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Improvements in physical function mirrored pain results, with WOMAC physical function scores improving by more than 70% in retatrutide-treated participants

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In subchondral bone, chronic mechanical stress leads to microfracture, osteosclerosis, and angiogenesis, often accompanied by excessive iron deposition and oxidative stress

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The distinct physical activity patterns observed in ME/CFS, characterized by reduced activity intensity but not increased sedentary behavior, further highlight the link between PEN and metabolic dysfunction, likely driven by issues with energy metabolism (Newton et al., 2011)