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Furthermore, these findings, along with others, led to the now well-established theory that seasonal fluctuations in reproductive capability in photosensitve species are a result of the changing duration of the elevated nocturnal pineal melatonin secretion, which is determined by the annual fluctuations in night length (30, 31)

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The effect of kidney disease, in particular, is quite pronounced: pre-dialysis patients may have twice the level of TMAO, and hemodialysis patients may have 10 times the level of TMAO as otherwise healthy patients