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Pathophysiological mechanisms of HE HE occurs due to a combination of distinct pathophysiological mechanisms such as inflammation [32], oxidative stress [33], impaired bloodbrain barrier (BBB) permeability, neurotoxins, impaired energy metabolism of the brain [34] and more (Fig

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The results suggest that elevated anti-PMSG levels are the primary reason for the decline in ES efficiency, and that high E2 and P4 levels at some time points also impair reproductive performance

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