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ROS are unstable oxygen-containing molecules that easily react with other molecules in a cell [14] and are generated after physiological dysfunctions or exposure to physical agents, such as ultraviolet rays and heat, chemical factors, environmental toxicants, smoking, alcohol, or even other factors, such as obesity, varicocele, aging, or diabetes [11]

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Without adequate carnitine, long-chain fatty acids cannot enter mitochondria for oxidation, leading to impaired energy production and metabolic dysfunction