Background: One of the goals of the Multi-site Clinical Assessment of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (MCAM) study was to evaluate whether clinicians experienced in diagnosing and caring for patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) recognized the same clinical entity. Methods: We enrolled participants from seven specialty clinics in the United States. We used baseline data (n = 465) on standardized questions measuring general clinical characteristics, functional impairment, post-exertional malaise, fatigue, sleep, neurocognitive/autonomic symptoms, pain, and other symptoms to evaluate whether patient characteristics differed by clinic. Results: We found few statistically significant and no clinically significant differences between clinics in their patients’ standardized measures of ME/CFS symptoms and function. Strikingly, patients in each clinic sample and overall showed a wide distribution in all scores and measures. Conclusions: Illness heterogeneity may be an inherent feature of ME/CFS. Presenting research data in scatter plots or histograms will help clarify the challenge. Relying on case–control study designs without subgrouping or stratification of ME/CFS illness characteristics may limit the reproducibility of research findings and could obscure underlying mechanisms. © 2024 by the authors.

BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a multisystem illness characterized by substantial reduction in function accompanied by profound unexplained fatigue not significantly relieved by rest, post-exertional malaise, and other symptoms. Reduced natural killer (NK) cell count and cytotoxicity has been investigated as a biomarker for ME/CFS, but few clinical laboratories offer the test and multi-site verification studies have not been conducted. METHODS: We determined NK cell counts and cytotoxicity in 174 (65%) ME/CFS, 86 (32%) healthy control (HC) and 10 (3.7%) participants with other fatigue associated conditions (ill control [IC]) from the Multi-Site Clinical Assessment of ME/CFS (MCAM) study using an assay validated for samples shipped overnight instead of testing on day of venipuncture. RESULTS: We found a large variation in percent cytotoxicity [mean and (IQR) for ME/CFS and HC respectively, 34.1% (IQR 22.4-44.3%) and 33.6% (IQR 22.9-43.7%)] and no statistically significant differences between patients with ME/CFS and HC (p-value = 0.79). Analysis stratified on illness domain measured with standardized questionnaires did not identify an association of NK cytotoxicity with domain scores. Among all participants, NK cytotoxicity was not associated with survey results of physical and mental well-being, or health factors such as history of infection, obesity, smoking, and co-morbid conditions. CONCLUSION: These results indicate this assay is not ready for clinical implementation and studies are needed to further explore immune parameters that may be involved in the pathophysiology of ME/CFS.

Background: Collisions involving workers and mobile machines continue to be a major concern in underground coal mines. Over the last 30 years, these collisions have resulted in numerous injuries and fatalities. Recently, the Mine Safety and Health Administration (MSHA) proposed a rule that would require mines to equip mobile machines with proximity detection systems (PDSs) (systems designed for automated collision avoidance). Even though this regulation has not been enacted, some mines have installed PDSs on their scoops and hauling machines. However, early implementation of PDSs has introduced a variety of safety concerns. Past findings show that workers' trust can affect technology integration and influence unsafe use of automated technologies. Methods: Using a mixed-methods approach, the present study explores the effect that factors such as mine of employment, age, experience, and system type have on workers' trust in PDSs for mobile machines. The study also explores how workers are trained on PDSs and how this training influences trust. Results: The study resulted in three major findings. First, the mine of employment had a significant influence on workers' trust in mobile PDSs. Second, hands-on and classroom training was the most common types of training. Finally, over 70% of workers are trained on the system by the mine compared with 36% trained by the system manufacturer. Conclusion: The influence of workers' mine of employment on trust in PDSs may indicate that practitioners and researchers may need to give the organizational and physical characteristics of each mine careful consideration to ensure safe integration of automated systems.

Accident data indicates that mobile haulage poses a significant pinning, crushing, and striking risk. Proximity detection systems (PDSs) have the potential to protect mineworkers from these risks. However, unintended consequences of mobile PDSs can undermine the safety benefit they provide. Soliciting iterative user input can improve the design process. Users help provide a critical understanding of how mobile PDSs may hinder normal operation and endanger mineworkers. Researchers explored users’ perspectives by conducting interviews with mineworkers from seven mines that have installed mobile PDSs on some of their haulage equipment. Mineworkers reported that mobile PDSs affect loading, tramming, section setup, maintenance, and general work on the section. Mineworkers discussed the operational effects and increased burden, exposure, and risk. Mineworkers also suggested that improved task compatibility, training, logistics, and PDS performance might help address some of these identified issues. This paper also gives additional insights into mobile PDS design and implementation.