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Four amino acids in the sequence are substituted at positions 2, 8, 15, and 27.  Here is what some researchers believe about these modifications

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Potential risks — beyond the regulatory concerns I outline below — include infection at the cannula site, allergic reaction to any of the infused substances, air embolism (rare but serious), fluid overload, electrolyte imbalance, and phlebitis (inflammation of the vein)