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In addition to its role in energy metabolism with some antioxidant properties, L-acetyl-carnitine can cross the blood-brain barrier, where it modulates brain neurotransmitters, such as acetylcholine, serotonin and dopamine, and acts on neurotrophic factors by modifying the activity of the relevant genes

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Drawing on his research and years in the operating theatre, Alex reflects on the limitations he saw with cemented partial knee replacement and why rethinking fixation could redefine what surgeons and patients come to expect