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She also had chronic BV that nothing would cure and even had shingles twice as a teenager
doi:10.1016/j.smrv.2020.101405
Importantly, this relationship is bidirectional: progressive MASLD and MASH impair circadian regulation through hyperammonemia, astrocyte dysfunction, altered glutamatergic signaling within the SCN, neuroinflammation, endocrine dysregulation, and HE, thereby reinforcing sleepwake fragmentation and chronobiologic instability
