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Raskind et al[18] extensively reviewed the pathophysiology and significance of VPA-induced carnitine deficiency and evaluated the literature pertaining to carnitine supplementation during VPA therapy in children, and concluded that despite the lack of prospective, randomized clinical trials, a few studies have shown carnitine supplementation in patients receiving VPA result in subjective and objective improvements along with increases in carnitine serum levels

On the other hand, intense physical activity has similarly altered microbial diversity, affecting systemic oxidative stress and sperm health [240, 241]

Methods Genome collection and quality control We first extracted all Klebsiella pneumoniae genomes derived from faecal samples available in the Unified Human Gastrointestinal Genome (UHGG) 18 v.1.0 database ( n = 985)

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