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High-profile admissions and visible transformations from figures such as Oprah Winfrey and Kelly Clarkson, combined with relentless social media commentary, have reframed dramatic weight loss as both aspirational and medically sanctioned

NAD can be generated through salvage, de novo, and related metabolic pathways [106], but its physiological relevance lies in dynamic partitioning between oxidized and reduced redox currencies

Storage and cold-chain integrity is a third documented failure category

Immunohistochemistry was carried out using an automated immunohistochemical stainer according to the manufacturers guidelines (Bond-Max autostainer, Leica, Wetzlar, Germany), after dewaxing and rehydrating paraffin sections and antigen retrieval by pretreatment with high temperature at pH 9

JW: Formal analysis, Funding acquisition, Writing original draft

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