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In the case of an existing vitamin B12 deficiency, the blood-forming tissues are affected first - this can therefore lead to pernicious anaemia

The strongest, best-documented effects are the antioxidant support and the gradual evening of skin tone

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A few commenters suggested alternatives to blanket penalties in public reporting, proposing the use of performance flags or annotations to highlight poor Safety of Care scores without reducing hospitals' Overall Hospital Quality Star Rating, thereby providing meaningful safety information while preserving rating comparability