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This evolutionary path is fundamentally different from the generally accepted idea that conflicting functions in a single gene favour duplication and diversification, as is the case for Exendin-4 in gila monster

Given the heterogeneity of the included evidencespanning case reports, pharmacovigilance analyses, and observational cohortsthis review is framed primarily as a signal-detection and evidence-mapping exercise rather than a causal-inference analysis

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