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The second is the conversion of methylmalonyl-CoA into succinyl-CoA, which is an important step in the extraction of chemical energy from foods (Hvas 2006)
What outcomes (QALY, life-years gained, etc.) and which costs (NHS only vs broader) are considered
Optimized volume/price ratio, extended autonomy (several weeks at typical 250-500 mcg dose), final concentration adjustable to protocol (5 mg/ml with 2 ml bacteriostatic, or 2.5 mg/ml with 4 ml for finer dosing)
The goal is always protein first, even if the total volume is small
Because coordination complexes can dissociate in the electrospray source
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