Does the effect of cognitive behavior therapy for chronic fatigue syndrome (ME/CFS) vary by patient characteristics? A systematic review and individual patient data meta-analysis.

Debate is ongoing on the efficacy of cognitive behavior therapy (CBT) for myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). With an individual patient data (IPD) meta-analysis we investigated whether the effect of CBT varied by patient characteristics. These included post-exertional malaise (PEM), a central feature of ME/CFS according to many. We searched for randomized controlled trials similar with respect to comparison condition, outcomes and treatment-protocol. Moderation on fatigue severity (Checklist Individual Strength, subscale fatigue severity), functional impairment (Sickness Impact Profile-8) and physical functioning (Short Form-36, subscale physical functioning) was investigated using linear mixed model analyses and interaction tests. PROSPERO (CRD42022358245). Data from eight trials (n = 1298 patients) were pooled. CBT showed beneficial effects on fatigue severity (ß = -11.46, 95% CI -15.13 to -7.79); p < 0.001, functional impairment (ß = -448.40, 95% CI -625.58 to -271.23); p < 0.001; and physical functioning (ß = 9.64, 95% CI 3.30 to 15.98); p < 0.001. The effect of CBT on fatigue severity varied by age (pinteraction = 0.003), functional impairment (pinteraction = 0.045) and physical activity pattern (pinteraction = 0.027). Patients who were younger, reported less functional impairments and had a fluctuating activity pattern benefitted more. The effect on physical functioning varied by self-efficacy (pinteraction = 0.025), with patients with higher self-efficacy benefitting most. No other moderators were found. It can be concluded from this study that CBT for ME/CFS can lead to significant reductions of fatigue, functional impairment, and physical limitations. There is no indication patients meeting different case definitions or reporting additional symptoms benefit less from CBT. Our findings do not support recent guidelines in which evidence from studies not mandating PEM was downgraded.

Simple, rapid method for detecting phase transititons of lipids.

A simple rapid method was worked out for studying the physical and structural state of lipids by measuring the refractive indices of a layered lipid film. Melting processes of n-paraffins and phase transitions of phospholipids and the lecithin-cholesterol system also can be followed as a function of temperature. In accordance with data from the relevant literature, the measured refractive indices show that cholesterol lowers the phase transition temperature of lecithin. By isorefraction curves, the most ordered structure of the layers is indicated to occur at the equimolar ratio of cholesterol and lecithin. The method may be applied to study the effect of lipid-soluble agents upon lipid structure and is applicable for routine investigations and industrial purposes as well.

Image enhancement for light-focusing gradient-index optical fibers.

Image intensifiers (Generations 1, 2, and 3) in graded-index systems convert IR radiation to visible light, provide screen presentation, and supply 100,000 gain. An idealized system is described.

Current gain parameters of microchannel plates.

The current gain characteristics of microchannel plates (MCPs) are discussed in light of optimization of the design parameters of MCPs. The paper extends over such topics as optimum channel length-to-diameter ratio, maximum current gain condition, and end-spoiling effect.

Recent advancements in the field of image intensification: the generation 3 wafer tube.

The construction, performance characteristics, and the photocathode of the generation 3 wafer tube are discussed and presented. The discussion concentrates on the fundamental aspects of image intensification with the generation 3 wafer tube.

Modulation transfer function of image tube lenses.

The modulation transfer function (MTF) of the proximity focusing biplanar lens and the sharp focusing electrostatic and electromagnetic lenses is derived and presented. It is shown that for a Maxwellian emission energy distribution, the MTF of the biplanar lens is MTF = exp(-4pi(2)epsilon/V(s)L(2)F(2)), where L is the screen to cathode separation in mm, f is the spatial frequency in lp/mm, V(s), is the screen voltage, and epsilon is the voltage equivalent of the most probable emission energy. For a cosine distribution, the MTF of the biplanar lens is MTF = exp(-7 piepsilon/V(s)L(2)f(2)). The MTF of sharp focusing image tube lenses is MTF = exp(-0.06pi(2)epsilon(2)M(2)f(2)/E(c)(2)), where E(c), is the cathode field strength in volts per mm and M is the magnification. In general, the MTF of image tube lenses is MTF = exp[-(pirhof)(2)], where rho is the focusing error coefficient of a particular lens.