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This metabolic dysregulation is defined by systemically reduced levels of metabolites such as amino acids and fatty acids, leading to reduced TCA cycle activity and oxidative phosphorylation, which may ultimately be a major contributor to neuropsychiatric symptoms associated with reduced energy, such as fatigue and other cognitive impairments [43, 62]

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The method is applicable also for various other phosphonates (not only in the HPMP series) (Hostetler, 2009)