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The norleucine-4 and D-phenylalanine-7 modifications are verified through sequence analysis on every production batch

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In the ED: Fasting history is unreliable Treat as higher aspiration risk especially if symptomatic Anticipate vomiting and difficult visualization Practical considerations: Optimize positioning (ramped, head elevated, or slight reverse Trendelenburg) Use RSI when appropriate Minimize bag-mask ventilation Ensure suction is immediately available and functioning

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