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Response: We thank commenters for their concern regarding whether the proposed Overall Hospital Quality Star Rating methodology updates adequately address the overall CMS goal of prioritizing patient safety across programs

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The paracellular translocation of macromolecules up to 125 is carried out by a low-capacity leak pathway regulated by zonula occludens (ZO), occludins, and tricellulins (Odenwald and Turner 2017

Textbook of medical physiology