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Overt hepatic encephalopathy was recognized by the detection of marker symptoms, such as disorientation and flapping tremor, because of their excellent interobserver reliability 2,3

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The process of generating ATP naturally produces reactive oxygen species (ROS), which are highly volatile molecules that can cause severe cellular damage if left unchecked

The benefit of screening for these patients is not yet clear since their risk of developing symptoms in the future is yet unknown [55, 58]

doi: 10.1002/mrd.23542 23 XuZKalbfleischJD

This discrepancy primarily stems from methodological variations in patient selection, intervention design, and endpoint assessment, rather than contradicting the established biological plausibility of LC's mechanisms