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This pathway consists of several steps and is sometimes called the 'carnitine shuttle' (Fig

One of the enzymes in this pathway, -butyrobetaine hydroxylase, is absent from cardiac and skeletal muscle but highly expressed in human liver, testes, and kidney [4]

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Carnitine palmitoyltransferase 1C promotes cell survival and tumor growth under conditions of metabolic stress

Nevertheless, therapeutic hypothermia is only partially effective (5760), and many infants with HIE remain at substantial risk of death or severe long-term neurodevelopmental impairments (55)