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A second surgery to reach further shunt attenuation should only be attempted in patients with persistent clinical signs that have high fasting blood ammonia concentration or abnormal rectal ATT result 3 months after the first surgery.18, 86 Spontaneous gradual shunt closure would not occur beyond 3 months after surgical ligation

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Recurrent loss of NFE2L2 Exon 2 is a mechanism for Nrf2 pathway activation in human cancers