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This sample size is consistent with prior mechanistic studies and the 3R principles [52, 53], although the relatively small cohort remains a limitation and should be expanded in future work

Metabolic treatments in ALS Given that defects in energy metabolism are evident in ALS, addressing these disturbances is a reasonable approach to improve quality of life and prolong survival in patients with ALS

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Stop treatment and seek medical guidance if you develop chest pain, shortness of breath, severe swelling, sudden vision changes, allergic reaction symptoms, or significant mood changes.