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The TIP3P model in Desmond System Builder was used to solvate the protein

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Although guidelines suggest cautious use in compensated cirrhosis and avoidance in decompensated liver disease, a large retrospective cohort study found no significant drug-induced liver injury from naltrexone and no attributed decompensations, supporting its use in both compensated and decompensated cirrhosis with close monitoring [120,121]

Extreme restriction is unnecessary and often counterproductive, causing metabolic slowdown that persists beyond the protocol