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This signaling can stimulate GLP-1 release through mechanisms that include modulation of intracellular calcium and cyclic adenosine monophosphate (cAMP) signaling, as well as indirect gut, brain metabolic pathways described in experimental models
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In contract, overt hepatic encephalopathy can present with disorientation, obvious personality change, inappropriate behavior, somnolence, stupor, confusion, and coma (106)
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