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The article says freezing damages the peptide structure irreversibly and that a frozen pen should be discarded immediately rather than thawed and used
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One of the key aspects of diagnosing this disorder, aside from having a clinical suspicion in the setting of anion gap metabolic acidosis without another explanation, is the detection of 5-oxoproline in the urine
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This rebound effect is likely related to physiologic mechanisms triggered by weight reduction that induce compensatory changes in energy balance homeostasis, including increased appetite and reduced energy expenditure [1417]
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