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This is a rate-limiting step in the rate of rise in mitochondrial ATP re-synthesis in skeletal muscle at the onset of exercise, which in turn will dictate the magnitude of oxygen-independent ATP delivery, and thereby the rate of fatigue development during intense exercise. Stephens Group This can be overcome by priming through manipulating muscle carnitine pools at rest so as to make available sufficient energy substrate and by activating the PDC prior to the event by warming up before intense exercise

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A chronic fatigue syndromerelated proteome in human cerebrospinal fluid