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In the United States, atypical mycobacterial infections, while rare, appear to have become a more common complication of TNF inhibitor therapy than mTB infection, presumably because there are no screening tests for such infections

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Unlike our laboratory experiments, field samples generally contain a mixture of INPs from both biogenic and non-biological sources, making interpretation of loss of INP activity on heating, and source apportionment, extremely challenging 71

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