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  1. Remove the semantic tag, (substance)       
  2. Substances are the 'source of truth' so an alternate Preferred Term (PT) must always be added for all concepts when there are dialect variations in spellings for US/GB (language acceptability P/A) and vice versa
  3. Align case sensitivity with substance term for FSN (ci or cI) and PT (ci, CS or cI)

JIRA ticket for implementation:

https://jira.ihtsdotools.org/browse/DRUGS-540