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Comment: A few commenters recommended that CMS assign more weight to numerator component (3) (that is, the patient boarded in the ED for longer than 4 hours), to reflect its importance and the likelihood that it may affect other ED outcomes

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Symptom scores were stable in both groups during this phase, indicating 45 days of a very-low-carbohydrate ketogenic diet followed by 45 days of a low-glycemic and insulinemic diet had a lasting benefit that could not be achieved by 90 days on a low-glycemic and insulinemic diet

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