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Given its numerous functions, low levels of thiamine can lead to reduced energy production due to impaired mitochondrial function, which damages neurons, and cells that have high energy demands, making them particularly vulnerable to potential damage or cell death (40)

anti-fibrotic effects via PPAR upregulation followed by TGF-, CTGF, and PDGF downregulation

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This helps to ensure a balance between the benchmark and the performance year such that an ACO is not unfairly benefitting from a benchmark that includes certain expenditures that are excluded from the performance year