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Bibcode:2012ApEnM..78.8025R

Oshitari, T., Yoshida-Hata, N

Inaccuracies result when different examiners evaluate identical patients based on the WSL index (interexaminer reliability)

Changes in the gut microbiome may significantly impact ME/CFS, potentially due to increased gut permeability that allows bacteria to enter the body, or through fermentation products affecting cells and immune responses, exacerbating cognitive and physical impairment in ME/CFS patients