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Among the operative mechanisms, protective effects of SEMA on cardiac remodelling with decreased hypertrophy and fibrosis with improved mitochondrial function, microvascular function and reduced apoptosis have been postulated in both experimental and clinical models,27,28 as well as other metabolic effects related to fat mass reduction (Fig

BMJ Open 2013, 3(1)

This approach reduces the risk of inappropriate adjustment, such as controlling for mediators (variables on the causal pathway between exposure and outcome) or colliders (variables influenced by both exposure and outcome), which can introduce bias

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