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In conclusion, OA pathogenesis is propelled by a metabolically dysregulated milieu, where obesity, oxidative stress, gut dysbiosis, and broader metabolic syndrome converge to create a self-perpetuating cycle of inflammation and tissue damage (Figure 1)

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Dean Robinson, a member of the Massachusetts Society of Professors at UMass Amherst, and the MTA's representative on the GIC, told the commission before its vote that it did not make sense to separate the issues of obesity and illnesses related to obesity

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