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that is, low p53 levels lead to growth arrest, while increased p53 levels result in apoptosis ( 2.3 p53 and germ cell death in spermatogenesis The apoptosis of germ cells is a normal phenomenon in spermatogenesis and has been widely observed in SSCs, spermatogonia, spermatocytes and spermatids

However, if dual users are defined as using either product once in the past month (a broader definition), prevalence of dual use will be high