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cDNA synthesis was done using 0.11 g approximately of RNA following the manufacturer protocol (Takara Bio, Kusatsu, Japan)

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67 The role of acetyl-L-carnitine in the treatment of HE is postulated to be related to reduction of serum ammonia by increasing ureagenesis 67 in addition to enhancing the production of acetylcholine in the brain (by facilitating the uptake of acetyl-coenzyme A) and stimulating protein and phospholipid synthesis, all of which increase cellular energy production and reduce neuronal toxicity in patients with HE

Furthermore, in the CR-like signaling, TOR pathway plays a pivotal role in growth, metabolism, and aging (Keith Blackwell et al., 2019)

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This intervention was also highly cost-effective, with estimates ranging between 128 and 310$ per quality-adjusted life year, or even less if screening was targeted to high-risk populations