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These practices not only increase the risk of ADRs but also intensify environmental selection pressure for resistant organisms, the combined effects of multiple pharmaceuticals (mixture toxicity) in the environment may produce synergistic or additive effects that are not predicted from single-compound assessments, representing a critical knowledge gapas noted by researchers such as Golding et al

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120 It has been demonstrated that genetic ablation of GIPR and GLP-1R either individually or at the same time in mice results in impaired insulin secretion confirming that both GIP and GLP-1 mediate the incretin effect