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American Journal of Physiology-Gastrointestinal and Liver Physiology , 279 (1), G7-G11

Do not expose the mechanical pen structure to autoclaving or high-temperature sterilization processes, as extreme heat can damage the internal dialing calibration

The main friction is the $250 first-visit fee (subsequent visits $150) and the hard Medicare/Medicaid exclusion, which cannot be worked around on the public funnel