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PLOS Computational Biology 18 (7): e1010330.

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If no refrigerator is available, keep the insulated bag closed as much as possible and replace gel packs with fresh ice wrapped in a barrier (like a Ziploc bag inside a towel) if the original packs warm up

Choline supplementation promotes hepatic insulin resistance in phosphatidylethanolamine N-methyltransferase-deficient mice via increased glucagon action