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As we also discuss in the CY 2025 PFS proposed rule, across an ACO's reconciliations where improper payments impact performance year or BY expenditures, the overall net impact of using the proposed methodology on the ACO's aggregate shared savings or shared losses across those reconciliations could be positive or negative and would depend on the circumstances of a given reopening scenario

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The ability of ROS to enhance the tyrosine phosphorylation status of human spermatozoa depends partly on the ability of H 2 O 2 to suppress tyrosine phosphatase activity, and partly on the ability of these molecules to stimulate cAMP generation by the soluble form of adenylyl cyclase (sAC) [16, 17]

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