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Despite the established treatment regimen comprising surgical intervention, radiotherapy, temozolomide administration, and the exploration of emerging modalities such as immunotherapy and integration of medicine and engineering technology therapy, the efficacy of these approaches remains constrained, resulting in suboptimal prognostic outcomes

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If that lactate is not being metabolized in the skeletal muscle, its going to the liver to get converted back to glucose

They are isomers (or mirror images) of each other