Objective sleep measures in chronic fatigue syndrome patients: A systematic review and meta-analysis.

Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) often report disrupted and unrefreshing sleep in association with worsened fatigue symptoms. However, the nature and magnitude of sleep architecture alteration in ME/CFS is not known, with studies using objective sleep measures in ME/CFS generating contradictory results. The current manuscript aimed to review and meta-analyse of case-control studies with objective sleep measures in ME/CSF. A search was conducted in PubMed, Scopus, Medline, Google Scholar, and Psychoinfo databases. After review, 24 studies were included in the meta-analysis, including 20 studies with 801 adults (ME/CFS = 426; controls = 375), and 4 studies with 477 adolescents (ME/CFS = 242; controls = 235), who underwent objective measurement of sleep. Adult ME/CFS patients spend longer time in bed, longer sleep onset latency, longer awake time after sleep onset, reduced sleep efficiency, decreased stage 2 sleep, more Stage 3, and longer rapid eye movement sleep latency. However, adolescent ME/CFS patients had longer time in bed, longer total sleep time, longer sleep onset latency, and reduced sleep efficiency. The meta-analysis results demonstrate that sleep is altered in ME/CFS, with changes seeming to differ between adolescent and adults, and suggesting sympathetic and parasympathetic nervous system alterations in ME/CFS.

Removal behaviour of NSAIDs from wastewater using a P-functionalised microporous carbon.

Diclofenac (DCF), naproxen (NPX) and ibuprofen (IBF) are three of the most commonly used non-steroidal anti-inflammatory drugs (NSAIDs) worldwide. They are widely detected in natural waters due to their persistence in wastewater treatment, and their removal is desirable in future wastewater management worldwide. In this study, "acid catalyst" functionalisation and subsequent carbonisation were adopted to synthesise a P-doped microporous carbonous adsorbent (CScPA) for NSAID removal. The CScPA was evaluated in depth for its adsorption performance (i.e., isotherms, kinetics and thermodynamics of adsorption at lab-scale). The CScPA had a large surface area (791.1 m2/g) and good porosity (0.392 cm3/g), which facilitated a high maximum adsorption capacity of 62.02 mg/g for a NSAID mixture. Thermodynamic data indicated that the adsorption of these NSAIDs was an endothermic process determined by physisorption (low-energy interactions). XPS analysis revealed the specific interactions involved in the adsorption process, including π-π and n-π electron donor-acceptor (EDA) interactions and hydrogen (H-) bonding. The Freundlich isotherm and Elovich kinetic model provided the best fit to the experimental results, which indicated surface heterogeneity (of the CScPA) and cooperative adsorption mechanisms. The adsorption process was shown to have potential to be applied to real wastewater effluent containing NSAIDs at low environmentally relevant concentrations (removal reached > 90% at 10 µg/L). Analysis of different implementation and cost related factors suggested that the CScPA has the potential for use with "real-world" water matrices, offering a sustainable treatment process for pharmaceutical remediation in wastewater.