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68 Reduction of serum ammonia level and improvement in performance on neuropsychological testing, 69 improvement in energy levels, general functioning and well-being, and reduction of anxiety and depression, 70 reduction of physical and mental fatigue, 71 and improvement of cognitive deficits and EEG findings 71 in these studies were limited by small number of participants, high risk of bias, and low power for detection of meaningful differences between the treatment groups