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IGF-1 as a Performance-Enhancing Drug (PED): Doping in Sports IGF-1 has gained a reputation as a popular doping agent in sport, implicated in many of the most high-profile doping cases in recent years including the Bay Area Laboratory Co-operative (BALCO) [86], Major League Baseball (MLB) [87] and Tour de France [88] scandals to name a few

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Additionally, underreporting of mild or transient cases could lead to an underestimation of the true incidence in postvaccination surveillance data

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