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None of this constitutes evidence of efficacy

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Myalgic encephalomyelitis/chronic fatigue syndrome patients exhibit altered t cell metabolism and cytokine associations

(Yes, the Nintendo Switch Pro Controller has a D-pad, but the assembled twin-analog controller (comprising the two Joy-Cons) does not.) With the Joy-Cons usable in local multiplayer, Nintendo likely didn't want to give one side an advantage over the other, and/or found making both button interfaces a D-pad to be unworkable (they allow for 8-direction input, instead of a true four buttons, after all)