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Patients with DKD also exhibit increased mitochondrial division, resulting in mitochondrial fragmentation, uneven mtDNA distribution, reduced expression of enzyme complexes in the ETC, decreased OXPHOS activity, and enhanced glycolysis as a compensatory mechanism [35, 36]

Synaptic Glu signalling is involved in neuronal growth and synaptic plasticity 24 contributing to learning and memory processing and cognitive functioning 1,2,25,26

The applicant calculated a final inflated average case-weighted standardized charge per case of $293,241, which exceeded the average case-weighted threshold amount of $218,560