Christopher Snell: Difference between revisions

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===Open letter to ''The Lancet''===
===Open letter to ''The Lancet''===
Three [[open letter to the Lancet|open letters to the editor of ''The Lancet'']] urged the editor to commission a fully independent review of the [[PACE trial]], which the journal had published in 2011. In 2016, Dr. Snell, along with 42 colleagues in the [[ME/CFS]] field, signed the second letter.<ref>{{Cite web|url=http://www.virology.ws/2016/02/10/open-letter-lancet-again/|title=Open Letter Lancet Again|last=|first=|date=|website=|archive-url=|archive-date=|url-status=|access-date=}}</ref> In 2018, Dr. Snell, with more than 100 colleagues in the ME/CFS field, signed the third letter.<ref>{{Cite web|url=http://www.virology.ws/2018/06/19/trial-by-error-an-open-letter-to-the-lancet-two-years-on/|title=An Open Letter to The Lancet, Two Years On|last=|first=|date=|website=|archive-url=|archive-date=|url-status=|access-date=}}</ref>
Three [[open letter to the Lancet|open letters to the editor of ''The Lancet'']] urged the editor to commission a fully independent review of the [[PACE trial]], which the journal had published in 2011. In 2016, Dr. Snell, along with 42 colleagues in the [[ME/CFS]] field, signed the second letter.<ref>{{Cite web|url=http://www.virology.ws/2016/02/10/open-letter-lancet-again/|title=Open Letter Lancet Again|last=Tuller |first=David |date=2016-02-10|website=|archive-url=|archive-date=|url-status=|access-date=}}</ref> In 2018, Dr. Snell, with more than 100 colleagues in the ME/CFS field, signed the third letter.<ref>{{Cite web|url=http://www.virology.ws/2018/06/19/trial-by-error-an-open-letter-to-the-lancet-two-years-on/|title=An Open Letter to The Lancet, Two Years On|last=Tuller|first=David|date=2018-06-19|website=|archive-url=|archive-date=|url-status=|access-date=}}</ref>
*Feb 10, 2016, [http://www.virology.ws/2016/02/10/open-letter-lancet-again/ An open letter to The Lancet, again - Virology blog]
*Feb 10, 2016, [http://www.virology.ws/2016/02/10/open-letter-lancet-again/ An open letter to The Lancet, again - Virology blog]
*Jun 18, 2018, [http://www.virology.ws/2018/06/19/trial-by-error-an-open-letter-to-the-lancet-two-years-on/ Trial By Error: An Open Letter to The Lancet, Two Years On]
*Jun 18, 2018, [http://www.virology.ws/2018/06/19/trial-by-error-an-open-letter-to-the-lancet-two-years-on/ Trial By Error: An Open Letter to The Lancet, Two Years On]
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*2012, Minimum data elements for research reports on CFS<ref name="Jason,Unger 2012" /> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643273/ FULL TEXT]
*2012, Minimum data elements for research reports on CFS<ref name="Jason,Unger 2012" /> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643273/ FULL TEXT]
*2013, Discriminative Validity of [[Metabolic]] and Workload Measurements for Identifying People With Chronic Fatigue Syndrome<ref name="Snell, 2013" /> [https://academic.oup.com/ptj/article/93/11/1484/2735315 FULL TEXT]
*2013, Discriminative Validity of [[Metabolic]] and Workload Measurements for Identifying People With Chronic Fatigue Syndrome<ref name="Snell, 2013" /> [https://academic.oup.com/ptj/article/93/11/1484/2735315 FULL TEXT]
*2018, Editorial - Checking our blind spots: current status of research evidence summaries in [[ME/CFS]].<ref>{{Cite journal|last=Davenport|first=Todd E.|last2=Stevens|first2=Staci R.|last3=VanNess|first3=J. Mark|last4=Stevens|first4=Jared|last5=Snell|first5=Christopher R.|date=2018-07-17|title=Checking our blind spots: current status of research evidence summaries in ME/CFS|url=https://bjsm.bmj.com/content/early/2018/07/17/bjsports-2018-099553|journal=Br J Sports Med|language=en|pages=bjsports–2018–099553|doi=10.1136/bjsports-2018-099553|issn=0306-3674|pmid=30018122|volume=53|issue =19|pages=1198|via=|author-link=Todd Davenport|author-link2=Staci Stevens|author-link3=Mark VanNess|author-link5=Christopher Snell}}</ref> [https://bjsm.bmj.com/content/early/2018/07/17/bjsports-2018-099553.long (Introduction)]
*2018, Editorial - Checking our blind spots: current status of research evidence summaries in [[ME/CFS]].<ref>{{Cite journal|last=Davenport|first=Todd E.|last2=Stevens|first2=Staci R.|last3=VanNess|first3=J. Mark|last4=Stevens|first4=Jared|last5=Snell|first5=Christopher R.|date=2018-07-17|title=Checking our blind spots: current status of research evidence summaries in ME/CFS|url=https://bjsm.bmj.com/content/early/2018/07/17/bjsports-2018-099553|journal=Br J Sports Med|language=en|doi=10.1136/bjsports-2018-099553|issn=0306-3674|pmid=30018122|volume=53|issue =19|pages=1198|via=|author-link=Todd Davenport|author-link2=Staci Stevens|author-link3=Mark VanNess|author-link5=Christopher Snell}}</ref> [https://bjsm.bmj.com/content/early/2018/07/17/bjsports-2018-099553.long (Introduction)]
*2018, [[Two-day cardiopulmonary exercise test|Cardiopulmonary Exercise Test]] Methodology for Assessing [[Exertion]] Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome<ref>{{Cite journal|last=Stevens|first=Staci|author-link=Staci Stevens|last2=Snell|first2=Chris|author-link2=Christopher Snell|last3=Stevens|first3=Jared|last4=Keller|first4=Betsy|author-link4=Betsy Keller|last5=VanNess|first5=J. Mark|author-link5=Mark VanNess|date=2018|title=Cardiopulmonary Exercise Test Methodology for Assessing Exertion Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|url=https://www.frontiersin.org/articles/10.3389/fped.2018.00242/abstract|journal=Frontiers in Pediatrics|language=English|volume=6|issue =|pages=|doi=10.3389/fped.2018.00242|issn=2296-2360|via=}}</ref> [https://www.frontiersin.org/articles/10.3389/fped.2018.00242/abstract Abstract]
*2018, [[Two-day cardiopulmonary exercise test|Cardiopulmonary Exercise Test]] Methodology for Assessing [[Exertion]] Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome<ref>{{Cite journal|last=Stevens|first=Staci|author-link=Staci Stevens|last2=Snell|first2=Chris|author-link2=Christopher Snell|last3=Stevens|first3=Jared|last4=Keller|first4=Betsy|author-link4=Betsy Keller|last5=VanNess|first5=J. Mark|author-link5=Mark VanNess|date=2018|title=Cardiopulmonary Exercise Test Methodology for Assessing Exertion Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome|url=https://www.frontiersin.org/articles/10.3389/fped.2018.00242/abstract|journal=Frontiers in Pediatrics|language=English|volume=6|issue =|pages=|doi=10.3389/fped.2018.00242|issn=2296-2360|via=}}</ref> [https://www.frontiersin.org/articles/10.3389/fped.2018.00242/abstract Abstract]
*2019, [[Chronotropic incompetence|Chronotropic Intolerance]]: An Overlooked Determinant of Symptoms and Activity Limitation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?<ref>{{Cite journal|last=Davenport|first=Todd E.|author-link=Todd Davenport|last2=Lehnen|first2=Mary|author-link2=|last3=Stevens|first3=Staci R.|author-link3=Staci Stevens|last4=VanNess|first4=J. Mark|author-link4=Mark VanNess|last5=Stevens|first5=Jared|author-link5=|last6=Snell|first6=Christopher R.|author-link6=Christopher Snell|date=2019-03-22|title=Chronotropic Intolerance: An Overlooked Determinant of Symptoms and Activity Limitation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?|url=https://www.frontiersin.org/article/10.3389/fped.2019.00082/full|journal=Frontiers in Pediatrics|volume=7|issue=|pages=|doi=10.3389/fped.2019.00082|issn=2296-2360|quote=|via=}}</ref> [https://www.frontiersin.org/articles/10.3389/fped.2019.00082/full (Full text)]
*2019, [[Chronotropic incompetence|Chronotropic Intolerance]]: An Overlooked Determinant of Symptoms and Activity Limitation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?<ref>{{Cite journal|last=Davenport|first=Todd E.|author-link=Todd Davenport|last2=Lehnen|first2=Mary|author-link2=|last3=Stevens|first3=Staci R.|author-link3=Staci Stevens|last4=VanNess|first4=J. Mark|author-link4=Mark VanNess|last5=Stevens|first5=Jared|author-link5=|last6=Snell|first6=Christopher R.|author-link6=Christopher Snell|date=2019-03-22|title=Chronotropic Intolerance: An Overlooked Determinant of Symptoms and Activity Limitation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?|url=https://www.frontiersin.org/article/10.3389/fped.2019.00082/full|journal=Frontiers in Pediatrics|volume=7|issue=|pages=|doi=10.3389/fped.2019.00082|issn=2296-2360|quote=|via=}}</ref> [https://www.frontiersin.org/articles/10.3389/fped.2019.00082/full (Full text)]

Revision as of 18:26, September 28, 2021

Source:Workwell

Christopher Ronald Snell, PhD, is the Scientific Director of Workwell Foundation, Ripon, California. He directs the Pacific Fatigue Lab at the Department of Health, Exercise, and Sport Sciences, at the University of the Pacific, Stockton, California, US.[1]

Committees and boards[edit | edit source]

IOM Committee on Diagnostic Criteria for ME/CFS[edit | edit source]

Dr Snell was a reviewer for the 2015 report produced by the Institute of Medicine's (IOM) Committee on Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS).[2]

Chronic Fatigue Syndrome Advisory Committee[edit | edit source]

Dr. Snell was Chair of the Health and Human Services's (HHS) Chronic Fatigue Syndrome Advisory Committee (CFSAC) committee from 04/01/07-04/01/11.[3]

ME/CFS Common Data Element (CDE) Project[edit | edit source]

Member of the Quality of Life/Functional Status (CPET)/Activity Working Group of the Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Common Data Element (CDE) Project sponsored by the National Institute of Neurological Disorders and Stroke (NINDS) and the Centers for Disease Control and Prevention (CDC).[4]

Advocacy[edit | edit source]

Open letter to The Lancet[edit | edit source]

Three open letters to the editor of The Lancet urged the editor to commission a fully independent review of the PACE trial, which the journal had published in 2011. In 2016, Dr. Snell, along with 42 colleagues in the ME/CFS field, signed the second letter.[5] In 2018, Dr. Snell, with more than 100 colleagues in the ME/CFS field, signed the third letter.[6]

Books[edit | edit source]

  • 2012, An International Perspective on the Future of Research in Chronic Fatigue Syndrome, edited by Christopher R. Snell[7]


Notable studies[edit | edit source]

  • 2001, Assessment of Functional Impairment by Cardiopulmonary Exercise Testing in Patients with Chronic Fatigue Syndrome[8] ABSTRACT
  • 2001, Chronic Fatigue Syndrome, Ampligen, and Quality of Life: A Phenomenological Perspective[9] ABSTRACT
  • 2002, Physical performance and prediction of 2-5A synthetase/RNase L antiviral pathway activity in patients with chronic fatigue syndrome[10] ABSTRACT
  • 2003, Subclassifying chronic fatigue syndrome through exercise testing[11] ABSTRACT
  • 2004, Immunologic Aspects of Chronic Fatigue Syndrome: Report on a Research Symposium Convened by The CFIDS Association of America and Co-Sponsored by the US Centers for Disease Control and Prevention and the National Institutes of Health[12] ABSTRACT
  • 2005, Exercise capacity and immune function in male and female patients with chronic fatigue syndrome (CFS)[13] FULL TEXT
  • 2007, Legal and Scientific Considerations of the Exercise Stress Test[14] ABSTRACT
  • 2007, Diminished Cardiopulmonary Capacity During Post-Exertional Malaise[15] ABSTRACT
  • 2010, Post-exertional malaise in women with chronic fatigue syndrome[16] ABSTRACT
  • 2010, Conceptual model for physical therapist management of chronic fatigue syndrome/myalgic encephalomyelitis[17] ABSTRACTFULL TEXT
  • 2011, Reliability and validity of Short Form 36 Version 2 to measure health perceptions in a sub-group of individuals with fatigue[18] ABSTRACT
  • 2011, Diagnostic accuracy of symptoms characterising chronic fatigue syndrome[19] ABSTRACT
  • 2012, Minimum data elements for research reports on CFS[20] FULL TEXT
  • 2013, Discriminative Validity of Metabolic and Workload Measurements for Identifying People With Chronic Fatigue Syndrome[21] FULL TEXT
  • 2018, Editorial - Checking our blind spots: current status of research evidence summaries in ME/CFS.[22] (Introduction)
  • 2018, Cardiopulmonary Exercise Test Methodology for Assessing Exertion Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome[23] Abstract
  • 2019, Chronotropic Intolerance: An Overlooked Determinant of Symptoms and Activity Limitation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?[24] (Full text)
  • 2019, Whole blood human transcriptome and virome analysis of ME/CFS patients experiencing post-exertional malaise following cardiopulmonary exercise testing[25] (Full text)

Talks and interviews[edit | edit source]

  • 2011, National Institutes of Health (NIH) State of the Knowledge Workshop regarding Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Research presenter
Cardiopulmulmonary Exercise Testing to Assess fatigue in ME/CFS (presentation starts at the 8:02:00 time marker)[26]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. ↑ https://www.researchgate.net/profile/Christopher_Snell-UOP
  2. ↑ https://www.nap.edu/resource/19012/MECFS_Powerpoint.pdf
  3. ↑ http://nih.granicus.com/DocumentViewer.php?file=nih_e174f9bd-ae0f-4a45-9955-827cb608db2f.pdf
  4. ↑ "Complete Myalgic Encephalomyelitis/Chronic Fatigue Syndrome CDE Roster". NIH. Retrieved October 11, 2019.
  5. ↑ Tuller, David (February 10, 2016). "Open Letter Lancet Again".
  6. ↑ Tuller, David (June 19, 2018). "An Open Letter to The Lancet, Two Years On".
  7. ↑ Snell, Christopher R., ed. (February 15, 2012). An International Perspective on the Future of Research in Chronic Fatigue Syndrome. InTech. doi:10.5772/1460. ISBN 978-953-51-0072-0.
  8. ↑ VanNess, J Mark; Snell, Christopher R; Fredrickson, Dean M.; Strayer, David R.; Stevens, Staci R (2001), "Assessment of Functional Impairment by Cardiopulmonary Exercise Testing in Patients with Chronic Fatigue Syndrome", Journal of Chronic Fatigue Syndrome, 8 (3–4): 103–109, doi:10.1300/J092v08n03_09
  9. ↑ Snell, Christopher R; Stevens, Staci R; VanNess, J Mark (2001), "Chronic Fatigue Syndrome, Ampligen, and Quality of Life: A Phenomenological Perspective", Journal of Chronic Fatigue Syndrome, 8 (3–4): 117–121, doi:10.1300/J092v08n03_11
  10. ↑ Snell, Christopher R; VanNess, J Mark; Strayer, David R.; Stevens, Staci R (2002), "Physical performance and prediction of 2-5A synthetase/RNase L antiviral pathway activity in patients with chronic fatigue syndrome", In Vivo, 16 (2): 107–109, PMID 12073768
  11. ↑ VanNess, J Mark; Snell, Christopher R; Strayer, David R.; Dempsey, IV, Line; Stevens, Staci R (2003), "Subclassifying chronic fatigue syndrome through exercise testing", Med Sci Sports Exerc, 35 (6): 908–13, doi:10.1249/01.MSS.0000069510.58763.E8, PMID 12783037
  12. ↑ Gerrity, T.R.; Papanicolaou, D.A.; Amsterdam, J.D.; Bingham, S.; Grossman, A.; Hedrick, T.; Herberman, R.B.; Krueger, G.; Levine, S.; Mohagheghpour, N.; Moore, R.C.; Oleske, J.M.; Snell, C.R.; CFIDS Association of America (2004), "Immunologic Aspects of Chronic Fatigue Syndrome: Report on a Research Symposium Convened by The CFIDS Association of America and Co-Sponsored by the US Centers for Disease Control and Prevention and the National Institutes of Health", Neuroimmunomodulation, 11: 351–357, doi:10.1159/000080144, PMID 15467349
  13. ↑ Snell, Christopher R; VanNess, J Mark; Strayer, David R.; Stevens, Staci R (2005), "Exercise capacity and immune function in male and female patients with chronic fatigue syndrome (CFS)", In Vivo, 19 (2): 387–390, PMID 15796202
  14. ↑ Ciccolella, Margaret; Stevens, Staci R.; Snell, Christopher R.; Vanness, J. Mark (2007), "Legal and Scientific Considerations of the Exercise Stress Test", Journal of Chronic Fatigue Syndrome, 14 (2): 61–75, doi:10.1300/J092v14n02_06
  15. ↑ VanNess, J Mark; Snell, Christopher R; Stevens, Staci R (2007), "Diminished Cardiopulmonary Capacity During Post-Exertional Malaise", Journal of Chronic Fatigue Syndrome, 14 (2): 77–85, doi:10.1300/J092v14n02_07
  16. ↑ VanNess, J Mark; Stevens, Staci R; Bateman, Lucinda; Stiles, Travis L; Snell, Christopher R (January 4, 2010), "Post-exertional malaise in women with chronic fatigue syndrome", J Womens Health (Larchmt), 19 (2): 239-44, doi:10.1089/jwh.2009.1507, PMID 20095909
  17. ↑ Davenport, Todd E.; Stevens, Staci R.; Snell, Christopher R.; Little, Tamara (2010), "Conceptual Model for Physical Therapist Management of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis", Physical Therapy, 90 (4): 602–614, doi:10.2522/ptj.20090047, PMID 20185614
  18. ↑ Davenport, Todd E.; Stevens, Staci R.; Baroni, K; Vanness, J. Mark; Snell, Christopher R. (2011), "Reliability and validity of Short Form 36 Version 2 to measure health perceptions in a sub-group of individuals with fatigue", Disabil Rehabil, 33 (25–26): 2596–2604, doi:10.3109/09638288.2011.582925, PMID 21682669
  19. ↑ Davenport, Todd E.; Stevens, Staci R.; Baroni, Katie; Vanness, J. Mark; Snell, Christopher R. (2011), "Diagnostic accuracy of symptoms characterizing chronic fatigue syndrome", Disabil Rehabil, 33 (19–20): 1768–75, doi:10.3109/09638288.2010.546936, PMID 21208154
  20. ↑ Jason, LA; Unger, ER; Dimitrakoff, JD; Fagin, AP; Houghton, M; Cook, DB; Marshall, GD, Jr; Klimas, N; Snell, C (2012), "Minimum data elements for research reports on CFS", Brain, Behavior, Immunology, 26 (3): 401–6, doi:10.1016/j.bbi.2012.01.014, PMID 22306456
  21. ↑ Snell, Christopher R; Stevens, Staci R; Davenport, Todd E.; VanNess, J Mark (2013), "Discriminative Validity of Metabolic and Workload Measurements for Identifying People With Chronic Fatigue Syndrome", Physical Therapy, 93 (11): 1484–1492, doi:10.2522/ptj.20110368
  22. ↑ Davenport, Todd E.; Stevens, Staci R.; VanNess, J. Mark; Stevens, Jared; Snell, Christopher R. (July 17, 2018). "Checking our blind spots: current status of research evidence summaries in ME/CFS". Br J Sports Med. 53 (19): 1198. doi:10.1136/bjsports-2018-099553. ISSN 0306-3674. PMID 30018122.
  23. ↑ Stevens, Staci; Snell, Chris; Stevens, Jared; Keller, Betsy; VanNess, J. Mark (2018). "Cardiopulmonary Exercise Test Methodology for Assessing Exertion Intolerance in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome". Frontiers in Pediatrics. 6. doi:10.3389/fped.2018.00242. ISSN 2296-2360.
  24. ↑ Davenport, Todd E.; Lehnen, Mary; Stevens, Staci R.; VanNess, J. Mark; Stevens, Jared; Snell, Christopher R. (March 22, 2019). "Chronotropic Intolerance: An Overlooked Determinant of Symptoms and Activity Limitation in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome?". Frontiers in Pediatrics. 7. doi:10.3389/fped.2019.00082. ISSN 2296-2360.
  25. ↑ Bouquet, Jerome; Li, Tony; Gardy, Jennifer L.; Kang, Xiaoying; Stevens, Staci; Stevens, Jared; VanNess, Mark; Snell, Christopher; Potts, James; Miller, Ruth R.; Morshed, Muhammad; McCabe, Mark; Parker, Shoshana; Uyaguari, Miguel; Tang, Patrick; Steiner, Theodore; Chan, Wee-Shian; De Souza, Astrid-Marie; Mattman, Andre; Patrick, David M.; Chiu, Charles Y. (March 21, 2019). "Whole blood human transcriptome and virome analysis of ME/CFS patients experiencing post-exertional malaise following cardiopulmonary exercise testing". PLOS ONE. 14 (3): e0212193. doi:10.1371/journal.pone.0212193. ISSN 1932-6203. PMID 30897114.
  26. ↑ http://www.pacific.edu/Academics/Schools-and-Colleges/College-of-the-Pacific/Academics/Departments-and-Programs/Archives.html

National Academy of Medicine (NAM) - An American non-profit, non-governmental organization which provides expert advice to governmental agencies on issues relating to biomedical science, medicine and health. Formerly known as the Institute of Medicine (IOM).

Chronic Fatigue Syndrome Advisory Committee (CFSAC) - (sometimes pronounced SIF-SACK) A US government advisory council that met twice per year, covering current topics related to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Meetings usually lasted for two days and the results were presented to the Secretary of Health and Human Services (HHS). After 15 years, on September 5, 2018, CFSAC's charter was not renewed by the Department of HHS, effectively dissolving the committee without notice or warning.

two-day cardiopulmonary exercise test (CPET) - A diagnostic test which involves testing an ME/CFS patient exercising on an exercise machine, while monitoring their respiration, especially oxygen consumption. This test is repeated the following day in order to confirm the patient's inability to replicate the first-day performance. This test is thought to be the most objective way to detect post-exertional malaise.

myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

Centers for Disease Control and Prevention (CDC) - The Centers for Disease Control and Prevention is a U.S. government agency dedicated to epidemiology and public health. It operates under the auspices of the Department of Health and Human Services.

stress Stress can by either physical or psychological, or both. Stress is either 1) a state of emotional or psychological strain or 2) the physical stress (pressure or tension) that a physical object such the human body is placed under, e.g., a stress test is a medical test that monitors the cardiovascular system during strenuous exercise.

accuracy The "closeness of an observation to the true clinical state". With respect to diagnostic tests, "accuracy" means how specific and sensitive the test is.

virome The human virome is the collection of all viruses that are found in or on humans.

post-exertional malaise (PEM) - A notable exacerbation of symptoms brought on by small physical or cognitive exertions. PEM may be referred to as a "crash" or "collapse" and can last for days or weeks. Symptoms can include cognitive impairments, muscle pain, trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, and others.

National Institutes of Health (NIH) - A set of biomedical research institutes operated by the U.S. government, under the auspices of the Department of Health and Human Services.

Chronic Fatigue and Immune Dysfunction Syndrome (CFIDS) - Chronic Fatigue and Immune Dysfunction Syndrome is another term for Chronic Fatigue Syndrome, but one which emphasizes the immunological aspects of the disease. Popular in the 1990s, this term has apparently fallen into disuse.

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