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propecia long term side effects The past decade has seen several examples of the integration of circadian clocks directly with cell physiology AMP activated protein kinase AMPK 48, mTOR and autophagy in response to nutrient and growth signals 49 53, NAD dependent deacetylase sirtuin 1 SIRT1 54 57, oxidative stress inducible transcription factor NRF2 58, 59, and hypoxia inducible factor HIF1О± 60 62