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Similarly to CBT, the cultural adaptation of medication approaches is also an opportunity and a shortcoming when identifying potentially successful therapies in Pacific and indigenous populations (Pihama and Tuhiwai-Smith, 2023:5)

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MMP-9 activity has been previously shown to be elevated in the lungs and upper airways of vapers 13,21 , and MMP-9 is known to play an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD) 22

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Again, we do not really know why smoking has a protective effect against UC