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Br J Ind Med 48:243246 Shang N, Zhang L, Wang S et al (2021) Increased aluminum and lithium and decreased zinc levels in plasma is related to cognitive impairment in workers at an aluminum factory in China: a cross-sectional study

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All findings referenced are from peer-reviewed preclinical studies

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But if they coincide with a temperature excursion or nearing the end of a vial shelf life, degradation should be high on your list of suspects