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Assembly of the L-Carnitine Biosynthetic Pathway After efficient enzymes for the last and penultimate step of the L-carnitine biosynthetic pathway had been identified, enzymes for the first two steps were selected: TML hydroxylase and an HTML aldolase (Supplementary Table 1)

From structural pressures and inequities to the long-term impact on patient care and workforce sustainability, we unpack the realities shaping the profession today