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In apoptosis, -sitosterol upregulates pro-apoptotic factors such as p53 and Bax, while downregulating anti-apoptotic proteins such as Bcl-2, leading to an increase in mitochondrial outer membrane permeability and the activation of key apoptotic enzyme cascades such as caspase-9 and 3, which induces programmed cell death (83)

This limited detail restricts understanding of whether the most immature neonates are more prone to neurological issues from midazolam use

2021;4:e2121106

Together, this layered strategy provides a framework for disease subtyping, early risk stratification, and identification of patients most likely to benefit from targeted interventions