II 

117TH CONGRESS 

1ST SESSION S. 3041 

To amend the Public Health Service Act to provide for and support liver 

illness visibility, education, and research, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 21, 2021 

Ms. DUCKWORTH introduced the following bill; which was read twice and 

referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to provide for 

and support liver illness visibility, education, and research, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Liver Illness Visibility, 

5 Education, and Research Act of 2021’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 

8 (1) Liver cancer is among the fastest-growing 

9 cause of cancer death in the United States and 

10 among the leading causes of cancer deaths globally. 


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1 (2) The Division of Cancer Control and Popu2 lation Sciences of the National Cancer Institute esti3 mated that there will be 42,230 new liver cancer di4 agnoses in the year 2021, and approximately 30,200 

5 individuals will die from the disease. 

6 (3) Liver cancer is a leading cause of cancer 

7 death among the Asian American and Pacific Is8 lander community. 

9 (4) The most vulnerable Asian Americans are 

10 those who are foreign-born, low-income, and living in 

11 ethnic enclaves. 

12 (5) Asian and Pacific Islander men and women 

13 are nearly twice as likely to develop liver cancer 

14 compared to the non-Hispanic White population. 

15 (6) Among the Asian and Pacific Islander pop16 ulation, the higher incidence rate of liver cancer is 

17 partially explained by higher incidence rates of hepa18 titis B and diabetes comorbidities which are shown 

19 to increase an individual’s risk of developing liver 

20 cancer. 

21 (7) The most common causes of liver cancer in22 clude hepatitis B virus and hepatitis C virus infec23 tion. 

24 (8) Hepatitis B is a primary risk factor for de25 veloping liver cancer, and approximately 15 to 25 


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1 percent of those chronically infected with hepatitis B 

2 develop cirrhosis, liver failure, or liver cancer. 

3 (9) More than half of all individuals with hepa4 titis B in the United States are Asian American or 

5 Pacific Islander, though this group accounts for only 

6 6 percent of the population of the United States. 

7 (10) Among African immigrants in the United 

8 States, the prevalence of hepatitis B infection is ap9 proximately 1 in 12, and African immigrants make 

10 up 12 percent of those with chronic hepatitis B in11 fection in the United States. 

12 (11) Among Hispanic/Latino communities, liver 

13 cancer incidence and death rates are twice as high 

14 compared to the non-Hispanic White population. 

15 (12) Hispanics/Latinos are 70 percent more 

16 likely to die from viral hepatitis than non-Hispanic 

17 Whites. 

18 SEC. 3. LIVER CANCER AND DISEASE RESEARCH. 

19 Subpart 1 of part C of title IV of the Public Health 

20 Service Act (42 U.S.C. 285 et seq.) is amended by adding 

21 at the end the following new section: 

22 ‘‘SEC. 417H. LIVER CANCER AND DISEASE RESEARCH. 

23 ‘‘(a) EXPANSION AND COORDINATION OF ACTIVI24 TIES.—The Director of the Institute shall expand, intenVerDate Sep 11 2014 00:59 Oct 26, 2021 Jkt 029200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3041.IS S3041

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1 sify, and coordinate the activities of the Institute with re2 spect to research on liver cancer and other liver diseases. 

3 ‘‘(b) PROGRAMS FOR LIVER CANCER.—In carrying 

4 out subsection (a), the Director of the Institute shall pro5 vide for an expansion and intensification of the conduct 

6 and support of— 

7 ‘‘(1) basic research concerning the etiology and 

8 causes of liver cancer; 

9 ‘‘(2) clinical research and related activities con10 cerning the causes, prevention, detection, and treat11 ment of liver cancer; 

12 ‘‘(3) control programs with respect to liver can13 cer, in accordance with section 412, including com14 munity-based programs designed to assist members 

15 of medically underserved populations (including 

16 women), low-income populations, or minority groups; 

17 and 

18 ‘‘(4) information and education programs with 

19 respect to liver cancer, in accordance with section 

20 413. 

21 ‘‘(c) INTER-INSTITUTE WORKING GROUP.—The Di22 rector of the Institute shall establish an inter-institute 

23 working group to coordinate research agendas focused on 

24 finding treatments and cures for liver cancer and other 


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1 liver diseases, including hepatitis B and nonalcoholic 

2 steatohepatitis. 

3 ‘‘(d) GRANTS AND COOPERATIVE AGREEMENTS.— 

4 ‘‘(1) IN GENERAL.—The Secretary may award 

5 grants and enter into cooperative agreements with 

6 entities for the purpose of expanding, conducting, 

7 and supporting research on— 

8 ‘‘(A) conditions known to increase an indi9 vidual’s risk of developing a major liver disease, 

10 such as liver cancer, hepatitis B, hepatitis C, 

11 nonalcoholic fatty liver disease, nonalcoholic 

12 steatohepatitis, and cirrhosis of the liver; and 

13 ‘‘(B) early detection and diagnostic meas14 ures for such a disease, including the study of 

15 molecular pathology and biomarkers for early 

16 detection. 

17 ‘‘(2) EXPERIMENTAL TREATMENT AND PRE18 VENTION.—In the case of an entity that is a hospital 

19 or a health care facility, the Secretary may award a 

20 grant or enter into a cooperative agreement with 

21 such an entity for the purpose of supporting an ex22 perimental treatment or prevention program for liver 

23 cancer carried out by such entity. 

24 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

25 For purposes of carrying out this subsection, there 


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1 is authorized to be appropriated $45,000,000 for 

2 each of fiscal years 2023 through 2027.’’. 

3 SEC. 4. LIVER CANCER AND DISEASE PREVENTION, AWARE4 NESS, AND PATIENT TRACKING GRANTS. 

5 Subpart I of part D of title III of the Public Health 

6 Service Act (42 U.S.C. 254b et seq.) is amended by adding 

7 at the end the following new section: 

8 ‘‘SEC. 330O. LIVER CANCER AND DISEASE PREVENTION, 

9 AWARENESS, AND PATIENT TRACKING 

10 GRANTS. 

11 ‘‘(a) PREVENTION INITIATIVE GRANT PROGRAM.— 

12 ‘‘(1) IN GENERAL.—The Secretary, acting 

13 through the Director of the Centers for Disease 

14 Control and Prevention, may award grants and 

15 enter into cooperative agreements with entities for 

16 the purpose of expanding and supporting— 

17 ‘‘(A) prevention activities (including pro18 viding screenings, vaccinations, or other pre19 ventative interventions) for conditions known to 

20 increase an individual’s risk of developing a 

21 major liver disease, such as liver cancer, hepa22 titis B, hepatitis C, nonalcoholic fatty liver dis23 ease, nonalcoholic steatohepatitis, and cirrhosis 

24 of the liver; 


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1 ‘‘(B) activities relating to detection and 

2 provision of guidance for individuals at high 

3 risk for contracting liver cancer and other liver 

4 diseases; and 

5 ‘‘(C) viral hepatitis surveillance to provide 

6 for timely and accurate information regarding 

7 progress to eliminate viral hepatitis. 

8 ‘‘(2) REPORT.—An entity that receives a grant 

9 or cooperative agreement under paragraph (1) shall 

10 submit to the Secretary, at a time specified by the 

11 Secretary, a report describing each activity carried 

12 out pursuant to such paragraph and evaluating the 

13 effectiveness of such activity in promoting prevention 

14 and treatment of liver cancer and other liver dis15 eases. 

16 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

17 For purposes of carrying out this subsection, there 

18 is authorized to be appropriated $90,000,000 for 

19 each of fiscal years 2023 through 2027. 

20 ‘‘(b) AWARENESS INITIATIVE GRANT PROGRAM.— 

21 ‘‘(1) IN GENERAL.—The Secretary, acting 

22 through the Director of the Centers for Disease 

23 Control and Prevention, may award grants to eligi24 ble entities for the purpose of raising awareness for 

25 liver cancer and other liver diseases, which may inVerDate Sep 11 2014 00:59 Oct 26, 2021 Jkt 029200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S3041.IS S3041

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1 clude the production, dissemination, and distribution 

2 of informational materials targeted towards commu3 nities and populations with a higher risk for devel4 oping liver cancer and other liver diseases. 

5 ‘‘(2) ELIGIBLE ENTITIES.—To be eligible to re6 ceive a grant under paragraph (1), an entity shall 

7 submit to the Secretary an application, at such time, 

8 in such manner, and containing such information as 

9 the Secretary may require, including a description of 

10 how the entity, in disseminating information on liver 

11 cancer and other liver diseases pursuant to para12 graph (1), will— 

13 ‘‘(A) with respect to any community or 

14 population, consult with members of such com15 munity or population and provide such informa16 tion in a manner that is culturally and linguis17 tically appropriate for such community or popu18 lation; 

19 ‘‘(B) highlight the range of preventative 

20 measures and treatments available for liver can21 cer and other liver diseases; 

22 ‘‘(C) integrate information on available 

23 hepatitis B and hepatitis C testing programs 

24 into any liver cancer presentations carried out 

25 by the entity; and 


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1 ‘‘(D) address communities and populations 

2 with a higher risk for contracting liver cancer 

3 and other liver diseases. 

4 ‘‘(3) PREFERENCE.—In awarding grants under 

5 paragraph (1), the Secretary shall give preference to 

6 entities that— 

7 ‘‘(A) work with a federally-qualified health 

8 center; 

9 ‘‘(B) are community-based organizations; 

10 or 

11 ‘‘(C) serve communities and populations 

12 with a higher risk for contracting liver cancer 

13 and other liver diseases. 

14 ‘‘(4) REPORT.—An entity that receives a grant 

15 under paragraph (1) shall submit to the Secretary, 

16 at a time specified by the Secretary, a report de17 scribing each activity carried out pursuant to such 

18 paragraph and evaluating the effectiveness of such 

19 activity in raising awareness for liver cancer and 

20 other liver diseases. 

21 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 

22 For purposes of carrying out this subsection, there 

23 is authorized to be appropriated $10,000,000 for 

24 each of fiscal years 2022 through 2027.’’. 


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1 SEC. 5. HEPATITIS B RESEARCH. 

2 The Director of the National Institutes of Health 

3 shall, in collaboration with the Director of the National 

4 Institute of Allergy and Infectious Diseases, issue targeted 

5 calls for hepatitis B research proposals focused on key re6 search questions identified by the research community and 

7 discussed in peer-reviewed research journal articles. 

8 SEC. 6. CHANGES RELATING TO NATIONAL INSTITUTE OF 

9 DIABETES AND DIGESTIVE AND KIDNEY DIS10 EASES. 

11 (a) CHANGE OF NAME OF NATIONAL INSTITUTE OF

12 DIABETES AND DIGESTIVE AND KIDNEY DISEASES.— 

13 (1) IN GENERAL.—Subpart 3 of part C of title 

14 IV of the Public Health Service Act (42 U.S.C. 285c 

15 et seq.) is amended in the subpart heading by strik16 ing ‘‘National Institute of Diabetes and Di17 gestive and Kidney Diseases’’ and inserting 

18 ‘‘National Institute of Diabetes and Diges19 tive, Kidney, and Liver Diseases’’. 

20 (2) TREATMENT OF DIRECTOR OF NATIONAL

21 INSTITUTE OF DIABETES AND DIGESTIVE AND KID22 NEY DISEASES.—The individual serving as the Di23 rector of the National Institute of Diabetes and Di24 gestive and Kidney Diseases as of the date of enact25 ment of this Act may continue to serve as the Direc26 tor of the National Institute of Diabetes and DigesVerDate Sep 11 2014 00:59 Oct 26, 2021 Jkt 029200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S3041.IS S3041

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1 tive, Kidney, and Liver Diseases commencing as of 

2 that date. 

3 (3) REFERENCES.—Any reference to the Na4 tional Institute of Diabetes and Digestive and Kid5 ney Diseases, or the Director of the National Insti6 tute of Diabetes and Digestive and Kidney Diseases, 

7 in any law, regulation, document, record, or other 

8 paper of the United States shall be deemed to be a 

9 reference to the National Institute of Diabetes and 

10 Digestive, Kidney, and Liver Diseases, or the Direc11 tor of the National Institute of Diabetes and Diges12 tive, Kidney, and Liver Diseases, respectively. 

13 (4) CONFORMING AMENDMENTS.— 

14 (A) Section 401(b)(3) of the Public Health 

15 Service Act (42 U.S.C. 281(b)(3)) is amended 

16 by striking ‘‘The National Institute of Diabetes 

17 and Digestive and Kidney Diseases.’’ and in18 serting ‘‘The National Institute of Diabetes and 

19 Digestive, Kidney, and Liver Diseases.’’. 

20 (B) Section 409A(a) of the Public Health 

21 Service Act (42 U.S.C. 284e(a)) is amended by 

22 striking ‘‘the National Institute of Diabetes and 

23 Digestive and Kidney Diseases’’ and inserting 

24 ‘‘the National Institute of Diabetes and Diges25 tive, Kidney, and Liver Diseases’’. 


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1 (b) PURPOSE OF THE INSTITUTE.—Section 426 of 

2 the Public Health Service Act (42 U.S.C. 285c) is amend3 ed— 

4 (1) by striking ‘‘National Institute of Diabetes 

5 and Digestive and Kidney Diseases’’ and inserting 

6 ‘‘National Institute of Diabetes and Digestive, Kid7 ney, and Liver Diseases’’; and 

8 (2) by striking ‘‘and kidney, urologic, and hem9 atologic diseases’’ and inserting ‘‘kidney, urologic, 

10 and hematologic diseases, and liver diseases’’. 

11 (c) DATA SYSTEMS AND INFORMATION CLEARING12 HOUSES.—Section 427 of the Public Health Service Act 

13 (42 U.S.C. 285c–1) is amended by adding at the end the 

14 following new subsection: 

15 ‘‘(d) The Director of the Institute shall (1) establish 

16 the National Liver Diseases Data System for the collec17 tion, storage, analysis, retrieval, and dissemination of data 

18 derived from patient populations with liver diseases, in19 cluding, where possible, data involving general populations 

20 for the purpose of detection of individuals with a risk of 

21 developing liver diseases, and (2) establish the National 

22 Liver Diseases Information Clearinghouse to facilitate and 

23 enhance knowledge and understanding of liver diseases on 

24 the part of health professionals, patients, and the public 

25 through the effective dissemination of information.’’. 


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1 (d) REESTABLISHMENT OF LIVER DISEASE RE2 SEARCH BRANCH WITHIN DIVISION OF DIGESTIVE DIS3 EASES AND NUTRITION AS DIVISION OF LIVER DIS4 EASES.— 

5 (1) IN GENERAL.—The Liver Disease Research 

6 Branch within the Division of Digestive Diseases 

7 and Nutrition of the National Institute of Diabetes 

8 and Digestive and Kidney Diseases (referred to in 

9 this subsection as the ‘‘Liver Disease Research 

10 Branch’’) is hereby redesignated and promoted as 

11 the Division of Liver Diseases, which shall be within 

12 the National Institute of Diabetes and Digestive, 

13 Kidney, and Liver Diseases, as redesignated by sub14 section (a), as a separate division from the other di15 visions within such Institute. 

16 (2) DIVISION DIRECTOR.—Section 428 of the 

17 Public Health Service Act (42 U.S.C. 285c–2) is 

18 amended— 

19 (A) in the section heading, by striking 

20 ‘‘DIVISION DIRECTORS FOR DIABETES, EN21 DOCRINOLOGY, AND METABOLIC DIS22 EASES, DIGESTIVE DISEASES AND NUTRI23 TION, AND KIDNEY, UROLOGIC, AND HEM24 ATOLOGIC DISEASES’’ and inserting ‘‘DIVI25 SION DIRECTORS FOR DIABETES, ENDOVerDate Sep 11 2014 00:59 Oct 26, 2021 Jkt 029200 PO 00000 Frm 00013 Fmt 6652 Sfmt 6201 E:\BILLS\S3041.IS S3041

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1 CRINOLOGY, AND METABOLIC DISEASES, 

2 DIGESTIVE DISEASES AND NUTRITION, 

3 KIDNEY, UROLOGIC, AND HEMATOLOGIC

4 DISEASES, AND LIVER DISEASES’’; 

5 (B) in subsection (a)(1)— 

6 (i) in the matter preceding subpara7 graph (A), by striking ‘‘and a Division Di8 rector for Kidney, Urologic, and Hemato9 logic Diseases’’ and inserting ‘‘a Division 

10 Director for Kidney, Urologic, and Hem11 atologic Diseases, and a Division Director 

12 for Liver Diseases’’; and 

13 (ii) in subparagraph (A), by striking 

14 ‘‘and kidney, urologic, and hematologic dis15 eases’’ and inserting ‘‘kidney, urologic, and 

16 hematologic diseases, and liver diseases’’; 

17 and 

18 (C) in subsection (b)— 

19 (i) in the matter preceding paragraph 

20 (1), by striking ‘‘and the Division Director 

21 for Kidney, Urologic, and Hematologic 

22 Diseases’’ and inserting ‘‘the Division Di23 rector for Kidney, Urologic, and Hemato24 logic Diseases, and the Division Director 

25 for Liver Diseases’’; and 


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1 (ii) in paragraph (1), by striking ‘‘and 

2 kidney, urologic, and hematologic diseases’’ 

3 and inserting ‘‘kidney, urologic, and hem4 atologic diseases, and liver diseases’’. 

5 (3) TREATMENT OF DIRECTOR OF LIVER DIS6 EASE RESEARCH BRANCH.—The individual serving 

7 as the Director of the Liver Disease Research 

8 Branch as of the date of enactment of this Act may 

9 continue to serve as the Division Director for Liver 

10 Diseases commencing as of that date. 

11 (4) TRANSFER OF AUTHORITIES.—The Sec12 retary of Health and Human Services shall delegate 

13 to the Division Director for Liver Diseases all duties 

14 and authorities that were vested in the Director of 

15 the Liver Disease Research Branch as of the day be16 fore the date of enactment of this Act. 

17 (5) REFERENCES.—Any reference to the Liver 

18 Disease Research Branch, or the Director of the 

19 Liver Disease Research Branch, in any law, regula20 tion, document, record, or other paper of the United 

21 States shall be deemed to be a reference to the Divi22 sion of Liver Diseases, or the Division Director for 

23 Liver Diseases, respectively. 


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1 (e) INTERAGENCY COORDINATING COMMITTEES.— 

2 Section 429(a) of the Public Health Service Act (42 

3 U.S.C. 285c–3(a)) is amended— 

4 (1) in paragraph (1), by striking ‘‘and kidney, 

5 urologic, and hematologic diseases’’ and inserting 

6 ‘‘kidney, urologic, and hematologic diseases, and 

7 liver diseases’’; and 

8 (2) in the matter following paragraph (2), by 

9 striking ‘‘and a Kidney, Urologic, and Hematologic 

10 Diseases Coordinating Committee’’ and inserting ‘‘a 

11 Kidney, Urologic, and Hematologic Diseases Coordi12 nating Committee, and a Liver Diseases Coordi13 nating Committee’’. 

14 (f) ADVISORY BOARDS.—Section 430 of the Public 

15 Health Service Act (42 U.S.C. 285c–4) is amended— 

16 (1) in subsection (a), by striking ‘‘and the Na17 tional Kidney and Urologic Diseases Advisory 

18 Board’’ and inserting ‘‘the National Kidney and 

19 Urologic Diseases Advisory Board, and the Liver 

20 Diseases Advisory Board’’; and 

21 (2) in subsection (b)(2)(A)(i)— 

22 (A) by striking ‘‘the Director of the Na23 tional Institute of Diabetes and Digestive and 

24 Kidney Diseases’’ and inserting ‘‘the Director 


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1 of the National Institute of Diabetes and Diges2 tive, Kidney, and Liver Diseases’’; and 

3 (B) by striking ‘‘and the Division Director 

4 of the National Institute of Diabetes and Diges5 tive and Kidney Diseases’’ and inserting ‘‘and 

6 the Division Director of the National Institute 

7 of Diabetes and Digestive, Kidney, and Liver 

8 Diseases’’. 

9 (g) RESEARCH AND TRAINING CENTERS.—Section 

10 431 of the Public Health Service Act (42 U.S.C. 285c– 

11 5) is amended— 

12 (1) by redesignating subsection (e) as sub13 section (f); and 

14 (2) by inserting after subsection (d) the fol15 lowing new subsection: 

16 ‘‘(e) The Director of the Institute shall provide for 

17 the development or substantial expansion of centers for 

18 research in liver diseases. Each center developed or ex19 panded under this subsection— 

20 ‘‘(1) shall utilize the facilities of a single insti21 tution, or be formed from a consortium of cooper22 ating institutions, meeting such research qualifica23 tions as may be prescribed by the Secretary; 

24 ‘‘(2) shall develop and conduct basic and clin25 ical research into the cause, diagnosis, early detecVerDate Sep 11 2014 00:59 Oct 26, 2021 Jkt 029200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6201 E:\BILLS\S3041.IS S3041

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1 tion, prevention, control, and treatment of liver dis2 eases and related functional, congenital, metabolic, 

3 or other complications resulting from such diseases; 

4 ‘‘(3) shall encourage research into and pro5 grams for— 

6 ‘‘(A) providing information for patients 

7 with such diseases and complications and the 

8 families of such patients, physicians and others 

9 who care for such patients, and the general 

10 public; 

11 ‘‘(B) model programs for cost effective and 

12 preventive patient care; and 

13 ‘‘(C) training physicians and scientists in 

14 research on such diseases and complications; 

15 and 

16 ‘‘(4) may perform research and participate in 

17 epidemiological studies and data collection relevant 

18 to liver diseases in order to disseminate such re19 search, studies, and data to the health care profes20 sion and to the public.’’. 

21 (h) ADVISORY COUNCIL SUBCOMMITTEES.—Section 

22 432 of the Public Health Service Act (42 U.S.C. 285c– 

23 6) is amended— 

24 (1) by striking ‘‘and a subcommittee on kidney, 

25 urologic, and hematologic diseases’’ and inserting ‘‘a 


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1 subcommittee on kidney, urologic, and hematologic 

2 diseases, and a subcommittee on liver diseases’’; and 

3 (2) by striking ‘‘and kidney, urologic, and hem4 atologic diseases’’ and inserting ‘‘kidney, urologic, 

5 and hematologic diseases, and liver diseases’’. 

Æ 


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