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Vigorous shaking denatures the peptide, breaking the molecular bonds that make it functional

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The study was conducted between October 2024 and August 2025 and reported following the Reporting of Studies Conducted Using Observational Routinely Collected Health Data for Pharmacoepidemiology (RECORD-PE) statement and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidance 45