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Similar for me. Sometimes delayed, sometimes seems pretty immediate.

Well, it wouldn't really fit the name of "malaise", so if only for that reason, it wouldn't seem to fit. But for the reasons I said, I think that is kind of arbitrary. Just saying that if fatigue+brain fog+vomiting is considered PEM, then vomiting is considered connected to the PEM process...

Hmm, yeah I suppose. I think my mental model of PEM is a delay plus it lasting strangely long (greater than 2 or 3 days) plus it being quite out of proportion to the exertion.

Is that the case? With muscle soreness, there's the DOMS diagnosis, right? But, people often suddenly get a lot more fatigued a day later? Maybe I'm working with an incorrect assumption that that is pretty rare.

I just think its arbitrary to use 3 symptoms instead of 1. I think we should err on the side of being potentially over-inclusive, not over-exclusive, for the sake of patients who, without the established ME/CFS communities [edit: like this forum] and support systems, [edit: and without any other...

No, I understood. I'm saying if we accept that vomiting is part of the pathophysiological PEM process if it occurs alongside fatigue, it seems logical to assume it could be related on its own as well. I'm mainly considering a delay of a single symptom if it's already associated with PEM if...

Maybe. So in that case, delayed fatigue, brain fog, and unrefreshing sleep are the three things required for it to be PEM? If someone had worsening fatigue, brainfog, and vomiting after 24 hours consistently, and the vomiting was considered related to PEM and not some total coincidence, then I...

I added the "not explained by anything else", but otherwise that basically seems like the NICE definition. They don't specify any specific symptoms in this definition. Why not? I think the most potentially useful way to separate PEM from pretty much anything else is that following a delay after...

If someone exercises and consistently 24 hours later they suddenly get a lot more fatigued, what is it if not PEM? Is there an established condition that this fits with? If not, what's the purpose of excluding those people and leaving them with no diagnosis? PEM is just describing a pattern that...

How could the fatigue be both rapid onset and delayed?

It seems like there are three possible options: 1. Point estimate over MID, compare CI to null - evidence of any effect 2. Point estimate over MID, compare CI to MID - evidence of important effect 3. Point estimate below MID, compare CI to MID - evidence against an important effect? And I think...

I see, thanks. Do you mean no important effect? We see that there's likely a nonzero effect since the CI doesn't cross null. And that's how they worded the plain language summary for vortioxetine. My brain is swimming trying to fully grasp it, but it seems weird to compare evidence for no...

I'm trying to understand this. So if, say, the MID is 1, and a study A has a result of 1.1, CI: 0.9-1.3 (same shape as b in fig. 5 above), then because the point estimate exceeds the MID, they downgrade for imprecision because the CI goes below the MID. But if a study B result is 0.8, CI...

Deep brain stimulation for obsessive-compulsive-disorder: a systematic review and meta-analysis of individual participant outcome data from sham-controlled trials Sem E. Cohen, Marisa J. Niemeijer, Jasper B. Zantvoord, Guido A. van Wingen, Roel J. T. Mocking & Damiaan Denys S [Line breaks...

New study on long COVID: S4ME thread: REGAIN: A Randomized Controlled Clinical Trial of Oxaloacetate for Improving the Symptoms of Long COVID, 2025, Vernon et al

REGAIN: A Randomized Controlled Clinical Trial of Oxaloacetate for Improving the Symptoms of Long COVID Suzanne D Vernon, Candace Rond, Jennifer Bell, Brindisi Butler, Sara Isolampi, Annaleah Otteson, Pearl Phalwane, Samantha Mower, Shad Roundy, David Kaufman, Alan Brian Cash, Lucinda Bateman...

Echoes of Gulf War Illness: A Case Study of Chronic Symptoms from Toxic Exposure in East Palestine, Ohio Alexander Lishuen Chen, Jun Hee Han, Beatrice Alexandra Golomb Published: 04 December 2024 [Line breaks added] Abstract Mixed toxic chemical exposures are a common problem, but...

Potentially some "tortured phrases" indicative of paper mills (found by AI): I think that's meant to be "causal association" Figure 2 caption: It's weird to refer to an odds ratio as "ratio of ratios".

Yeah, there's another CFS dataset on there as well: ukb-b-8961: Non-cancer illness code, self-reported: chronic fatigue syndrome They both have around 2000 controls and 500,000 controls, so I'm guessing they're both using UK BioBank data.

Hybrid Pulmonary Rehabilitation Improves Cardiorespiratory Exercise Fitness in Formerly Hospitalised Long COVID Patients Nikolaos Chynkiamis, Angelos Vontetsianos, Christina Anagnostopoulou, Christiana Lekka, Maria Ioanna Gounaridi, Evangelos Oikonomou, Manolis Vavuranakis, Nikoleta Rovina...