Dr. Liana Bruce, PhD, MSPH, BA - Campbell University, Lundy-Fetterman School of Business - Adjunct Professor

Dr. Liana Bruce

PhD, MSPH, BA

Campbell University, Lundy-Fetterman School of Business

Adjunct Professor

Buies Creek, North Carolina | United States

Main Specialties: Epidemiology, Internal Medicine, Oncology, Pain Medicine, Public Health, Statistics

ORCID logohttps://orcid.org/0000-0003-1221-2441


Top Author

Dr. Liana Bruce, PhD, MSPH, BA - Campbell University, Lundy-Fetterman School of Business - Adjunct Professor

Dr. Liana Bruce

PhD, MSPH, BA

Introduction

Dr. Bruce is a Senior Data Insights Analyst at Blue Cross Blue Shield of North Carolina, Co-Editor in Chief of the journal Patient Related Outcome Measures (Dove Medical Press, Ltd, part of Taylor & Francis Group), and Visiting Professor of Health Sciences at Campbell University Lundy-Fetterman School of Business. Research interests include longitudinal psychological and clinical health outcomes, veterans’ and military health, scale development in pain and social functioning, and risk/outcomes.

Primary Affiliation: Campbell University, Lundy-Fetterman School of Business - Buies Creek, North Carolina , United States

Specialties:

Research Interests:

Education

May 2006
University of North Carolina at Chapel Hill
PhD
Epidemiology

Experience

May 2014
https://clinicaltrials.gov/ct2/show/NCT00954564
Principal Investigator
Funded by American Cancer Society
Jan 2018
Campbell University
Adjunct Professor
Lundy-Fetterman School of Business
Sep 2016
Cigna Corp
Business Communication Senior Specialist

Publications

30Publications

2036Reads

1016Profile Views

487PubMed Central Citations

Loneliness in the United States: A 2018 National Panel Survey of Demographic, Structural, Cognitive, and Behavioral Characteristics.

Am J Health Promot 2019 11 16;33(8):1123-1133. Epub 2019 Jun 16.

Cigna Health and Life Insurance Company, Clinical Performance & Quality, Glendale, CA, USA.

Purpose: To inform health behavior intervention design, we sought to quantify loneliness and its correlates, including social media use, among adults in the United States.

Design: Cross-sectional research panel questionnaire.

Setting: Responses were gathered from individuals in all 50 states surveyed via Internet from February 2018 to March 2018.

Participants: A total of 20 096 US panel respondents aged 18+.

Measures: The University of California at Los Angeles (UCLA) Loneliness Scale (theoretical score range = 20-80) was administered along with demographic, structural, cognitive, and behavioral items.

Analysis: After calibrating the sample to population norms, we conducted multivariable linear regression analysis.

Results: The overall mean survey-weighted loneliness score was 44.03 (standard error = 0.09). Social support (standardized ? [s?] = -0.19) and meaningful daily interactions (s? = -0.14) had the strongest associations with lower loneliness, along with reporting good relationships, family life, physical and mental health, friendships, greater age, being in a couple, and balancing one's daily time. Social anxiety was most strongly associated with greater loneliness (s? = +0.20), followed by self-reported social media overuse (s? = +0.05) and daily use of text-based social media (s? = +0.03).

Conclusion: Our findings confirm that loneliness decreases with age, and that being in a relationship as well as everyday behavioral factors in people's control are most strongly related to loneliness. Population health promotion efforts to reduce loneliness should focus on improving social support, decreasing social anxiety, and promoting healthy daily behaviors.

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http://dx.doi.org/10.1177/0890117119856551DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323762PMC
November 2019
18 Reads
2.636 Impact Factor

Integration of the National Comprehensive Cancer Network (NCCN) Distress Screening Tool as a Guidepost for Telephonic Oncology Case Management.

Prof Case Manag 2019 May/Jun;24(3):148-154

Alysia Jean Swanson, BSOM, RN, CCM, leads Clinical Program Development and clinical oversight of Cigna's Oncology Case Management program as Clinical Program Development Manager at Cigna. A certified case manager and Six Sigma Green Belt, she serves as a board member for the Oncology Nurse Society of Chattanooga Tennessee. Liana DesHarnais Castel, PhD, MSPH, is Editor-in-Chief of Patient Related Outcome Measures (Dove Medical Press, part of Taylor & Francis Group), Adjunct Professor at Campbell University Lundy-Fetterman School of Business, and Business Communication Senior Specialist at Cigna. She holds PhD and MSPH degrees from University of North Carolina-Chapel Hill. Patricia A. McKenna, BSN, RN, is currently a Project Manager with Cigna Consumer Health Engagement. She received her BSN from Creighton University, College of Nursing, and is a Certified Six Sigma Green Belt. Yuming Albert Shen, PhD, holds the position of Informatics and Analytics Senior Specialist at Cigna. He holds a PhD in biophysics from University of Virginia, a PhD in statistics from Virginia Tech, and a master's degree in statistics from Columbia University in the City of New York. Bhuvana Sagar, MD, is Lead Medical Director at Cigna. She completed her MD from Kilpauk Medical College in Chennai, India, residency at St. Luke's-Roosevelt Hospital Center, New York, NY, and fellowship at University of Texas-Medical Branch, Galveston, TX. She is board certified in Internal Medicine and Medical Oncology and actively licensed in Texas.

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http://dx.doi.org/10.1097/NCM.0000000000000336DOI Listing
September 2019
25 Reads

Introducing the first articles of the veterans and military patient-related health outcomes thematic series.

Patient Relat Outcome Meas 2019 27;10:81-82. Epub 2019 Feb 27.

Lundy-Fetterman School of Business, Campbell University, Buies Creek, NC, USA,

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http://dx.doi.org/10.2147/PROM.S204114DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398394PMC
February 2019
12 Reads

Effectiveness of mailed letters to improve medication adherence among Medicare Advantage Plan participants with chronic conditions.

Patient Prefer Adherence 2019 20;13:37-46. Epub 2018 Dec 20.

Department of Pharmaceutical Health Outcomes and Policy, University of Houston College of Pharmacy, Houston, TX, USA.

Background: Medication adherence is associated with improved health outcomes in multiple chronic diseases. Information is needed on the effectiveness of specific adherence interventions. This study's objectives were to quantify effects of a targeted mailing intervention on adherence among older adults at risk for nonadherence, and to examine associations of individual and plan characteristics with adherence.

Materials And Methods: Among adults enrolled in a Medicare Advantage Plan with prescription drug coverage from May 2014 to June 2015, those identified as eligible for the mailing intervention had a late refill for oral antidiabetic medication, statin, angiotensin-converting enzyme inhibitor, or angiotensin receptor blocker medication and were previously unreachable by telephone. Pharmacy claims data were analyzed with the outcome of 6-month proportion of days covered (PDC) before and after the mailing. The -test and chi-square analyses were used to evaluate univariate associations. Multivariable linear and logistic regression models were conducted to assess relative covariate effects. A sub-analysis of those with at least one medication fill post-mailing was also performed.

Results: A total of 460 non-adherent individuals aged 70±10.5 years, with 50.2% female and 66.7% white individuals, were included. Of those who were mailed a letter, 24.1% became adherent to the specified maintenance medication. Those who received >30-day supplies were more than twice as likely to become adherent after the mailed letter than those who received 30-day supplies or less (<0.05). Baseline higher PDC was also associated with greater adherence post-mailing (<0.01). A total of 284 (61.7%) individuals filled their medication at least once after the mailed letter; of those, 39.1% became adherent (mean [SD] change in PDC =0.15 [±0.28]).

Conclusion: Our findings suggest that a single mailed letter improved medication adherence by 24.1% in adults with chronic conditions. As a health plan seeking to improve its customers' well-being and outcomes, Cigna continues to utilize targeted mail interventions to improve medication adherence.

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http://dx.doi.org/10.2147/PPA.S185848DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304824PMC
December 2018
24 Reads
2.097 Impact Factor

Economic and Clinical Outcomes Resulting From the Stage 4 Chronic Kidney Disease Case Management Quality Improvement Initiative.

Prof Case Manag 2017 Nov/Dec;22(6):291-298

Beverly Everett, MD, FACP, holds an MD degree from Tufts University School of Medicine, completed her Internal Medicine residency and Nephrology Fellowship at the University of North Carolina at Chapel Hill, practiced medicine for 15 years before joining Cigna, and after 18 years retired in 2015. Liana D. Castel, PhD, is Editor-in-Chief of Patient Related Outcome Measures (Dove Medical Press, Ltd), Adjunct Professor at the University of Mount Olive Tillman School of Business, and medical writer at Cigna. She holds a PhD degree from the University of North Carolina at Chapel Hill. Her research interests include outcomes and statistics. Matthew McGinnis, BS, has been with Cigna more than 13 years and leads the analytics team supporting Cigna's pharmacy benefits management business. He holds a US Patent for an End of Life Predictive Model, a Master of Science degree from Northwestern University, Illinois, and Certificate in Public Health from University of Florida. Amy Beresky, MS, holds a Master of Science in Statistics degree from University of Massachusetts Amherst. She has 8 years' experience in health care data mining, analytics, and predictive modeling, supporting Cigna's clinical programs, is fluent in Spanish, and has served on the Board of Directors and Environmental Committee in the residential community. Rudolph C. Cane Jr., MD, is Medical Director for Cigna Healthcare, Department of Clinical Performance and Quality. He holds board certification in Internal Medicine, completed Internal Medicine residency at Franklin Square Hospital Center, surgical internship at St. Agnes Medical Center, Baltimore, MD, and holds an MD degree from the University of Maryland School of Medicine. Tasha Cooper, RN, is a registered nurse who has been employed by Cigna for more than 20 years, holding various roles in the areas of Clinical Program Development, Case Management, Utilization Management, Disease Management, and Quality Accreditation and Compliance. Her career also includes more than 8 years of hospital and home health nursing experience. Rajesh K. Davda, MD, is the National Medical Director for network performance and quality improvement at Cigna Healthcare. Dr. Rajesh is board certified in internal medicine, nephrology and clinical informatics. Before joining Cigna in 2012, Raj was in private practice for 22 years in South Carolina and Texas. Donna Farmer, BSN, RN, CCM, has a clinical background in managing catastrophic illness and life care planning. She has been employed at Cigna since 2001 where she has worked as a case manager (CM), CM supervisor, and clinical program consultant. Stella M. John, BSN, RN, started at Cigna in 2005 as a catastrophic case manager and chronic condition kidney case manager. Currently, she holds the position of clinical coach with Cigna Workforce Development. Her 19 years' clinical experience includes surgical and medical ICU with a cardiac focus and intermediate care unit manager. Denise L. Sollars, BSN, RN, CCM, began her career with Cigna in August 2001. She is a certified nurse case manager and was part of the Case Management team for 12 years. She is currently a clinical consultant for the Mid-America Market. Before joining Cigna, Denise had 15 years' hospital clinical experience. John F. Rausch Jr., MD, FACP, FNKF, is board certified in Internal Medicine, has served as Board of Directors Chairman, National Kidney Foundation of Arizona, founding member and current Board of Directors member, Cardio Renal Society of America, and Medical Director at Cigna, Clinical Performance and Quality, Total Health and Network.

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http://dx.doi.org/10.1097/NCM.0000000000000253DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5636199PMC
September 2018
146 Reads

Cost drivers for breast, lung, and colorectal cancer care in a commercially insured population over a 6-month episode: an economic analysis from a health plan perspective.

J Med Econ 2017 Oct 3;20(10):1018-1023. Epub 2017 Jul 3.

c Cigna Health and Life Insurance Company , Bloomfield , CT , USA.

Aims: In the absence of clinical data, accurate identification of cost drivers is needed for economic comparison in an alternate payment model. From a health plan perspective using claims data in a commercial population, the objective was to identify and quantify the effects of cost drivers in economic models of breast, lung, and colorectal cancer costs over a 6-month episode following initial chemotherapy.

Research Design And Methods: This study analyzed claims data from 9,748 Cigna beneficiaries with diagnosis of breast, lung, and colorectal cancer following initial chemotherapy from January 1, 2014 to December 31, 2015. We used multivariable regression models to quantify the impact of key factors on cost during the initial 6-month cancer care episode.

Results: Metastasis, facility provider affiliation, episode risk group (ERG) risk score, and radiation were cost drivers for all three types of cancer (breast, lung, and colorectal). In addition, younger age (p?
Conclusions: Value-based reimbursement models in oncology should appropriately account for key cost drivers. Although claims-based methodologies may be further augmented with clinical data, this study recommends adjusting for the factors identified in these models to predict costs in breast, lung, and colorectal cancers.

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http://dx.doi.org/10.1080/13696998.2017.1339353DOI Listing
October 2017
128 Reads
1.885 Impact Factor

A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Trials of Clinical Emotional Freedom Techniques (EFT) for the Treatment of Depression.

Explore (NY) 2016 Nov - Dec;12(6):416-426. Epub 2016 Aug 18.

Lucyna Health and Safety Solutions, LLC, Tampa, FL.

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http://dx.doi.org/10.1016/j.explore.2016.08.001DOI Listing
June 2017
50 Reads
3 Citations
0.940 Impact Factor

Validity and reliability of the Patient-Reported Arthralgia Inventory: validation of a newly-developed survey instrument to measure arthralgia.

Patient Relat Outcome Meas 2015 28;6:205-14. Epub 2015 Jul 28.

Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

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http://dx.doi.org/10.2147/PROM.S47997DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524452PMC
August 2015
77 Reads

Determinants of health after hospital discharge: rationale and design of the Vanderbilt Inpatient Cohort Study (VICS).

BMC Health Serv Res 2014 Jan 8;14:10. Epub 2014 Jan 8.

Division of General Internal Medicine and Public Health, Department of Medicine, Vanderbilt University, 1215 21st Ave S, Suite 6000 Medical Center East, Nashville 37232, TN, USA.

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http://dx.doi.org/10.1186/1472-6963-14-10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893361PMC
January 2014
89 Reads
21 Citations
1.660 Impact Factor

Measuring participation: the Patient-Reported Outcomes Measurement Information System experience.

Arch Phys Med Rehabil 2010 Sep;91(9 Suppl):S60-5

Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

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http://dx.doi.org/10.1016/j.apmr.2009.10.035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3671872PMC
September 2010
59 Reads
7 Citations
2.565 Impact Factor

Measuring social health in the patient-reported outcomes measurement information system (PROMIS): item bank development and testing.

Qual Life Res 2010 Sep 25;19(7):1035-44. Epub 2010 Apr 25.

Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 710 N. Lake Shore Dr., Room 725, Chicago, IL 60611, USA.

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http://dx.doi.org/10.1007/s11136-010-9654-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138729PMC
September 2010
60 Reads
30 Citations
2.490 Impact Factor

A long way to go: practice patterns and evidence in chronic low back pain care.

Spine (Phila Pa 1976) 2009 Apr;34(7):718-24

Cecil G. Sheps Center for Health Services Research, University of North Carolina, 725 Airport Road, Chapel Hill, NC 27599-7590, USA.

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http://dx.doi.org/10.1097/BRS.0b013e31819792b0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664198PMC
April 2009
57 Reads
20 Citations
2.300 Impact Factor

Spine and pain clinics serving North Carolina patients with back and neck pain: what do they do, and are they multidisciplinary?

Spine (Phila Pa 1976) 2009 Mar;34(6):615-22

Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.

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http://dx.doi.org/10.1097/BRS.0b013e31817b8fa2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2757449PMC
March 2009
72 Reads
4 Citations
2.300 Impact Factor

Exercise prescription for chronic back or neck pain: who prescribes it? who gets it? What is prescribed?

Arthritis Rheum 2009 Feb;61(2):192-200

The Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC 27599-7590, USA.

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http://dx.doi.org/10.1002/art.24234DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339066PMC
February 2009
62 Reads
11 Citations
7.764 Impact Factor

The rising prevalence of chronic low back pain.

Arch Intern Med 2009 Feb;169(3):251-8

The Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., Chapel Hill, NC 27599-7590, USA.

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http://dx.doi.org/10.1001/archinternmed.2008.543DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4339077PMC
February 2009
62 Reads
206 Citations
17.333 Impact Factor

Content validity in the PROMIS social-health domain: a qualitative analysis of focus-group data.

Qual Life Res 2008 Jun 14;17(5):737-49. Epub 2008 May 14.

Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd, CB 7590, Chapel Hill, NC 27599, USA.

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http://dx.doi.org/10.1007/s11136-008-9352-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2757448PMC
June 2008
58 Reads
25 Citations
2.490 Impact Factor

Racial differences in pain during 1 year among women with metastatic breast cancer: a hazards analysis of interval-censored data.

Cancer 2008 Jan;112(1):162-70

Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.

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http://dx.doi.org/10.1002/cncr.23133DOI Listing
January 2008
77 Reads
8 Citations
4.890 Impact Factor

Hazards for pain severity and pain interference with daily living, with exploration of brief pain inventory cutpoints, among women with metastatic breast cancer.

J Pain Symptom Manage 2007 Oct 21;34(4):380-92. Epub 2007 Jun 21.

Department of Epidemiology, School of Public Health, and Cecil G. Sheps Center for Health Services Research, University of North Carolina, 725 Martin Luther King Jr. Boulevard, Chapel Hill, NC 27599, USA.

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http://dx.doi.org/10.1016/j.jpainsymman.2006.12.007DOI Listing
October 2007
77 Reads
9 Citations
2.800 Impact Factor

Effects of skeletal morbidities on longitudinal patient-reported outcomes and survival in patients with metastatic prostate cancer.

Support Care Cancer 2007 Jul;15(7):869-76

Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University Medical Center, P.O. Box 17969, Durham, NC 27715, USA.

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http://link.springer.com/content/pdf/10.1007/s00520-006-0203
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http://dx.doi.org/10.1007/s00520-006-0203-xDOI Listing
July 2007
58 Reads
21 Citations
2.364 Impact Factor

An exploration of relative health stock in advanced cancer patients.

Med Decis Making 2004 Nov-Dec;24(6):614-24

Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland 21205, USA.

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http://dx.doi.org/10.1177/0272989X04271041DOI Listing
March 2005
60 Reads
6 Citations
3.240 Impact Factor

Understanding of an aggregate probability statement by patients who are offered participation in Phase I clinical trials.

Cancer 2005 Jan;103(1):140-7

Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina 27715, USA.

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http://dx.doi.org/10.1002/cncr.20730DOI Listing
January 2005
66 Reads
5 Citations
4.890 Impact Factor

Health-related quality of life among patients with breast cancer receiving zoledronic acid or pamidronate disodium for metastatic bone lesions.

Med Care 2004 Feb;42(2):164-75

Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, North Carolina 27715, USA.

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http://dx.doi.org/10.1097/01.mlr.0000108746.69256.45DOI Listing
February 2004
80 Reads
18 Citations
3.232 Impact Factor

The correlation between patient characteristics and expectations of benefit from Phase I clinical trials.

Cancer 2003 Jul;98(1):166-75

Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina 27715, USA.

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http://dx.doi.org/10.1002/cncr.11483DOI Listing
July 2003
65 Reads
30 Citations
4.890 Impact Factor

Toward estimating the impact of changes in immigrants' insurance eligibility on hospital expenditures for uncompensated care.

BMC Health Serv Res 2003 Jan 10;3(1). Epub 2003 Jan 10.

Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Duke University Medical Center, PO Box 17969, Durham, NC 27715 USA.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC140321PMC
http://dx.doi.org/10.1186/1472-6963-3-1DOI Listing
January 2003
62 Reads
4 Citations
1.660 Impact Factor

Welfare reform and Latinas' use of perinatal health care.

Am J Public Health 2002 May;92(5):699-700; author reply 700

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447143PMC
http://dx.doi.org/10.2105/ajph.92.5.699-aDOI Listing
May 2002
58 Reads
4.552 Impact Factor

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