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Several possible explanations: The patent holder may not have found a pharmaceutical company willing to invest in the expensive process of clinical development

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Manna I, Mishra S, Bandyopadhyay M (2022) In vivo genotoxicity assessment of nickel oxide nanoparticles in the model plant Allium cepa L

Cerebrolysin is approved in over 50 countries (primarily Europe and Asia) for specific neurological indications including stroke, traumatic brain injury, and dementia, but not for cognitive enhancement in healthy populations