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One commenter noted that rural hospitals already contend with physician shortages, maternity care deserts, and ongoing obstetric unit closures, and cautioned that capping or reducing these hospitals' Overall Hospital Quality Star Rating could exacerbate rural health disparities, particularly in maternal health outcomes

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This selectivity represents a fundamental difference from not only full-length growth hormone but also growth hormone secretagogues and analogs like tesamorelin, which increase endogenous growth hormone and subsequently elevate IGF-1