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Notably, acetylcarnitine can act as an acetyl donor [37], supporting the acetylation process of cells through the shuttle mechanism of acetylcarnitine in the absence of conventional acetyl-CoA synthetase enzymes such as ATP-citrate lyase (ACLY) and acyl-CoA synthetase short chain 2 (ACSS2) [38]

Baseline differences between treatment groups, including demographic and metabolic parameters, may have influenced outcomes despite statistical adjustment, and residual confounding cannot be entirely excluded

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The market dynamics created perverse incentives