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The potential clinical implications of these observations have been confirmed by a recent multicenter trial involving over 4000 patients, in which dulaglutide resulted in approximately a 14% reduction in the risk of cognitive decline after 5 years of therapy [22]

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Vitamin B 12 deficiency can develop with heavy regular use of nitrous oxide N 2 O, also known as "laughing gas", used for anaesthesia in a clinical setting or as a propellant gas, commonly abused as a recreational drug

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