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  1. Several non canonical signaling pathways that do not depend on SMAD phosphorylation and nuclear accumulation have been described and include the mitogen activated protein kinases MAPKs ERK, p38 and JNK, PI3K Akt and Rho GTPase pathways 27 29 buy cialis cheap After the 18- month study period, medical records were collected from recruitment physician practices and any other physicians seen for infertility- related care during the study period