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Total body fat plays a crucial role in the timing of puberty through the hormone leptin. Leptin is a hormone produced by adipose tissue, or body fat, that regulates energy balance and metabolism. It also plays a key role in the onset of puberty by signaling to the brain when there is enough energy available to support the physical changes associated with puberty.

During childhood, leptin levels are low and steady. However, as total body fat increases with age, leptin levels rise as well. When leptin levels reach a certain threshold, they signal the brain to initiate the hormonal changes that lead to puberty. This is because the body needs a certain level of energy stores to support the growth spurt, maturation of the reproductive system, and other physical changes that occur during puberty.

Thus, the higher the total body fat, the earlier puberty is likely to begin. Conversely, low levels of body fat can delay the onset of puberty, as there may not be enough energy available to support the necessary physical changes. In summary, total body fat plays a critical role in the timing of puberty through its influence on the hormone leptin.

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Clinical signs of a low-level median nerve injury include numbness or tingling in the hand, weakness in thumb opposition and/or finger flexion, and difficulty with fine motor skills.

The median nerve is responsible for controlling movement and sensation in parts of the hand, including the thumb, index, middle, and part of the ring fingers. A low-level median nerve injury, also known as a mild or partial injury, can occur from repetitive strain or compression on the nerve.

Symptoms may include numbness or tingling in the affected fingers, weakness in thumb opposition (the ability to touch the thumb to the tip of each finger) and/or finger flexion (the ability to bend the fingers), and difficulty with fine motor skills such as writing or buttoning clothes.

Treatment may include rest, physical therapy, and in some cases, surgery.

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The correct statement that indicates an understanding of the procedure is "I need to keep the balls elevated as long as possible."

When using a flow-oriented incentive spirometer, the patient needs to take a slow, deep breath to lift the balls or indicator to the targeted level and then hold the breath for as long as possible (usually 5-10 seconds). This helps to expand the lungs and prevent respiratory complications such as atelectasis after surgery. Therefore, it is important to keep the balls elevated for as long as possible rather than trying to get them to the top quickly or using quick, rapid breaths.

An incentive spirometer is a device that helps patients take deep breaths and expand their lungs after surgery or prolonged bed rest. It works by creating resistance when the patient inhales, which helps to open up the airways and prevent mucus buildup or collapse of the alveoli (small air sacs in the lungs).

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The primary difference between a board certified and board eligible physician is their certification status.

A board certified physician has completed their residency, fulfilled all necessary requirements, and successfully passed the board certification examination for their medical specialty.

In contrast, a board eligible physician has completed their residency but has not yet passed the board certification examination or met all requirements for certification.

Hence, Board certified physicians have successfully completed all requirements and examinations for their specialty, while board eligible physicians have completed their residency but are still working towards obtaining their board certification.

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The World Conference on Social Determinants of Health took place in Rio de Janeiro, Brazil in 2011. At the conference, member states adopted the Rio Political Declaration, which called for action in five key areas:

Adopt policies and actions to tackle the social determinants of health: Member states were urged to take action to address the social determinants of health, such as poverty, unemployment, and lack of education.

Promote health equity through governance and participation: Member states were encouraged to promote health equity by involving communities in decision-making and improving governance structures.

Improve health promotion and communication: Member states were called upon to improve health promotion and communication strategies, with a particular focus on reducing health inequities.

Strengthen global governance and collaboration: Member states were urged to strengthen global governance and collaboration to tackle health inequities, including through the United Nations and other international organizations.

Monitor progress and increase accountability: Member states were encouraged to monitor progress and increase accountability in addressing health inequities, including through the use of indicators and data collection.

Overall, the Rio Political Declaration highlighted the need for a comprehensive approach to addressing health inequities, with action required across a range of sectors and levels of governance.

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The gene in phi-X174 (not phi-X147) that is responsible for blocking peptidoglycan production in the host is the E gene. The E gene encodes for a protein called endolysin degrades the peptidoglycan layer of the host bacterial cell wall.

The gene responsible for blocking peptidoglycan production in the host in the bacteriophage phi-X174 is indeed the E gene, which encodes for endolysin. Endolysin is a bacteriolytic enzyme that specifically degrades the peptidoglycan layer of the host bacterial cell wall, leading to lysis of the host cell and release of new bacteriophages. This mechanism of action makes endolysin a promising tool in the fight against antibiotic-resistant bacteria, as it can effectively target and kill bacteria without affecting the normal microbiota.

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If a client experiences a Manic or a Mixed episode, then the appropriate diagnosis should be Bipolar I Disorder. So the correct answer is d.

If a client experiences a manic or a mixed episode, which is characterized by high energy, elevated mood, and impulsive behavior, the appropriate diagnosis would be Bipolar I Disorder. This is because Bipolar I Disorder involves the presence of at least one manic episode, which is a distinct period of elevated or irritable mood, lasting for at least one week. Mixed episodes involve symptoms of both mania and depression. The diagnosis of Bipolar I Disorder is important for proper treatment and management of the condition. Treatment options may include medication, psychotherapy, and lifestyle changes.

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The Evans and Stoddart Framework of Determinants of Health is a model that outlines the multiple factors that influence health outcomes, beyond just individual behaviors and medical care.

The framework identifies three main categories of determinants of health:

Individual behavior and biology: This includes factors such as lifestyle choices (e.g. diet, exercise, smoking), genetics, and personal health practices.

Social and community context: This includes factors such as income, education, social support, and community resources (e.g. access to healthcare, transportation, and healthy food).

Physical environment: This includes factors such as housing, air and water quality, and access to green space.

The framework emphasizes that these three categories of determinants are interconnected and interact with each other to impact health outcomes. For example, an individual's access to healthy food may be influenced by their income level (social and community context) and the availability of grocery stores in their neighborhood (physical environment).

The framework also highlights the importance of policies and interventions that address these determinants at the population level, such as improving access to healthcare and healthy food, promoting education and employment opportunities, and creating safe and supportive physical environments.

Overall, the Evans and Stoddart Framework of Determinants of Health is a useful tool for understanding the complex and multifaceted nature of health outcomes and identifying areas where interventions can be targeted to improve population health.

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A person with a C4 spinal cord injury (SCI) typically has limited functionality, with paralysis affecting the upper and lower body, including the arms, trunk, and legs. They may retain some shoulder movement and neck control.

A C4 spinal cord injury is located at the fourth cervical vertebra level in the spinal column. At this level, the injury affects the nerves controlling the diaphragm, which is critical for breathing, as well as muscles controlling the upper limbs and trunk.

As a result, individuals with C4 SCI often require assistance with breathing and have limited or no use of their arms and legs. They may rely on powered wheelchairs, adaptive equipment, and assistance from caregivers for daily tasks.
Overall, a person with a C4 spinal cord injury has limited functionality due to paralysis affecting the upper and lower body.

However, with appropriate support and adaptive technology, they can still lead fulfilling lives and engage in a variety of activities.

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In reference to consumer characteristics, "demographics" can be determined from direct questioning or observation and categorized by a simple objective measure, whereas "psychographics" are abstract.

Demographics refer to easily observable and measurable attributes of a consumer, such as age, gender, income, education, and occupation. These can be directly obtained through surveys, questionnaires, or other data collection methods, and they help marketers segment the target audience based on these characteristics.

On the other hand, psychographics are more abstract consumer characteristics that involve a person's values, beliefs, attitudes, interests, and lifestyle preferences. These traits are not easily observed or measured, and they require more in-depth psychological and attitudinal questioning, such as through focus groups, interviews, or advanced survey techniques. Psychographics provide a deeper understanding of the consumer and can help marketers create more personalized and effective marketing campaigns that resonate with the target audience's mindset.

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Yes, it is possible for a client to make progress in therapy without the therapist's interpretations, diagnoses, evaluations, and directives. This is because the client is the expert on their own experiences, thoughts, and feelings, and can bring their own insights and understanding to the therapy process.

The therapist's role is to provide a safe and supportive environment, ask open-ended questions, and listen actively to the client's story.

By doing so, the therapist can help the client explore their thoughts and emotions, gain new perspectives, and develop their own solutions and strategies for change. In this way, the client is empowered to take ownership of their own growth and progress in therapy.

This approach is often referred to as client-centered therapy, and it has been shown to be effective in helping clients make significant progress in therapy. By providing a safe and supportive environment where clients feel heard and understood, therapists can help clients access their own inner resources and develop the skills and tools they need to with life's challenges.

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Sickle cell disease can cause injury to the cerebral arterial circulation resulting in cerebral infarction, stroke, and cognitive impairment.

This is due to the abnormal sickle-shaped red blood cells that can block blood vessels, reducing the blood supply to the brain and causing damage to brain tissue. People with sickle cell disease are at a higher risk of developing these complications, and regular monitoring and treatment are important to prevent and manage them.

Injury to the cerebral arterial circulation due to sickle cell disease can result in significant neurological complications, and management typically involves blood transfusions, medications, and supportive care to reduce the risk of complications and improve quality of life.

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During the superficial dissection of the Smith-Petersen anterior hip approach, the femoral nerve is in danger. These nerve roots are derived from L2 to L4.

The femoral nerve is responsible for providing sensation to the front of the thigh and motor function to the muscles in the anterior compartment of the thigh. Injury to the femoral nerve can result in weakness or paralysis of the affected muscles and loss of sensation in the front of the thigh.


The nerve in danger during the superficial dissection of the Smith-Petersen anterior hip approach is the lateral femoral cutaneous nerve. This nerve is responsible for providing sensation to the lateral thigh area.

The nerve roots that supply the lateral femoral cutaneous nerve are L2 and L3, originating from the lumbar plexus.

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Sensorimotor integration refers to the process by which an individual's sensory and motor systems work together to interpret and respond to environmental stimuli.

At around six months of age, infants begin to develop the ability to reach for and grasp objects, which is a critical component of sensorimotor integration. They also start to develop the ability to coordinate their hand movements with their visual and proprioceptive (body position) senses. As infants continue to develop, they become increasingly proficient at using their senses to guide their movements and interact with their environment.
By around nine months of age, infants have developed a more sophisticated understanding of cause-and-effect relationships and are able to engage in purposeful exploration of their environment. They can also use their motor skills to manipulate objects and explore their properties.
By the time infants reach twelve months of age, they have typically developed a strong foundation in sensorimotor integration, which sets the stage for more advanced cognitive and motor development in the years to come.

In summary, during the six to twelve month period, infants make significant strides in sensorimotor integration, developing the ability to reach for and manipulate objects, coordinate their hand movements with their senses, and engage in purposeful exploration of their environment. This is an important period of development that lays the groundwork for further growth and learning.

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Replicase, also known as RNA-Dependent RNA Polymerase, is an enzyme that plays a critical role in the replication of RNA viruses. It is responsible for copying the viral RNA genome, which allows the virus to multiply and spread throughout the host organism.

One reason why replicase was difficult to isolate is that it is a complex and highly specialized enzyme that only functions in the context of a viral infection. This means that it is not normally present in the host organism and must be purified from infected cells or tissues. Additionally, it is highly sensitive to changes in pH and temperature, which can cause it to become denatured and lose its activity. Despite these challenges, researchers have developed a variety of techniques for isolating and studying replicase, including the use of recombinant DNA technology and advanced imaging and spectroscopy methods. These approaches have helped to shed light on the structure and function of replicase, and have led to the development of new antiviral therapies that target this critical enzyme.

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Centrally acting agents are used to treat muscle spasms.

Muscle spasms occur due to a variety of reasons, including muscle strain, injury, or neurological conditions. Centrally acting agents are medications that affect the central nervous system to relieve muscle spasms.

These agents work by inhibiting the transmission of nerve impulses, reducing muscle contractions, and promoting muscle relaxation.Common centrally acting agents used to treat muscle spasms include baclofen, tizanidine, and cyclobenzaprine.

These medications are usually prescribed as part of a comprehensive treatment plan that may include physical therapy, exercise, and other modalities to manage the underlying condition causing the spasms.

It is important to follow the instructions of a healthcare professional when using these medications to minimize side effects and maximize their effectiveness in managing muscle spasms.

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In a starvation state, with low glucose levels, excess acetyl-CoA is used up in ketone body synthesis.

It is important to note that in the absence of glucose, the body turns to fatty acids as its primary fuel source. Fatty acids are broken down into acetyl-CoA molecules, which are then used in the Krebs cycle to produce ATP. However, when there is an excess of acetyl-CoA and insufficient oxaloacetate to enter the Krebs cycle, the liver converts the excess acetyl-CoA into ketone bodies such as acetoacetate and beta-hydroxybutyrate.

These ketone bodies can then be used by other tissues, such as the brain, for energy during periods of prolonged fasting or starvation.

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During the S1 phase of the cardiac cycle, the valve that closes first is the mitral valve. S1, also known as the first heart sound, occurs at the beginning of systole when the atrioventricular (AV) valves close.

The AV valves include the mitral valve (located between the left atrium and left ventricle) and the tricuspid valve (located between the right atrium and right ventricle).

The mitral valve closes slightly before the tricuspid valve due to the pressure differences between the left and right sides of the heart. The left ventricle, which pumps blood to the entire body, generates higher pressure compared to the right ventricle, which pumps blood to the lungs. As a result, the pressure in the left atrium rises more rapidly, causing the mitral valve to close first.

This valve closure is essential to prevent blood from flowing back into the atria during ventricular contraction (systole). Proper closure of the mitral and tricuspid valves ensures that blood is efficiently pumped out of the heart and into the circulatory system.

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A receptor is more sensitive when more receptor proteins are present and produce a greater response.

Receptors are specialized proteins found on the surface or within cells that can detect signals from the environment or other cells. When a signal molecule, or ligand, binds to the receptor, it triggers a series of events within the cell that ultimately leads to a physiological response.

When there are more receptor proteins present, there is a higher chance that the ligand will bind to the receptor, and thus a greater response will be produced. This is known as receptor density, and it can vary among different types of cells and tissues.

In some cases, changes in receptor density can occur in response to certain stimuli. For example, chronic exposure to a particular ligand may cause a decrease in receptor density, leading to a decreased response. Alternatively, exposure to certain hormones or growth factors may cause an increase in receptor density, resulting in a more sensitive response.

Overall, the sensitivity of a receptor is dependent on the number of receptor proteins present, and this can have important implications for cellular signaling and physiological responses.

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A receptor is said to be saturated when more receptor proteins are present and produce more responses.

The concept of saturation is important in understanding the relationship between receptor proteins and the cellular response they produce. Receptors are proteins that are located on the surface of cells or inside them. They are specialized to recognize specific molecules, such as hormones, neurotransmitters, or growth factors, and trigger a series of events that lead to a cellular response. The more receptors there are, the more molecules they can bind, and the stronger the response will be.

However, there is a limit to how much responsibility  can be generated by a given number of receptors. At a certain point, all the receptors will be occupied by the ligand (the molecule that binds to the receptor), and adding more ligand will not increase the response. This is the state of saturation.

Saturation is a dynamic process that depends on the concentration of the ligands, the affinity of the receptor for the ligand, and the number of receptors available. When the concentration of the ligand is high, the receptors will be saturated quickly, even if there are only a few of them. On the other hand, if the affinity of the receptor for the ligand is low, a large number of receptors may be needed to achieve saturation.

In summary, saturation is a key concept in receptor biology that describes the relationship between the number of receptors and the strength of the cellular response. It is an important consideration when designing drugs that target specific receptors, as the dose and timing of the drug must be carefully calibrated to avoid over-saturating the receptors and causing adverse effects.

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Two things that mediate whether a cell will respond to the hormone are the presence of specific receptors on the surface of the cell and the intracellular signaling pathways activated by the binding of the hormone to those receptors.

Different cell types may express different types or quantities of hormone receptors, which can influence their sensitivity to a particular hormone. Similarly, variations in intracellular signaling pathways or the expression of downstream effectors can also influence the magnitude or specificity of hormone responses in different cells or tissues.

Two things mediate whether a cell will respond to the hormone receptor presence, and receptor sensitivity.

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A psychological report is c. a formal summary and discussion of assessment results. This report typically includes the client's background information, test results, and the psychologist's interpretation of the data to provide a diagnosis.

A psychological report is a formal summary and discussion of assessment results. It is a written document prepared by a clinician or psychologist that summarizes the findings of psychological testing, clinical interviews, and other sources of information gathered during an evaluation. The report typically includes a description of the client's presenting problem, relevant background information, test results, diagnoses, and treatment recommendations. The report serves as a communication tool between the clinician and other professionals involved in the client's care, such as physicians, therapists, and educators. It may also be used in legal proceedings or to support applications for disability benefits or accommodations.

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The teaching can be considered effective if the client demonstrates an understanding of the following: purpose of medication, dosage and timing , possible side effects, diet and exercise etc.

The purpose of the medication: The client should be able to explain why they are taking acarbose and what it is supposed to do in their body. In this case, acarbose is used to treat type 2 diabetes by slowing down the digestion and absorption of carbohydrates, which helps to control blood sugar levels.

Dosage and timing: The client should understand how much medication to take and when to take it. Acarbose is usually taken three times a day with meals, and the dosage may be adjusted by the healthcare provider based on the client's blood sugar levels.

Possible side effects: The client should be aware of the potential side effects of acarbose, such as abdominal pain, diarrhea, and gas. The nurse should explain that these side effects may improve over time as the body adjusts to the medication.

Monitoring blood sugar levels: The client should be instructed to monitor their blood sugar levels regularly as directed by their healthcare provider. The nurse should explain how to use a blood glucose meter and how to interpret the results.

Diet and exercise: The client should be reminded that medication alone is not enough to control diabetes and that a healthy diet and regular exercise are also important. The nurse should provide information about recommended dietary changes and exercise routines.

Importance of follow-up appointments: The client should understand the importance of follow-up appointments with their healthcare provider to monitor their diabetes and adjust their treatment plan as needed.

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Based on the symptoms and physical exam findings you provided, the initial diagnosis that comes to mind is an abdominal aortic aneurysm (AAA).

This occurs when there is a weakening of the walls of the aorta, the main blood vessel in the abdomen, leading to a bulging or ballooning of the vessel. The pulsatile mass, tenderness, and bruit over the aorta are all consistent with an AAA.

AAA is a medical emergency and requires immediate evaluation and management. If the aneurysm ruptures, it can cause life-threatening bleeding. Therefore, James needs urgent referral for vascular surgery evaluation and stabilization.

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The  The Chapman's reflex point associated with the appendix is B) The tip of the twelfth right rib. associated with the appendix is B) The tip of the twelfth right rib.

Chapman's reflex points are specific points on the body that are associated with various organs and tissues.

These points can be palpated to help diagnose and treat dysfunction in those areas.

The spinous process of L1 is associated with the appendix, which is located in the lower right quadrant of the abdomen.
If a practitioner suspects an issue with a patient's appendix, they may check the spinous process of L1 for tenderness or other signs of dysfunction.
Chapman's reflex points are specific locations on the body that correspond to various organs and tissues. They are used by practitioners of osteopathic medicine to diagnose and treat various conditions.

In the case of the appendix, the associated reflex point is located at the tip of the twelfth right rib.
By understanding the specific Chapman's reflex point for the appendix (the tip of the twelfth right rib), osteopathic practitioners can more accurately diagnose and treat issues related to this organ.

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The MOST accurate statement after reading the chapter about familial impacts on career aspirations is that children from lower socioeconomic backgrounds receive messages of conformity and obedience from their parents.

This can have a negative impact on their educational and career aspirations as they may not feel encouraged or supported to pursue higher education or non-traditional career paths. However, it is important to note that this is not a universal experience for all children from lower socioeconomic backgrounds and individual family dynamics can vary.
After reading this chapter about familial impacts on career aspirations, the MOST accurate statement is:
d. ​Children from lower socioeconomic backgrounds often receive messages of conformity and obedience from their parents.

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The statement "Intercellular communication where a chemical messenger is distributed to the entire body by way of the bloodstream" is true.

Intercellular communication is  the transfer of information from one cell to another. Cells signal each other by direct contact with each other or by the release of a substance from one cell that is taken up by another cell. Intercellular communication is important for cells to grow and work normally.

This type of intercellular communication is known as endocrine signaling, where hormones are released into the bloodstream and travel throughout the body to target cells.. In endocrine signaling, glands release hormones (chemical messengers) into the bloodstream, which then circulate throughout the body to target cells or organs, leading to a specific response.

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At Allen's Cognitive Level 4, an individual is typically able to perform more complex activities of daily living independently, such as meal preparation, housekeeping, and personal care.

They may also be able to manage finances and transportation with minimal assistance. Individuals at this level may also have a better understanding of cause and effect relationships and may be able to problem-solve more complex tasks.

At Allen's Cognitive Level 4, they may enjoy participating in leisure activities that require more planning and organization, such as playing a musical instrument or participating in a hobby.

However, they may still struggle with abstract concepts and may require some guidance and support for more complex tasks.

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Answer: I don't know seconds specifically, but it should be 2 breaths every 30 compressions.

Explanation:

For a small child, the first aider should give 1 breath about every 3 seconds, hence Option (A).

For a small child, the recommended ratio of rescue breaths to chest compressions during CPR is 2 breaths to 30 compressions. As during During CPR, chest compressions are a vital component of the resuscitation process. They help to manually pump the heart and circulate blood to vital organs until advanced medical care can be provided. Chest compressions should be performed in cycles of 30 compressions to 2 breaths for both children and adults. The rate of compressions should be about 100-120 per minute, and the depth of compressions should be about 2 inches (5 cm) for adults and about 1/3 to 1/2 the depth of the chest for children. The first aider should give 2 breaths about every 30 compressions, which is roughly one breath every 15 compressions or every 4-5 seconds.

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When an opioid binds to pre-synaptic receptors, it can have several effects on the transmission of nerve impulses and the release of neurotransmitters.

Opioids work by binding to specific receptors in the brain, called mu, delta, and kappa receptors. When opioids bind to these receptors, they can inhibit the release of neurotransmitters, such as substance P, which are involved in pain perception.

Specifically, when an opioid binds to pre-synaptic mu receptors, it inhibits the release of substance P and other neurotransmitters that transmit pain signals from the peripheral nerves to the central nervous system.

This results in a decrease in the transmission of pain signals and a reduction in pain perception.

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