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However, it's important to contextualize this assessment within the limitations of the available evidence: most safety data comes from relatively small studies, often of short-to-moderate duration, conducted primarily in the Soviet Union, Russia, and Eastern Europe where methodological standards and reporting practices have sometimes differed from Western pharmaceutical trial requirements

It is also worth noting that two of the supporting studies [38, 64] were rated as having a moderate risk of bias, which may influence the reliability of their findings

So, I think what you just described that there

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