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These include lack of awareness of health care professionals about prompt diagnosis and adequate management of hyperammonemia, strained communication between physicians at primary, secondary, and tertiary hospitals, and lack of knowledge and availability of the diagnostic tools and medications required in the acute management of hyperammonemia

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These findings have revealed that NAD+ serves not only as a metabolic cofactor but also as a critical regulator of epigenetic information, linking cellular energy status to long-term gene expression patterns and cellular identity

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