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Under heat stress (39 C), spermatozoa exhibit mitochondrial dysfunction characterized by diminished membrane potential, impaired ATP synthesis, and a marked reduction in the activities of respiratory chain complexes I, III, IV, and V ( Figure 3b ) ( Figure 3b ) ( 4.3 Restoration of autophagic flux and apoptosis inhibition Autophagy is a highly conserved, lysosome-dependent catabolic process essential for the maintenance of cellular homeostasis

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Monitoring of amitriptyline levels should be considered for patients taking valproate concomitantly with amitriptyline