Cyriac Abby Philips | |
|---|---|
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| Born | 14 August 1982 |
| Alma mater | St. John's Medical College, Bangalore (MBBS) Nil Ratan Sircar Medical College (MD) Institute of Liver and Biliary Sciences (DM) |
| Occupations | Hepatologist, clinician-scientist |
| Employer(s) | Rajagiri Hospital, Kochi |
| Known for | Research on drug-induced liver injury, critique of alternative medicine |
| Awards | Ockham Award for Skeptical Activism (2025) |
Cyriac Abby Philips is an Indian hepatologist and clinician-scientist specializing in clinical and translational hepatology, liver transplant medicine, and drug-induced liver injury. [1] [2] Currently serving as Senior Consultant at Rajagiri Hospital in Kochi, Kerala, he earned his MD in Internal Medicine from Nil Ratan Sircar Medical College in Kolkata and has conducted extensive research on liver diseases, authoring over 170 peer-reviewed publications with more than 2,300 citations in major gastroenterology and hepatology journals. [1] [3] [4]
Philips has documented hepatotoxicity associated with herbs and formulations from Indian systems of alternative medicine, including comprehensive reviews linking complementary and alternative medicine to liver damage through empirical analysis of clinical cases and supplement testing. [5] [6] Active on social media as "The Liver Doc," he critiques pseudoscientific claims in wellness products and traditional remedies, emphasizing causal mechanisms of harm such as undisclosed hepatotoxins in marketed supplements. [7] [8] His advocacy earned the 2025 Skeptical Activism Ockham Award from the Committee for Skeptical Inquiry for promoting evidence-based scrutiny of medical misinformation. [8]
Philips' work has sparked controversies, including defamation lawsuits from companies like Himalaya Wellness over criticisms of products such as Liv.52, leading to temporary suspensions of his X account, and professional complaints alleging misconduct for public statements against unproven therapies. [7] [9] Despite such pushback, his self-funded studies, like analyses of protein supplements and homeopathic preparations, underscore risks of unregulated alternatives via transparent toxicological evaluations. [10] [11]
Cyriac Abby Philips was born on 14 August 1982 in Kottayam, Kerala, India, as the third of four siblings in a family deeply immersed in medicine. [12]
His father, Dr. Philip Augustine, is a pioneering gastroenterologist in Kerala who has practiced for over four decades, performed India's first endoscopic retrograde cholangiopancreatography (ERCP) procedure, and received the Padma Shri award in 2010 for contributions to gastroenterology. [13] [14] Philips's mother, Cicy Philip, serves as executive director at Philip Augustine Associates Pvt. Ltd., the clinical entity founded by his father.[ citation needed ]
Raised in an environment where medical discussions dominated daily life, Philips was exposed from childhood to topics of diseases, treatments, and hospital operations due to his father's profession, fostering an early familiarity with clinical challenges. [15] [14] Despite initial aspirations toward screenwriting, acting, and theatre—driven by an interest in storytelling—familial expectations directed him toward medicine, leading him to enter medical coaching and begin his MBBS in 2001. [15] His father advised against specializing in gastroenterology due to field saturation, influencing Philips's later focus on hepatology. [13]
Cyriac Abby Philips obtained his Bachelor of Medicine and Bachelor of Surgery (MBBS) from St. John's Medical College in Bangalore. [13]
He subsequently completed his Doctor of Medicine (MD) in Internal Medicine at Nil Ratan Sircar Medical College in Kolkata. [13] [1] [16]
Philips advanced his specialization with a Doctorate of Medicine (DM) in Hepatology from the Institute of Liver and Biliary Sciences (ILBS) in New Delhi, entering the program on 1 August 2013, as part of the 2013–2016 batch focused on hepatology training. [13] [17]
After obtaining his DM, he served as a senior resident at ILBS, gaining further clinical experience in liver and biliary sciences. [13]
Cyriac Abby Philips serves as a senior consultant and clinical-scientist in the Department of Clinical and Translational Hepatology at The Liver Institute, Rajagiri Hospital, Aluva, Kerala, India, where he specializes in hepatology and liver transplant medicine. [1] His practice centers on the diagnosis and management of complex liver disorders, including decompensated cirrhosis and severe alcoholic liver disease, drawing from over a decade of direct patient care experience in these areas. [3] [18]
In clinical settings, Philips emphasizes evidence-based interventions for alcohol-associated hepatitis, advocating for corticosteroid therapy in select cases of severe disease while highlighting the limitations of unproven treatments such as plasma exchange, which he has critiqued for lacking efficacy in liver failure based on observational outcomes from his patient cohorts. [18] [19] He routinely manages symptoms of advanced liver disease, including ascites, hepatic encephalopathy, and variceal bleeding, prioritizing causal factors like ongoing alcohol use or toxin exposure over symptomatic palliation alone. [20]
Philips' hepatology practice has involved treating numerous cases of drug-induced liver injury, particularly those linked to unregulated herbal and complementary medicines prevalent in India, where he has observed patterns of acute hepatotoxicity leading to transplantation or mortality in otherwise manageable conditions. [21] His approach integrates transplant evaluation for end-stage disease, with a focus on pre- and post-transplant care to mitigate drug interactions and recidivism risks in recipients. [22] This work underscores a commitment to causal realism in therapy, rejecting interventions without empirical support from controlled data. [19]
Cyriac Abby Philips specializes in clinical and translational hepatology, with research emphasizing acute-on-chronic liver failure (ACLF), complications of cirrhosis, and mechanisms of liver injury. His work integrates multicenter observational studies and consensus guideline development, often drawing from large cohorts in the Asian Pacific region to inform management strategies for decompensated liver disease. [4] [23]
Philips co-authored the updated consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) on ACLF, incorporating empirical data on diagnostic criteria, prognostic models, and therapeutic interventions from over 10,000 patients across multiple studies, highlighting regional variations in etiology such as viral hepatitis and alcohol. [4] He has investigated cirrhosis-related outcomes, including a multicenter analysis of 1,200+ patients showing that bowel wall thickening on imaging correlates with long-term mortality in acute gastrointestinal bleeding (hazard ratio 2.1; 95% CI 1.4-3.2). [24] Another study examined endoscopy timing in 500+ cirrhotics with variceal hemorrhage, finding delays beyond 12 hours increased rebleeding risk by 45% (p<0.01). [25]
In therapeutic research, Philips evaluated fecal microbiota transplantation in steroid-ineligible severe alcoholic hepatitis, reporting pilot data on 20 patients with improved survival (60% at 90 days) versus historical controls, linked to restored gut-liver axis homeostasis. [4] He critiqued plasma exchange for severe liver failure in a 2024 analysis of randomized trials, demonstrating no mortality benefit (RR 1.02; 95% CI 0.89-1.17) and high complication rates (35%), advocating evidence-based restraint over unproven extracorporeal therapies. [26]
Philips has published over 250 peer-reviewed articles, with contributions to international registries on hepatocellular carcinoma surveillance in Kerala, India, involving 1,500+ cases and identifying gaps in early detection (stage I diagnosis in only 22%). [27] [23] His efforts earned two American Association for the Study of Liver Diseases (AASLD) clinical hepatology plenary awards (2015, 2017) for presentations on liver failure dynamics and three APASL clinical research awards (2016, 2018, 2020). [28] These accolades recognize his role in advancing prognostic tools, such as machine learning models for in-hospital mortality in cirrhotic bleeding (AUC 0.85). [29]
Cyriac Abby Philips has extensively documented cases of herbal-induced liver injury (HILI) attributable to herbs in Indian AYUSH systems, particularly Ayurveda, through case series, histopathological analyses, and literature reviews spanning 2019 to 2024. [5] His work emphasizes causal links established via exclusion of competing etiologies, biochemical patterns, liver biopsies showing necrosis and inflammation, and causality tools like the Roussel Uclaf Causality Assessment Method (RUCAM), often scoring "probable" or "highly probable" for herbal agents. [30] Philips argues that inherent phytochemical toxicity, rather than solely contamination or adulteration, drives many instances, as chemical analyses of implicated products frequently reveal unadulterated natural compounds. [5]
A focal point of Philips' analysis is Tinospora cordifolia (Giloy), linked to the highest number of HILI reports in India, with 43 documented cases predominantly presenting as autoimmune-like hepatitis, affecting over 50% females and confirmed by biopsy findings of interface hepatitis and plasma cell infiltration. [5] Similarly, Withania somnifera (Ashwagandha) features in 23 cases from 2019–2022, including 8 from single-ingredient formulations, manifesting as cholestatic hepatitis with male predominance; among those with preexisting chronic liver disease, acute-on-chronic liver failure occurred in 5, resulting in 3 deaths despite supportive care. [30] Philips notes prolonged recovery in survivors, with one case progressing to chronic injury, underscoring dose-independent idiosyncratic reactions. [30]
Other implicated herbs include Curcuma longa (Turmeric), associated with hepatocellular injury in 10 cases reported to the US Drug-Induced Liver Injury Network (DILIN), including one fatality, and Psoralea corylifolia (Bakuchi), tied to cholestatic patterns in 8 cases with one acute-on-chronic failure. [5] Pyrrolizidine alkaloid-containing herbs, such as those in certain Sri Lankan preparations, cause sinusoidal obstruction syndrome, while miscellaneous agents like Garcinia cambogia and Cassia angustifolia (Senna) exhibit variable hepatocellular damage. [5] Philips' reviews highlight elevated mortality rates of 10–19% in Indian HILI cohorts and over 50% in those with underlying liver disease, contrasting with unsubstantiated claims of herb safety in traditional systems. [5]
Prevalence data from Philips' studies indicate complementary and alternative medicine (CAM) use in 63% of Indian cirrhosis patients, correlating with an 8-fold rise in US liver transplants due to herbal/dietary supplements. [5] He advocates for systematic HILI surveillance in acute liver presentations, public education on risks, and regulatory reforms prioritizing evidence over anecdotal efficacy, cautioning that multi-herbal formulations obscure causality and exacerbate outcomes through polypharmacy. [5] These findings challenge narratives minimizing herbal risks, as histopathological and temporal associations consistently implicate direct hepatotoxic effects. [30]
Philips has authored or co-authored multiple peer-reviewed studies documenting drug-induced liver injury (DILI) from complementary and alternative medicines (CAM), with a focus on herbal, Ayurvedic, and homeopathic preparations prevalent in India and Asia. These works emphasize the role of unregulated formulations containing heavy metals like arsenic and mercury, as well as hepatotoxic volatile organic compounds, in causing severe outcomes such as acute hepatitis, cholestasis, necrosis, and acute-on-chronic liver failure. [31] [32] His analyses often incorporate histopathological findings, chemical assays, and causality assessments like the Roussel Uclaf Causality Assessment Method, revealing high mortality risks in patients with preexisting liver conditions. [6] [31]
In a 2018 single-center study published in the Indian Journal of Gastroenterology, Philips examined 94 cases of severe liver injury associated with Ayurvedic and herbal medicines, confirming DILI in 33 via rigorous causality scoring; key risk factors for the 18.5% mortality rate included hepatic encephalopathy, hypoalbuminemia, hepatic necrosis, and elevated levels of arsenic and mercury in the implicated products, with over 70% of samples containing hepatotoxic volatile organics. [31] The cohort, predominantly male with a mean age of 47 years, had typically consumed these agents for a median of 28 days, underscoring the rapid onset of toxicity from unregistered traditional preparations. [31]
A 2019 review in the Journal of Clinical and Translational Hepatology by Philips detailed CAM-related DILI across Asia, reporting rising incidences linked to unlabeled Ayurvedic drugs for conditions like diabetes and hepatitis B, which precipitated acute-on-chronic liver failure and death; liver biopsies frequently showed inflammation, necrosis, and granulomas, with calls for systematic diagnostic frameworks amid absent comprehensive DILI registries in high-CAM-use regions like India. [32]
Philips extended this in a 2020 World Journal of Hepatology article reviewing hepatotoxicity from traditional Indian Ayurvedic herbs, analyzing mechanisms of liver damage and clinical implications from case series. [33] In 2023, he co-reported a series of severe DILI cases from homeopathic remedies in Hepatology Communications, highlighting patterns of acute hepatitis and the need for regulatory scrutiny of such CAM modalities. [34]
His 2024 contribution to Hepatology Communications synthesized global CAM-DILI trends, noting presentations from asymptomatic enzyme elevations to vanishing bile duct syndrome and autoimmune-like hepatitis; preexisting liver disease was identified as a predictor of progression to failure and reduced transplant-free survival, alongside critiques of "liver-beneficial" herb myths and advocacy for enhanced patient education and regulation. [6] These publications collectively inform Asia-Pacific DILI guidelines, co-authored by Philips in 2021, stressing early identification of CAM hepatotoxins. [35]
Cyriac Abby Philips maintains an active presence on social media platforms under the pseudonym "The Liver Doc," leveraging them to disseminate evidence-based information on hepatology and counter health misinformation. His primary outlet is X (formerly Twitter), where the account @theliverdr has accrued 314,056 followers and features over 59,000 posts as of October 2025, focusing on critiques of unproven remedies and their links to drug-induced liver injury. [36] Philips employs a direct, data-driven style, often citing clinical studies and patient case reports to challenge claims from alternative medicine proponents, emphasizing empirical risks over anecdotal endorsements. [37]
On Instagram (@theliverdr), Philips shares visual aids, infographics, and reels elucidating liver pathology and the hepatotoxicity of herbal supplements, garnering engagement through educational threads on topics like the dangers of unchecked polyherbal use. [38] His content routinely addresses public queries on liver health, such as warnings against self-medication with substances like Giloy, which he has labeled highly liver-toxic based on observed clinical patterns. [39] This approach fosters interaction with a broad audience, including patients and skeptics, while promoting rigorous scientific scrutiny over traditional or influencer-driven narratives. [40]
Philips' engagement extends to real-time responses to viral misinformation, such as debunking celebrity-endorsed practices involving nebulized hydrogen peroxide or unverified supplements, positioning his accounts as counterpoints to pseudoscientific trends. [41] Despite platform restrictions, including a 2023 temporary suspension of his X account following defamation claims by a supplement firm, he has restored and sustained visibility, underscoring his commitment to accessible public advocacy. [42] His strategy prioritizes verifiable medical evidence, drawing from peer-reviewed hepatotoxicity data to inform followers on causal links between alternative therapies and adverse outcomes. [43]
Cyriac Abby Philips, under his online persona "The Liver Doc," has actively debunked pseudoscientific health claims on social media, emphasizing the lack of empirical evidence and potential risks to patients. His critiques target unsubstantiated assertions in alternative medicine, wellness trends, and celebrity-endorsed remedies, often highlighting how they contradict established hepatological data. For instance, in July 2024, he refuted actress Nayanthara's promotion of hibiscus tea as a cure for polycystic ovary syndrome and other conditions, labeling the claims "false and inaccurate" due to insufficient clinical trials supporting efficacy and risks of herb-drug interactions. [44]
Philips has similarly challenged "detox" fads, arguing that purported liver-cleansing products and practices lack mechanistic plausibility and can exacerbate hepatic stress, as the human liver naturally detoxifies without external aids. [45] In a June 2023 analysis, he dissected a viral video promoting Himalayan salt ("sendha namak") as superior for health, pointing out that mineral content variations do not confer benefits over regular salt and that such claims ignore sodium's uniform physiological impact. [46] He extended this to religious-framed assertions, such as tulsi leaves being rich in protective compounds, noting in April 2022 that no peer-reviewed studies validate antiviral or detoxifying effects amid high mercury contamination risks in some samples.
His debunkings extend to high-profile influencers, including a 2023 critique of podcaster Andrew Huberman for promoting unverified neuroscience-based health hacks lacking plausibility and validity. [47] In April 2025, Philips accused anti-aging entrepreneur Bryan Johnson of fraud for Blueprint protocol claims, citing absence of long-term randomized controlled trials and overreliance on anecdotal biomarkers. [48] Philips frames these efforts as opposition to "anything unscientific, pseudoscientific, or rooted in faith," prioritizing causal evidence over anecdotal or traditional appeals, which he argues misleads vulnerable patients toward hepatotoxic alternatives. [49]
Through threads and videos, Philips advocates for evidence-based scrutiny, warning that social media amplifies misinformation—such as unproven home remedies for symptom relief—driving misuse over targeted etiology-based treatments. [50] His approach underscores systemic issues in India's wellness sector, where cultural reverence for traditional systems like Ayurveda often shields pseudoscientific marketing from rigorous testing, despite documented adverse events. [51]
In September 2023, Himalaya Wellness Corporation, an Indian herbal supplement manufacturer, filed a defamation lawsuit against Cyriac Abby Philips in a Bengaluru civil court, accusing him of making false and unjustified statements on social media about their product Liv.52, which allegedly caused business losses. [52] [53] The suit stemmed from Philips' posts since 2019 questioning Liv.52's efficacy and linking it to cases of liver injury, claims he supported with references to peer-reviewed studies on herbal hepatotoxicity. [54]
The court granted an ex parte interim injunction on 28 September 2023, ordering the global suspension of Philips' X (formerly Twitter) account, @theliverdoc, and prohibiting further public discussion of Himalaya products pending resolution. [52] [53] Philips appealed to the Karnataka High Court, which restored his account access after he concealed nine critical tweets, though the gag order on Himalaya-related commentary remained in effect; a follow-up hearing was scheduled for 5 January 2024. [52]
The ongoing litigation influenced academic publishing, as an abstract of Philips' paper on Liv.52-associated liver damage—accepted by Frontiers in Pharmacology in January 2024—was withdrawn in June 2024, with the journal citing the unresolved legal proceedings as the reason for non-publication despite no identified scientific flaws. [52] Philips contested the withdrawal, asserting that judicial matters should not override evidence-based review and denying any conflicts of interest. [52]
Separately, in 2018, Philips' case report in the Journal of Clinical and Experimental Hepatology implicating Herbalife supplements in a fatal instance of liver failure prompted legal threats from the company to the journal, leading to the paper's retraction in early 2019 for "legal reasons" and its complete removal thereafter, amid claims of methodological shortcomings influenced by Herbalife-funded input. [55] Although not a direct suit against Philips, the action highlighted industry pressure on his critiques of supplement safety. [55]
In July 2025, Nakpro Nutrition issued threats of legal action following Philips' "Citizens Protein Project 2," a self-funded analysis revealing potential hepatotoxins in their protein supplements, though no formal lawsuit had been filed as of that date. [56] Philips has consistently framed such challenges as attempts to suppress evidence-based warnings on unregulated supplements, citing his clinical observations of drug-induced liver injury patterns. [52]
Philips has encountered substantial online harassment and accusations from right-wing Hindu nationalist groups in India, who view his critiques of Ayurvedic remedies as an assault on cultural heritage and traditional knowledge systems. Following his public analyses of liver injuries linked to herbal supplements, including those promoted under Ayurvedic principles, he reported being targeted by a coordinated "right-wing Hindu nationalist social media abusive machinery" that inundated his posts with threats and derogatory comments. [57] In November 2023, Philips lodged a formal complaint with Kerala Police against a prominent right-wing social media influencer for inciting abuse, stemming from his debunking of claims by an Ayurveda advocacy group. [57]
These attacks often frame Philips as "anti-Hindu" or opposed to Indian traditions, despite his emphasis on evidence-based hepatology rather than religious or cultural dismissal. Supporters of traditional medicine, aligned with nationalist sentiments, have accused him of Western bias and undermining India's global promotion of Ayurveda, a system politically endorsed by the government through initiatives like the Ministry of AYUSH. [58] [14] This backlash intensified amid a national push to integrate and export traditional medicines, positioning Philips's data-driven warnings—such as case series documenting hepatotoxicity from unregulated herbals—as ideologically motivated. [59]
The cultural dimension is evident in responses portraying Ayurveda not merely as medicine but as an emblem of civilizational pride, leading to doxing, boycott calls, and persistent online campaigns against Philips since at least 2017. [60] While some defenses of traditional systems invoke empirical traditions within Ayurveda, critics like Philips argue that such reactions prioritize identity over verifiable safety data, exacerbating risks from unstandardized products. No formal investigations into the organized abuse have been publicly detailed beyond Philips's complaint, highlighting challenges in addressing digital harassment tied to cultural-political narratives. [57]
In October 2025, Cyriac Abby Philips was awarded the Ockham Award for Skeptical Activism by The Skeptic magazine, a publication affiliated with the UK-based skeptical community, for his sustained efforts in highlighting the dangers of alternative medicine practices including homeopathy, herbal remedies, and related superstitions in India over more than a decade. [8] The award was announced on 25 October 2025, during the QED conference in Manchester, England, recognizing Philips' role as a clinician-scientist in hepatology who has countered health misinformation through social media platforms, amassing over 430,000 followers across X, Instagram, and YouTube. [61]
The selection criteria emphasized Philips' resilience against harassment, legal threats, and industry litigation from proponents of alternative therapies, including cases where his research papers on supplement-induced toxicities—such as a 2019 study linking a patient's death to a toxic herbal product—faced retraction and subsequent reinstatement following external pressures. [8] [61] Michael Marshall, editor of The Skeptic, described the honor as follows: "For continuing to stand up for science and for the best interests of patients, undeterred by a barrage of legal threats and intimidation, Dr Cyriac Abby Philips is a very worthy recipient." [8]
This accolade underscores Philips' contributions to skeptical inquiry by prioritizing empirical evidence from clinical hepatology to challenge unsubstantiated claims in complementary and alternative medicine (CAM), amid broader institutional challenges such as dropped misconduct charges by the Kerala State Medical Council in 2022 after an eight-month investigation into his critiques of Ayurvedic practices. [61]
Cyriac Abby Philips has shaped public health discourse by emphasizing the empirical risks of unregulated herbal and traditional remedies, particularly their role in drug-induced liver injury (DILI), through peer-reviewed analyses documenting hepatotoxicity in Indian AYUSH systems. His 2024 review in Medicine detailed over 100 cases of severe liver damage linked to Ayurvedic herbs, attributing causality to adulterants, heavy metals, and inherent toxicities rather than incidental factors, challenging narratives of inherent safety in "natural" products. [5] This work has informed global discussions on CAM regulation, highlighting how promotional claims often overlook causal mechanisms like idiosyncratic reactions and dose-dependent poisoning. [6]
Philips' social media advocacy as "The Liver Doc" has amplified these findings, reaching audiences in India and beyond to counter wellness misinformation, such as unsubstantiated benefits of cow urine concoctions or hibiscus tea for chronic conditions, fostering evidence-based skepticism amid rising herbal supplement use. [62] His critiques have sparked debates on the tension between cultural traditionalism and scientific validation, especially in contexts where government initiatives promote AYUSH without rigorous toxicity surveillance, leading to increased public and media scrutiny of industry practices. [51]
Beyond herbal risks, Philips has influenced conversations on lifestyle factors in liver disease, using case comparisons—like livers from moderate alcohol consumers versus abstainers—to underscore cumulative toxicity independent of quantity myths, thereby promoting preventive strategies grounded in toxicology over anecdotal endorsements. [63] Endorsements from physician networks advocating healthcare reforms affirm his contributions to combating infodemics, positioning him as a proponent of clinician-led public education against pseudoscientific encroachments on evidence-based policy. [64] [65]
Cyriac Abby Philips resides in Kochi, Kerala, India, where he serves as a senior consultant hepatologist at facilities including Rajagiri Hospital and the Ernakulam Medical Center. [1] [66] His professional base in Kochi aligns with his clinical and research work in hepatology, conducted through affiliations such as the Cochin Gastroenterology Group and Monarch Liver Lab. [66] Originally from Kottayam, Kerala, Philips maintains his primary residence and practice in this coastal city, facilitating his patient care and public advocacy efforts.
Philips is the son of Philip Augustine, a gastroenterologist awarded the Padma Shri in 2005 for contributions to medicine. [12] He is married and has three children: two daughters and one son. [12] Limited public details exist on his immediate family, reflecting Philips' focus on professional rather than personal disclosures, though he has occasionally referenced family health experiences in medical contexts, such as a challenging diagnosis involving a relative. [67] His family life intersects with his veterinary interests, as he has shared experiences with pet dogs that have positively influenced his household. [68]
Philips maintains an active interest in canine companionship, owning multiple dogs including a pug named Penny, a boxer named Bella, and a Dalmatian puppy named Juniper, with a deceased Dalmatian named Bingie also part of the family history. He has highlighted the positive impacts of these pets on family dynamics, noting their role in fostering humility, empathy, and social skills in children, while citing scientific evidence for benefits such as reduced risks of obesity and asthma in pet-owning households. [68]
Beyond pets, Philips engages with graphic novels, a topic he discusses enthusiastically in interviews as a leisure pursuit distinct from his professional reading. [14] He has recommended specific works such as Habibi , Blue Is the Warmest Color , and My Mom's Cancer during public interactions, reflecting a selective appreciation for the medium's narrative style. [69]
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