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Many cases are physical hydration or bubble effects that resolve with correct dilution, gentle mixing, and time

Sedding DG, Boyle EC, Demandt JAF, Sluimer JC, Dutzmann J, Haverich A, Bauersachs J (2018) Vasa Vasorum Angiogenesis: Key Player in the Initiation and Progression of Atherosclerosis and Potential Target for the Treatment of Cardiovascular Disease

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Consider the case of megaloblastic anemia where vitamin B deficiency causes the production of unusually big and inefficient red blood cells