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The study lacks a control group, making it impossible to determine whether the reported improvement in muscle strength reflects a true treatment effect or simply learning or general well-being from weight loss

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However, the prevailing biological hypothesis for konzo development is that famine-stricken populations rely on diets that are deficient in the key sulfur amino acids methionine and cysteine, likely decreasing their ability to fully detoxify cyanide 10,11

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