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However, when accounting for within-patient clustering using a MANCOVA with patient as a fixed effect, the multivariate omnibus test was significant, and univariate effects remained significant for insomnia and end-of-dose crash, but not for poor appetite or return of symptoms

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These protective effects involve activation of cell survival pathways and may include antioxidant mechanisms, though the precise molecular pathways mediating cytoprotection require further elucidation

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