A PHES value of 4 is the most commonly applied threshold in clinical practice and epidemiological studies to diagnose MHE, whereas more stringent cut-offs such as 5 or 6 have been used in some studies to define more severe impairment [84, 85]
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The Evidence Base: What Human and Animal Studies Actually Show Translating rodent data to human protocols requires caution, but the MOTS-c literature offers enough cross-species convergence to draw meaningful clinical inferences
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