [[Endowed Professorships | Endowed Professorships and Chairs in Health / Medical / Nursing / Biomedical Informatics]]
 
* [[Endowed Professorships | Endowed Professorships and Chairs in Health / Medical / Nursing / Biomedical Informatics]]
 
* [[Graduate Medical Education Milestones]]
 
* [[Graduate Medical Education Milestones]]
 +
* [[List of Clinical Informatics Conferences]]
  
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==[[:Category:Specialites and Disciplines | Specialites and Disciplines]]==
+
==[[:Category:Specialties and Disciplines | Specialties and Disciplines]]==
−
* [[Medical Subspecialty Board of Clinical Informatics]]
+
* [[Bioinformatics]]
 +
* [[Chief Nursing Informatics Officer]]
 
* [[Clinical Informatics Fellowship]]
 
* [[Clinical Informatics Fellowship]]
 +
* [[Clinical research informatics]]
 +
* [[Clinical Social Work Informatics]]
 +
* [[Cognitive Informatics]]
 +
* [[Consumer health informatics]]
 +
* [[Dental informatics]]
 
* [[Health informatics]]
 
* [[Health informatics]]
 +
* [[Imaging informatics]]
 +
* [[Medical laboratory informatics]]
 +
* [[Medical Subspecialty Board of Clinical Informatics]]
 +
* [[Mental health informatics]]
 +
* [[Neuroinformatics]]
 
* [[Nursing informatics]]
 
* [[Nursing informatics]]
−
* [[Imaging informatics]]
+
* [[Pediatric Informatics]]
−
* [[Consumer health informatics]]
+
* [[Pharmacy Informatics]]
 
* [[Public Health Informatics]]
 
* [[Public Health Informatics]]
−
* [[Dental informatics]]
 
−
* [[Medical laboratory informatics]]
 
 
* [[Quality Informatics]]
 
* [[Quality Informatics]]
−
* [[Bioinformatics]]
+
* [[Traditional Chinese Medicine (TCM) informatics]]
 
* [[Translational Bioinformatics]]
 
* [[Translational Bioinformatics]]
−
* [[Clinical Social Work Informatics]]
+
* [[Ethics in Informatics]]
−
* [[Pharmacy Informatics]]
+
−
* [[Clinical research informatics]]
+
−
* [[Traditional Chinese Medicine (TCM) informatics]]
+
  
 
==[[:Category:Research Groups | Research Groups]]==
 
==[[:Category:Research Groups | Research Groups]]==

Latest revision as of 13:46, 26 April 2022

Welcome to the OHSU Clinfowiki

The OHSU Clinical Informatics Wiki (aka ClinfoWiki) is the implementation of a wiki website devoted to topics in Biomedical Informatics.

The Department of Medical Informatics & Clinical Epidemiology (DMICE) is one of 27 academic departments in the School of Medicine at Oregon Health & Science University (OHSU). The mission of DMICE is to provide leadership, discovery and dissemination of knowledge in clinical informatics, clinical epidemiology, and bioinformatics / computation biology. This mission is fulfilled through programs of research, education, and service. DMICE programs are recognized internationally for their accomplishment and innovation. The OHSU Biomedical Informatics program is one of the largest of its kind in the world.

Clinfowiki is edited by Vishnu Mohan, M.D., M.B.I., and was created in 2005 by Dean F. Sittig, Ph.D..

The site can be browsed by anyone. To begin a new article, or edit an existing article, you must first create an account and login to the ClinfoWiki. The easiest way to create a new page is to edit an existing page where you want your article to link from, and then place your page's name within double square brackets, like so: [[Your page name here]] If you then save the page and click on that link, you will be taken to a screen with a box where you can begin to write your content.

We are currently working on 1,581 articles, and we need your help to complete this study of Informatics. See Special:Statistics for more complete information on the site.

The Clinfowiki has recently been reorganized into the 20 categories below. When adding (or editing) content, please try to ensure the content traces back to one of these categories.


Technologies

Electronic Medical Record (EMR)

Computerized Physician Order Entry (CPOE)

Clinical Decision Support (CDS)

Personal Health Record (PHR)

Reviews of scientific papers

Integrated Data Repositories (IDR)

Ancillary Systems

Medical Devices

Information Retrieval

Other Technologies

Applications

Evidence Based Medicine (EBM)

Methodologies and Frameworks

Government, Public and Private Initiatives

Training and User Support

Terminology and Coding

Workflow

Interface, Usability and Accessibility

Data Visualization

Reference

Academics and Education

Specialties and Disciplines

Research Groups

Literature

External Links

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