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COA verification is a meaningful distinction from research-grade or grey-market sources, which frequently fail independent purity testing and may contain incorrect concentrations, contaminating peptides, or bacterial endotoxins

Finally, given the pragmatic nature of the proposed trial, the decision was taken to include consecutive patients seeking medical help at the participating centres, thus ensuring the enrolment of subjects similar to those that would be seen in normal clinical practice

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The principle of Strict Liability applies: athletes are responsible for any prohibited substance in their system, regardless of intent. Vigilance with all substances, including supplements, is crucial