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The problem is extended room-temperature storage, repeated warming, leaving the vial on a bench, or shipping and storing reconstituted solution outside a controlled cold chain
The other couple of things to say is that there is a lock which is a red triangle and an open and that is so you don't fire the product accidentally when you don't mean to
However, this is an inherent limitation of large real-world datasets, and such misclassification is likely non-differential, biasing results toward the null
1 And for a good reason
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