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Not everyone with a genetic profile associated with RA will develop the disease, and while not all environmental factors are known, smoking tobacco has been consistently identified as a major contributor to the risk of developing RA that is associated with elevated levels of anticyclic citrullinated peptide (anti-CCP), which in turn is associated with more aggressive disease and severe joint erosion (5)

I think people get trapped in working towards a result instead of thinking about the process, right

Where was the cultural or psychological foundation which allowed someone to do this

practically, there was the danger of mutation

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