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The study suggests that the survival benefit of surgery is largely tied to how much weight patients shed, especially in the early years of diabetes when the body may still respond strongly to such changes

[27] The gut immune system is composed of the gut-associated lymphoid tissue (GALT), which is a component of the mucosa-associated lymphoid tissue (MALT)

The random sequence was generated using block randomization with a fixed block size of four and stratification by sex to ensure balanced treatment order distribution