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However, if their degradation or biliary excretion are impaired, LPS can reach the systemic circulation, where they bind to Toll-like receptor 4 (TLR4) on leukocytes, endothelial cells, and platelets, causing arterial inflammation

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The survey data used in RUC recommendations often have low response rates (as low as the single digits, even when publications for research usually require a response rate of at least 60, and appropriate characterization of non-responders to ensure that nonresponse bias does not threaten the validity of the findings [62] ), the survey data is based on clinical vignettes that have raised concerns for bias