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Starting with topical application represents a conservative entry point

Key refrigeration guidelines include: Store in the main body of the refrigerator , not in the door where temperature fluctuations are more common due to frequent opening and closing Keep away from the freezer compartment to prevent accidental freezing, which permanently damages the medication Never freeze GLP-1 medications frozen medication must be discarded even if subsequently thawed [1] [2] Protect from light by keeping medications in their original carton until ready for use Avoid storing near cooling elements or at the back of the refrigerator where temperatures may drop below the recommended range Do not store pens with needles attached Many GLP-1 medications can be stored at room temperature for limited periods before use: Wegovy (semaglutide) : May be stored at room temperature (up to 86F/30C) for up to 28 days before use [1] [2] Trulicity (dulaglutide) : May be stored at room temperature (up to 86F/30C) for up to 14 days before use Mounjaro/Zepbound (tirzepatide) : May be stored at room temperature (up to 86F/30C) for up to 21 days before use Bydureon BCise (exenatide ER) : May be stored at room temperature for up to 4 weeks before use (per prescribing information) Patients should verify their refrigerator maintains appropriate temperatures using a refrigerator thermometer

Heart Failure with Reduced Ejection Fraction (HFrEF): The HF-ACTION trial demonstrated that supervised aerobic training (36 sessions over 3 months, progressing to home-based exercise) improves VO peak by 0.6 mL/kg/min and reduces all-cause mortality/hospitalization (HR 0.89, 95% CI 0.810.99) when added to optimal medical therapy (112)

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( B ) MBP pull-down assay demonstrating the interaction of MBP-fused HJURP (chicken: ggHJURP 100-150 , human: hsHJURP 137-192 ) with CENP-C C-terminus (chicken: ggCENP-C 677-864 , human: hsCENP-C 760-943 )