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Documentation red flags include Certificates of Analysis from unknown or unverifiable testing laboratories, HPLC purity results without corresponding endotoxin or sterility testing, and testing performed by the seller rather than an independent third-party laboratory

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In contrast, the Grooved Pegboard Test, a commonly used measure of fine motor coordination and dexterity, demonstrates a broader dynamic range and has been shown to decline progressively with disease worsening, making it a more reliable response biomarker in longitudinal studies [512]