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Acknowledgements The authors acknowledge the support of the McCluskey family and the Interstellar Initiative (NYAS/AMED)

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This review redefines the pathophysiology of severe acute pancreatitis-associated multiple organ dysfunction (SAP-MODS) by exploring the glycocalyxs central mechanistic role and proposes stabilizing glycocalyx structure as a potential strategy to prevent microcirculatory failure

while elevation of SIRT1 expression enhances insulin sensitivity [147]

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