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Slowly inject the vitamin B12 solution

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The pH is adjusted to 6.0 - 6.5 with hydrochloric acid or sodium hydroxide

Robustness was greater for inverse associations, with E-values of 5.70 for pemphigus (HR 0.32) and 2.66 for bullous pemphigoid (HR 0.61), indicating that comparatively strong residual confounding would be necessary to nullify these findings