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Most people with endogenous excess uric acid production appear to have a salvage pathway, and FA promotes uric acid synthesis through the purine salvage pathway by activating hypoxia-inducible factor-1 (HIF-1) to upregulate the expression of purine metabolism-related enzymes (100102)
Integration also amplifies the challenges of reproductive cohorts: high dimensionality under modest n, partially missing omics blocks (cycle cancellation, biopsy selection, embryo availability), center/protocol batch structure, and heterogeneous endpoints (biochemical pregnancy vs live birth vs cumulative live birth)
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