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However, real-world reports from patients describe irritability and mood changes, suggesting individual variation and potential mechanisms through brain GLP-1 receptors and metabolic stress responses

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C.StollB.et al

It has good functionality in distinguishing those patients at the lower and higher ends of the scale, but the main limitation lies in accurate identification and discrimination of grade 1 HE from those who have no HE and those with mHE due to significant inter- and intra-observer inconsistency [7]