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Recently, Pescosolido and colleagues [161] evaluated the presence of carnitine in tears of dry eye patients and suggested that the damage incurred on the ocular surface of dry eye patients may, in part, be due to a lack of carnitine in the tear film of these patients relative to the ocular surface cells and suggested use of solutions containing carnitine to reduce this damage

Another key strength is the study design, which minimized biases related to the inclusion of prevalent users without excluding patients with a history of self-harm or suicidal ideation

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