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Long Fatigue: The exhaustion that lingers after an infection
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lingers after an infection<!-- --></h1></div><div data-component="byline-block" class="sc-18fde0d6-0 dlWCEZ"><!--$!--><!--/$--></div><figure><div data-component="image-block" class="sc-18fde0d6-0 EXUng"><div data-testid="hero-image" class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 50vw, (min-width: 1008px) 66vw, 96vw" srcSet="https://ichef.bbci.co.uk/images/ic/160xn/p0k5m7z2.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240xn/p0k5m7z2.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320xn/p0k5m7z2.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480xn/p0k5m7z2.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640xn/p0k5m7z2.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800xn/p0k5m7z2.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024xn/p0k5m7z2.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376xn/p0k5m7z2.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920xn/p0k5m7z2.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480xn/p0k5m7z2.jpg.webp" alt="Getty Images A man standing in a woodland (Credit: Getty Images)" class="sc-a34861b-0 efFcac"/><span class="sc-a34861b-2 fxQYxK">Getty Images</span></div></div></figure><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe"><b id="before-long-covid-there-was-post-viral-fatigue-–-a-mysterious-set-of-illnesses-caused-by-other-infections.-now-scientists-are-starting-to-unravel-its-secrets." class="sc-7dcfb11b-0 kVRnKf">Before long Covid there was post-viral fatigue – a mysterious set of illnesses caused by other infections. Now scientists are starting to unravel its secrets.<!-- --></b></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">Since an acute infection with Covid-19 in the summer of 2023, Rachael Edwards has been battling a fatigue so crippling that it has left her bedridden for weeks at a time. A previously healthy 31-year-old marketing manager living in Amsterdam, she describes feeling like she is "weighted down by an anchor".<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">"Long Covid fatigue differs from the exhaustion of parenting newborns or long days at the office in a number of ways," says Edwards. "Imagine you've completed the hardest marathon of your life with poor sleep and no fuel. Then after the adrenaline has worn off, try walking up a flight of 100 stairs. That is how my body feels. My muscles won't move. I can't even hold my hand above my head," she says.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">With the Covid-19 pandemic came long Covid, the lingering symptoms after an infection with the virus has cleared. Now it is <!-- --><a target="_blank" href="https://www.tandfonline.com/doi/abs/10.1080/21641846.2020.1778227" class="sc-c9299ecf-0 bZUiKB">long Covid<!-- --></a> which has opened a new window into the study of post-viral fatigue – a similar illness of persistent exhaustion which some people experience after recovering from other kinds of infection.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">Post-viral fatigue has long been poorly understood, and for many years was often <!-- --><a target="_blank" href="https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1011523" class="sc-c9299ecf-0 bZUiKB">dismissed as psychological<!-- --></a>. But this long-term fatigue with varying degrees of severity has been linked to infections ranging from <!-- --><a target="_blank" href="https://link.springer.com/article/10.1186/1471-2377-11-37" class="sc-c9299ecf-0 bZUiKB">Sars<!-- --></a> to <!-- --><a target="_blank" href="https://www.tandfonline.com/doi/full/10.1586/14787210.2015.1079128" class="sc-c9299ecf-0 bZUiKB">Ebola<!-- --></a>, <!-- --><a target="_blank" href="https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.656797/full" class="sc-c9299ecf-0 bZUiKB">Epstein-Barr virus<!-- --></a> and <!-- --><a target="_blank" href="https://www.tandfonline.com/doi/abs/10.1080/21641846.2020.1778227" class="sc-c9299ecf-0 bZUiKB">influenza<!-- --></a>, as well as infections with tick-borne pathogens such as the bacteria <!-- --><a target="_blank" href="https://www.bmj.com/content/333/7568/575" class="sc-c9299ecf-0 bZUiKB"><i id="borrelia-burgdorferi" class="sc-7dcfb11b-0 kKcaog">Borrelia burgdorferi<!-- --></i></a>, which causes Lyme disease.<!-- --></p></div><div data-component="ad-slot" data-testid="ad-unit" class="sc-d2ebd0a7-0 iayHyW"><div data-testid="dotcom-mid_1" id="dotcom-mid_1" class="dotcom-ad"></div></div><div data-component="subheadline-block" class="sc-18fde0d6-0 eeiVGB"><h2 class="sc-518485e5-0 kRvAla"><span id="an-enigma" class="sc-7dcfb11b-0 kPypaC"><b id="an-enigma" class="sc-7dcfb11b-0 kVRnKf">An enigma<!-- --></b></span><span id="tic-issue" class="sc-7dcfb11b-0 kPypaC"><b id="tic-issue" class="sc-7dcfb11b-0 kVRnKf">tic issue <!-- --></b></span></h2></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">As a GP based in Aberdeen, Scotland, Rosalind Adam is familiar with seeing patients suffering from problematic fatigue. But over time, she has been increasingly struck by the generic nature of the term, and how we use this single phrase to encompass everything from everyday weariness to crippling energy deficits which leave people housebound and unable to work.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">"I don't think we should think of fatigue as a single entity and I'd like to understand whether different patterns of fatigue respond differently to different approaches," says Adam.<!-- --></p></div><figure><div data-component="image-block" class="sc-18fde0d6-0 jFCfG"><div data-testid="image" class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 50vw, (min-width: 1008px) 66vw, 96vw" srcSet="https://ichef.bbci.co.uk/images/ic/160xn/p0k5m94v.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240xn/p0k5m94v.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320xn/p0k5m94v.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480xn/p0k5m94v.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640xn/p0k5m94v.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800xn/p0k5m94v.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024xn/p0k5m94v.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376xn/p0k5m94v.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920xn/p0k5m94v.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480xn/p0k5m94v.jpg.webp" alt="Getty Images There are many conditions that involve long-term post-viral fatigue, including ME, CFS, and long Covid (Credit: Getty Images)" class="sc-a34861b-0 efFcac"/><span class="sc-a34861b-2 fxQYxK">Getty Images</span></div></div><div data-component="caption-block" class="sc-18fde0d6-0 bdPeAJ"><figcaption class="sc-8353772e-0 cvNhQw">There are many conditions that involve long-term post-viral fatigue, including ME, CFS, and long Covid (Credit: Getty Images)<!-- --></figcaption></div></figure><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">As an academic researcher at the University of Aberdeen, Adam has launched <!-- --><a target="_blank" href="https://www.abdn.ac.uk/news/16714/" class="sc-c9299ecf-0 bZUiKB">a study<!-- --></a> of 40 people suffering from varying forms of problematic fatigue, from long Covid patients to those with heart failure or cancer. For the research, they were given digital sensors to track a variety of physical parameters from breathing rate to body temperature, sleep quality, heart activity and activity levels, along with an app to rate their physical and mental fatigue throughout the day. <!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">The aim is to use AI to identify patterns in the data which might represent what Adam calls "fatiguotypes" – distinct traits which could be used to categorise subtypes of fatigue more accurately. She hopes that the findings could ultimately lead to more tailored clinical trials for fatigue, and potentially pave the way for new medicines.<!-- --></p></div><div data-component="ad-slot" data-testid="ad-unit" class="sc-d2ebd0a7-0 iayHyW"><div data-testid="dotcom-mid_2" id="dotcom-mid_2" class="dotcom-ad"></div></div><figure><div data-component="image-block" class="sc-18fde0d6-0 jFCfG"><div data-testid="image" class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 50vw, (min-width: 1008px) 66vw, 96vw" srcSet="https://ichef.bbci.co.uk/images/ic/160xn/p0k5m7th.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240xn/p0k5m7th.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320xn/p0k5m7th.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480xn/p0k5m7th.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640xn/p0k5m7th.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800xn/p0k5m7th.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024xn/p0k5m7th.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376xn/p0k5m7th.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920xn/p0k5m7th.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480xn/p0k5m7th.jpg.webp" alt="Getty Images Many people with long Covid experience debilitating post-exertional malaise, where minimal exertion can lead to an energy ‘crash’ (Credit: Getty Images)" class="sc-a34861b-0 efFcac"/><span class="sc-a34861b-2 fxQYxK">Getty Images</span></div></div><div data-component="caption-block" class="sc-18fde0d6-0 bdPeAJ"><figcaption class="sc-8353772e-0 cvNhQw">Many people with long Covid experience debilitating post-exertional malaise, where minimal exertion can lead to an energy ‘crash’ (Credit: Getty Images)<!-- --></figcaption></div></figure><div data-component="subheadline-block" class="sc-18fde0d6-0 eeiVGB"><h2 class="sc-518485e5-0 kRvAla"><span id="a" class="sc-7dcfb11b-0 kPypaC"><b id="a" class="sc-7dcfb11b-0 kVRnKf">A <!-- --></b></span><span id="daily-challenge" class="sc-7dcfb11b-0 kPypaC"><b id="daily-challenge" class="sc-7dcfb11b-0 kVRnKf">daily challenge <!-- --></b></span></h2></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">This kind of physiological shutdown is intrinsic to post-exertional malaise or PEM, a much more severe and complex phenomenon compared with ordinary post-viral fatigue. With PEM, patients like Edwards find themselves locked into a state in which the tiniest overexertion can result in a crash which lasts for months and sometimes even years.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">David Putrino, a professor in the department of rehabilitation and human performance at the Icahn School of Medicine at Mount Sinai, believes that there are at least 10 different plausible explanations for why people develop PEM, which range from <!-- --><a target="_blank" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC3501671/" class="sc-c9299ecf-0 bZUiKB">sleep disruption<!-- --></a> to <!-- --><a target="_blank" href="https://link.springer.com/article/10.1007/s12035-016-0170-2" class="sc-c9299ecf-0 bZUiKB">hormonal impairments<!-- --></a> and <!-- --><a target="_blank" href="https://link.springer.com/article/10.1186/s12967-022-03244-7" class="sc-c9299ecf-0 bZUiKB">inflammation of the lining of blood vessels<!-- --></a>. But at the heart of many of these theories are tubular, energy-creating structures called mitochondria which can be found in every single one of our cells.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">When viruses invade our cells, they hijack mitochondria and leach some of the energy which is being generated for our benefit and use it to help them replicate and pump more virus through the body. "Now you have a cell that is working way over capacity to produce energy for both viral replication as well as the general functions it needs to perform," says Putrino.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">According to Putrino, this means that while we're trying to recover from an infection, the body is also coping with what he calls an "energy debt", having been generating twice the customary amount of energy during the infection phase. One of the theories for why Sars-CoV-2 and other viruses can lead to PEM is because small amounts of virus <!-- --><a target="_blank" href="https://www.nature.com/articles/s41590-023-01601-2" class="sc-c9299ecf-0 bZUiKB">can persist<!-- --></a> in parts of the body. As such, returning to normal activities before the body has recovered from its energy debt can causes a crash, during which time the virus can <!-- --><a target="_blank" href="https://elifesciences.org/articles/86015" class="sc-c9299ecf-0 bZUiKB">flare up or reactivate dormant viruses<!-- --></a> and <!-- --><a target="_blank" href="https://www.mdpi.com/2227-9059/10/12/3113" class="sc-c9299ecf-0 bZUiKB">induce further mitochondrial damage<!-- --></a>.<!-- --></p></div><div data-component="ad-slot" data-testid="ad-unit" class="sc-d2ebd0a7-0 iayHyW"><div data-testid="dotcom-mid_3" id="dotcom-mid_3" class="dotcom-ad"></div></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">In other cases, the muscle weakness and physical impairments which many people with severe post-viral fatigue and PEM describe, are thought to be due to the initial infection <!-- --><a target="_blank" href="https://link.springer.com/article/10.1007/s15010-024-02386-8?trk=public_post_comment-text" class="sc-c9299ecf-0 bZUiKB">inducing a state of autoimmunity<!-- --></a>, changing the behaviour of immune cells and triggering them to attack the very nerve fibres which enable muscles to contract. In Ebola disease survivors, severe autoimmunity <!-- --><a target="_blank" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7381622/" class="sc-c9299ecf-0 bZUiKB">has been shown<!-- --></a> to be connected to the symptoms of prolonged fatigue which many experience, while <!-- --><a target="_blank" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7162060/" class="sc-c9299ecf-0 bZUiKB">similar processes<!-- --></a> were also linked to the chronic fatigue and disability experienced by survivors of the Sars outbreak in the early 2000s.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">"Viral infections may trigger long-term and persistent impairment in one's immune system," says Avik Roy, chief scientific officer at the non-profit Simmaron Research, which conducts research into the treatment of neuroimmune diseases. "Autoimmune responses due to the altered behaviour of immune cells such as T lymphocytes, natural killer cells and macrophages may cause damage in the myelin layer of peripheral nerves, resulting in muscle weakness and fatigue."<!-- --></p></div><figure><div data-component="image-block" class="sc-18fde0d6-0 jFCfG"><div data-testid="image" class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 50vw, (min-width: 1008px) 66vw, 96vw" srcSet="https://ichef.bbci.co.uk/images/ic/160xn/p0k5m9qb.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240xn/p0k5m9qb.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320xn/p0k5m9qb.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480xn/p0k5m9qb.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640xn/p0k5m9qb.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800xn/p0k5m9qb.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024xn/p0k5m9qb.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376xn/p0k5m9qb.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920xn/p0k5m9qb.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480xn/p0k5m9qb.jpg.webp" alt="Getty Images Post-viral fatigue sometimes lasts a few weeks, but it can also last years or be lifelong (Credit: Getty Images)" class="sc-a34861b-0 efFcac"/><span class="sc-a34861b-2 fxQYxK">Getty Images</span></div></div><div data-component="caption-block" class="sc-18fde0d6-0 bdPeAJ"><figcaption class="sc-8353772e-0 cvNhQw">Post-viral fatigue sometimes lasts a few weeks, but it can also last years or be lifelong (Credit: Getty Images)<!-- --></figcaption></div></figure><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">A third idea which Putrino and others have been studying, is related to <!-- --><a target="_blank" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10179190/" class="sc-c9299ecf-0 bZUiKB">impaired waste clearance.<!-- --></a> Working overtime means that mitochondria generate a lot of oxidative stress, yet the body is unable to adequately clear up after itself, because the immune system is in a state of prolonged exhaustion after battling the virus. This in itself may contribute to physical symptoms such as brain fog and muscle fatigue, impacting the ability to move and function normally. <!-- --><a target="_blank" href="https://www.nature.com/articles/s41467-023-44432-3#Sec8" class="sc-c9299ecf-0 bZUiKB">One study<!-- --></a> even showed that long Covid patients have an accumulation of toxic waste products in their muscle fibres.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">Because of all this, an approach known as "graded exercise" (sometimes known as "pacing"), by which patients attempt to slowly work their way back to normal levels of physical activity by progressively pushing themselves to do more and more, does not always work. In some Lyme disease, ME/CFS and long Covid patients, their underlying dysfunction <!-- --><a target="_blank" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10576275/" class="sc-c9299ecf-0 bZUiKB">means that graded exercise can actually make them worse<!-- --></a>.<!-- --></p></div><div data-component="ad-slot" data-testid="ad-unit" class="sc-d2ebd0a7-0 iayHyW"><div data-testid="dotcom-mid_4" id="dotcom-mid_4" class="dotcom-ad"></div></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">"Long Covid patients need to achieve some improvement in functional status by virtue of medication before embarking on any form of graded exercise," says David Systrom, a pulmonologist at Brigham & Women's Hospital.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">But finding the right medication involves identifying the underlying cause of their symptoms.<!-- --></p></div><div data-component="subheadline-block" class="sc-18fde0d6-0 eeiVGB"><h2 class="sc-518485e5-0 kRvAla"><span id="a-possible-solution" class="sc-7dcfb11b-0 kPypaC"><b id="a-possible-solution" class="sc-7dcfb11b-0 kVRnKf">A possible solution <!-- --></b></span></h2></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">Over several decades of studying people with ME/CFS, Betsy Keller, a professor in the department of exercise and sport sciences at Ithaca College in New York, has heard the phrase "mitochondrial dysfunction" cited repeatedly as a possible cause of their prolonged fatigue. However, she says the key question is what is causing the mitochondria to be impaired.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">In some cases of post-viral fatigue stemming from Ebola, Zika and influenza viruses, <!-- --><a target="_blank" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10779395/" class="sc-c9299ecf-0 bZUiKB">research has<!-- --></a> suggested that the cause is <!-- --><a target="_blank" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC10779395/" class="sc-c9299ecf-0 bZUiKB">direct viral damage<!-- --></a> to mitochondria DNA. Studies delving into possible mechanisms have found that viral invasion can <!-- --><a target="_blank" href="https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00123-2/fulltext" class="sc-c9299ecf-0 bZUiKB">inhibit the production of phosphocreatine<!-- --></a>, a crucial chemical in the energy creation process. But there are other cases where mitochondria may simply be suffering from a lack of oxygen.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">Sars-CoV-2 and other viruses appear to be capable of <!-- --><a target="_blank" href="https://portlandpress.com/bioscirep/article/41/8/BSR20210611/229418/SARS-CoV-2-spike-protein-S1-induces-fibrin-ogen" class="sc-c9299ecf-0 bZUiKB">driving the formation of micro-clots<!-- --></a>, tiny particles which move through blood vessels entrapping various proteins and impairing oxygen flow, while in other cases, viral damage can affect <!-- --><a target="_blank" href="https://www.mdpi.com/1660-4601/20/2/909" class="sc-c9299ecf-0 bZUiKB">normal heart rate<!-- --></a>, <!-- --><a target="_blank" href="https://www.nature.com/articles/s41579-021-00542-7" class="sc-c9299ecf-0 bZUiKB">respiratory function<!-- --></a> and <!-- --><a target="_blank" href="https://journals.physiology.org/doi/full/10.1152/ajpheart.00897.2020" class="sc-c9299ecf-0 bZUiKB">blood flow<!-- --></a>.<!-- --></p></div><div data-component="ad-slot" data-testid="ad-unit" class="sc-d2ebd0a7-0 iayHyW"><div data-testid="dotcom-mid_5" id="dotcom-mid_5" class="dotcom-ad"></div></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">If the mitochondria can't get enough oxygen to function normally, Keller says that the body shifts to <!-- --><a target="_blank" href="https://link.springer.com/chapter/10.1007/978-3-030-94305-9_4" class="sc-c9299ecf-0 bZUiKB">anaerobic energy production<!-- --></a>, a means of generating energy which is usually only required for short, intense bursts of activity such as sprinting at high speed. "When this shift towards anaerobic energy production occurs prematurely during low-level exertion, even simple activities of daily living will result in fatigue," says Keller.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">At Mount Sinai, Putrino is now leading <!-- --><a target="_blank" href="https://polybio.org/projects/lumbrokinase-longcovid-me-cfs-clinical-trial/" class="sc-c9299ecf-0 bZUiKB">a clinical trial<!-- --></a> looking at whether an enzyme called lumbrokinase, which breaks down fibrin, a protein <!-- --><a target="_blank" href="https://portlandpress.com/biochemj/article/479/4/537/230829/A-central-role-for-amyloid-fibrin-microclots-in" class="sc-c9299ecf-0 bZUiKB">which is thought<!-- --></a> to be at the core of micro-clots, can help improve mitochondrial function and energy levels in long Covid and ME/CFS patients.<!-- --></p></div><figure><div data-component="image-block" class="sc-18fde0d6-0 jFCfG"><div data-testid="image" class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 50vw, (min-width: 1008px) 66vw, 96vw" srcSet="https://ichef.bbci.co.uk/images/ic/160xn/p0k5m7hw.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240xn/p0k5m7hw.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320xn/p0k5m7hw.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480xn/p0k5m7hw.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640xn/p0k5m7hw.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800xn/p0k5m7hw.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024xn/p0k5m7hw.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376xn/p0k5m7hw.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920xn/p0k5m7hw.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480xn/p0k5m7hw.jpg.webp" alt="Getty Images Long Covid can be difficult to diagnose (Credit: Getty Images)" class="sc-a34861b-0 efFcac"/><span class="sc-a34861b-2 fxQYxK">Getty Images</span></div></div><div data-component="caption-block" class="sc-18fde0d6-0 bdPeAJ"><figcaption class="sc-8353772e-0 cvNhQw">Long Covid can be difficult to diagnose (Credit: Getty Images)<!-- --></figcaption></div></figure><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">This is just one of an entire range of possible solutions being explored. In long Covid patients where viral persistence or reactivated viruses seem to be behind PEM, Putrino is exploring whether various <!-- --><a target="_blank" href="https://polybio.org/projects/a-clinical-trial-of-repurposed-hiv-antivirals-in-longcovid/" class="sc-c9299ecf-0 bZUiKB">repurposed HIV medications<!-- --></a> can help restore these infections to a dormant form. Simmaron Research along with the Mayo Clinic and the Center for Chronic Diseases, have launched <!-- --><a target="_blank" href="https://clinicaltrials.gov/study/NCT06257420?cond=NCT06257420&rank=1" class="sc-c9299ecf-0 bZUiKB">a clinical trial<!-- --></a> of low-dose rapamycin in people with ME/CFS to see whether it can improve mitochondrial function and quality of life by stimulating a key bodily process called autophagy, encouraging cells to remove and recycle damaged components. "So far, the trial has produced very promising initial results," says Roy.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">This wealth of research is also identifying supplements which may help people with less severe forms of post-viral fatigue recover more quickly in the wake of an infection. Coenzyme Q10, a compound used by mitochondria to generate energy which has been <!-- --><a target="_blank" href="https://pubmed.ncbi.nlm.nih.gov/20010505/" class="sc-c9299ecf-0 bZUiKB">found to be depleted<!-- --></a> in ME/CFS patients, is now available over the counter in the US and the UK – it's regulated as a <!-- --><a target="_blank" href="https://www.ncbi.nlm.nih.gov/books/NBK531491/" class="sc-c9299ecf-0 bZUiKB">dietary supplement<!-- --></a> – and has been shown in <!-- --><a target="_blank" href="https://pmc.ncbi.nlm.nih.gov/articles/PMC9449413/" class="sc-c9299ecf-0 bZUiKB">some studies<!-- --></a> to reduce fatigue.<!-- --></p></div><div data-component="ad-slot" data-testid="ad-unit" class="sc-d2ebd0a7-0 iayHyW"><div data-testid="dotcom-mid_6" id="dotcom-mid_6" class="dotcom-ad"></div></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">Keller says that this research is also helping to identify subgroups of people who seem to be more at risk of post-viral fatigue. She believes that people who already have <!-- --><a target="_blank" href="https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-024-05410-5" class="sc-c9299ecf-0 bZUiKB">underlying muscle or nerve tension<!-- --></a> due to lifestyle habits, chronic injuries or surgeries could be more vulnerable because these underlying factors will already be inhibiting oxygen delivery around the body.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">"We've found that tension from frequent or prolonged sitting, or in the muscles of the neck, chest and shoulders due to excessive screen time, surfing on cell phones and low strength and endurance of the core muscles that support correct spinal alignment may be a contributing factor," she says. "Injuries or surgeries that cause scarring of the connective tissue such as C-section or breast reduction, may also contribute to this tension."<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">Putrino says it is vital that we get better at identifying the precise factors which can cause people to end up in a state of prolonged fatigue, as this will enable the development of better diagnostics and ultimately more targeted treatments aimed at various subgroups of individuals.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">"There are many drivers, and it's naive to think that a single drug or a single intervention will address everything," Putrino says. "But as long as we're methodical in investigating potential target drugs, and understanding why they don't work in different people, then we stand a chance of getting more sophisticated combination drug trials within the next 12 to 24 months. That could lead to some real hope for people living with these infection-associated chronic conditions," he says.<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe">--<!-- --></p></div><div data-component="text-block" class="sc-18fde0d6-0 dlWCEZ"><p class="sc-eb7bd5f6-0 fYAfXe"><i id="for-essential-climate-news-and-hopeful-developments-to-your-inbox,-sign-up-to-the" class="sc-7dcfb11b-0 kKcaog">For essential climate news and hopeful developments to your inbox, sign up to the <!-- --></i><a target="_self" href="https://cloud.email.bbc.com/FutureEarth_Newsletter_Signup?&at_bbc_team=studios&at_medium=Onsite&at_objective=acquisition&at_ptr_name=bbc.com&at_link_origin=futurearticle&at_campaign=futureearth&at_campaign_type=owned&&" class="sc-c9299ecf-0 bZUiKB"><i id="future-earth-newsletter," class="sc-7dcfb11b-0 kKcaog">Future Earth newsletter,<!-- --></i></a><i id="while" class="sc-7dcfb11b-0 kKcaog"> while <!-- --></i><a 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href="/culture/tags/features" data-testid="internal-link" class="sc-3df0d64d-0 kMyFYO">Features</a></div><div data-testid="anchor-inner-wrapper"><a href="/news/topics/cvenzmgyg2vt" data-testid="internal-link" class="sc-3df0d64d-0 kMyFYO">Flu</a></div></div></div></article><aside data-testid="texas-section-outer" data-analytics-group="true" data-analytics_group_name="Watch" data-analytics_group_type="texas-20" data-analytics_group_position="1" data-analytics_group_item_count="20" data-analytics_group_link="" class="sc-ba42a659-1 cYqRar"><div data-testid="texas-section" class="sc-ba42a659-2 jqWjKw"><div class="sc-7a382a26-2 lhbHDZ"><div class="sc-7a382a26-1 vyVNI"><hr data-testid="texas-line" class="sc-7a382a26-0 cZNAZj"/></div><div data-testid="section-title-wrapper" class="sc-7a382a26-3 gOPBZn"><div><div class="sc-7a382a26-7 jlJwDB"><span data-testid="texas-title" class="sc-7a382a26-4 gtFsyR">Watch<!-- --></span></div></div></div></div><div data-testid="texas-grid" class="sc-8a8cf983-0 iYKspt"><div class="sc-8a8cf983-1 gaQDrT"><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0jt8x5z/earth-tides-why-our-planet-s-crust-has-tides-too" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0jt9gtk.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0jt9gtk.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0jt9gtk.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0jt9gtk.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0jt9gtk.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0jt9gtk.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0jt9gtk.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0jt9gtk.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0jt9gtk.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0jt9gtk.jpg.webp" alt="Why our planet's crust has tides too" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">Earth tides: Why our planet's crust has tides too<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">How do they differ from the ocean? A geophysicist breaks it down for us.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">28 Sep 2024</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Weather & science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0jlbpl3/new-nasa-sonifications-listen-to-the-sound-of-the-universe" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0jp0p4j.png.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0jp0p4j.png.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0jp0p4j.png.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0jp0p4j.png.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0jp0p4j.png.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0jp0p4j.png.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0jp0p4j.png.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0jp0p4j.png.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0jp0p4j.png.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0jp0p4j.png.webp" alt="Screenshot 2024 08 22 at 8 51 13 PM" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">New Nasa sonifications: Listen to the sound of the Universe<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Nasa has released new 'sonifications' of the Universe on the 25th anniversary of Chandra, its X-ray Observatory.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">9 Sep 2024</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Space</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0jnbll0/uncovering-the-sunken-relics-of-an-ancient-city" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0jnbpvk.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0jnbpvk.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0jnbpvk.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0jnbpvk.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0jnbpvk.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0jnbpvk.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0jnbpvk.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0jnbpvk.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0jnbpvk.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0jnbpvk.jpg.webp" alt="Uncovering the sunken relics of an ancient city" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">Uncovering the sunken relics of an ancient city<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Bettany Hughes goes underwater in search of ancient archaeological finds in historic Sozopol, Bulgaria.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">4 Sep 2024</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Archaeology</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0jkkyc6/in-australia-sea-lions-help-researchers-map-the-ocean-floor" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0jklf59.png.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0jklf59.png.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0jklf59.png.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0jklf59.png.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0jklf59.png.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0jklf59.png.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0jklf59.png.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0jklf59.png.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0jklf59.png.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0jklf59.png.webp" alt="Screenshot 2024 08 20 at 2 00 51 PM min" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">In Australia, sea lions help researchers map the ocean floor<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Researchers in Australia put cameras on sea lions' backs to help them map the elusive ocean floor.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">21 Aug 2024</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Earth</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0jgsff2/the-scientists-drilling-into-an-active-icelandic-volcano" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0jhk026.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0jhk026.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0jhk026.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0jhk026.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0jhk026.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0jhk026.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0jhk026.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0jhk026.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0jhk026.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0jhk026.jpg.webp" alt="The scientists drilling into an anctive Icelandic volcano" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">The scientists drilling into an active Icelandic volcano<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Scientists are preparing to drill into the rock of an Icelandic volcano to learn more about how volcanoes behave.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">17 Aug 2024</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Climate solutions</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0j83nwv/why-we-may-have-misunderstood-the-universe" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0j882d0.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0j882d0.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0j882d0.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0j882d0.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0j882d0.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0j882d0.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0j882d0.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0j882d0.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0j882d0.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0j882d0.jpg.webp" alt="Why we may have misunderstood the Universe" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">Why we may have misunderstood the Universe<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Research by a Nobel Prize winning astrophysicist suggests we have been wrong about the expansion of our Universe.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">4 Jul 2024</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0gh5dgd/how-flickering-lights-can-help-you-learn-better" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0gh6xp8.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0gh6xp8.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0gh6xp8.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0gh6xp8.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0gh6xp8.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0gh6xp8.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0gh6xp8.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0gh6xp8.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0gh6xp8.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0gh6xp8.jpg.webp" alt="How to boost your ability to learn" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">How flickering lights can help you learn better<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">The stunning new science of how lights flickering in tune to our brain rhythms can improve how quickly we learn.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">8 Nov 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0gn8kps/the-butterfly-effect-what-is-chaos-theory-" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0gn8nnn.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0gn8nnn.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0gn8nnn.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0gn8nnn.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0gn8nnn.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0gn8nnn.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0gn8nnn.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0gn8nnn.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0gn8nnn.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0gn8nnn.jpg.webp" alt="What is chaos theory?" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">The butterfly effect: What is chaos theory?<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">The world was explained through the laws of physics until a meteorologist saw the pattern of chaos.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">23 Oct 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0gf55h4/scientists-create-world-s-first-synthetic-embryos" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0gf57b5.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0gf57b5.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0gf57b5.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0gf57b5.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0gf57b5.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0gf57b5.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0gf57b5.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0gf57b5.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0gf57b5.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0gf57b5.jpg.webp" alt="The world's first 'synthetic' embryos" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">Scientists create world's first 'synthetic' embryos<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Researchers in Israel have created 'synthetic' embryos without using a sperm or egg.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">17 Sep 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0fxn135/why-can-t-i-remember-people-s-faces-" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0gbyckf.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0gbyckf.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0gbyckf.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0gbyckf.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0gbyckf.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0gbyckf.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0gbyckf.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0gbyckf.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0gbyckf.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0gbyckf.jpg.webp" alt="Why can’t I remember people’s faces?" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">Why can’t I remember people’s faces?<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Prosopagnosia, or face blindness, is a brain disorder that affects the ability to recognise people.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">6 Sep 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0g9hhcg/four-ways-to-understand-the-multiverse" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0g9hzs2.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0g9hzs2.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0g9hzs2.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0g9hzs2.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0g9hzs2.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0g9hzs2.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0g9hzs2.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0g9hzs2.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0g9hzs2.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0g9hzs2.jpg.webp" alt="The multiverse explained...in four ways" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">Four ways to understand the multiverse<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Max Tobin and world-renowned physicist Max Tegmark guide us through four ways to understand the multiverse.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">29 Aug 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0g7ch3b/maui-s-grass-fire-cycle-explained" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0g7crg3.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0g7crg3.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0g7crg3.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0g7crg3.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0g7crg3.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0g7crg3.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0g7crg3.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0g7crg3.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0g7crg3.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0g7crg3.jpg.webp" alt="Maui's grass-fire cycle explained" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">Maui's grass-fire cycle explained<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Grasses that aren't native to Maui fueled the wildfires we see today. How did this happen?</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">17 Aug 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0g4fxxt/ancient-worms-found-in-siberia-permafrost-come-back-to-life" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0g4fych.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0g4fych.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0g4fych.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0g4fych.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0g4fych.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0g4fych.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0g4fych.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0g4fych.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0g4fych.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0g4fych.jpg.webp" alt="Ancient worms revived after 46,000 years" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">Ancient worms found in Siberia permafrost come back to life<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Scientists have revived a pair of 46,000-year-old worms found deep in the Siberian permafrost.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">3 Aug 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0g4174s/is-this-mysterious-animal-the-key-to-human-longevity-" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0g479zv.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0g479zv.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0g479zv.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0g479zv.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0g479zv.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0g479zv.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0g479zv.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0g479zv.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0g479zv.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0g479zv.jpg.webp" alt="Is this mysterious animal the key to human longevity?" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">Is this mysterious animal the key to human longevity?<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">The olm can live for 100 years. Scientists want to decode its genome to unveil the secret to longevity.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">1 Aug 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0g2wfwh/the-oppenheimer-dilemma-h-bomb-vs-a-bomb" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0g2wk28.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0g2wk28.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0g2wk28.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0g2wk28.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0g2wk28.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0g2wk28.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0g2wk28.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0g2wk28.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0g2wk28.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0g2wk28.jpg.webp" alt="The Oppenheimer dilemma: H-bomb vs A-bomb" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">The Oppenheimer dilemma: H-bomb vs A-bomb<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Oppenheimer, the father of the atomic bomb, was against hydrogen bombs. But what’s the difference?</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">27 Jul 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0g22nf3/the-enigmatic-blueprint-to-a-mirror-universe" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0g22ssz.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0g22ssz.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0g22ssz.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0g22ssz.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0g22ssz.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0g22ssz.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0g22ssz.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0g22ssz.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0g22ssz.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0g22ssz.jpg.webp" alt="The enigmatic blueprint to a mirror universe" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">The enigmatic blueprint to a mirror Universe<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">The discovery of the substance that could unravel the whole mystery of existence.</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">21 Jul 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0fvdy88/the-poisonous-origin-of-life-on-earth" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0fvmj7t.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0fvmj7t.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0fvmj7t.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0fvmj7t.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0fvmj7t.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0fvmj7t.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0fvmj7t.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0fvmj7t.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0fvmj7t.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0fvmj7t.jpg.webp" alt="Poison2" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">The poisonous origin of life on Earth<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Could proof of life on Mars reveal the poisonous origin of life on Earth?</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">21 Jun 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0f3k9ww/the-enigmatic-far-side-of-the-moon" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div data-testid="edinburgh-video" class="sc-b8778340-0 kpNmDb"><div data-testid="card-media-wrapper" class="sc-b8778340-1 jvzsLx"><div data-testid="card-media" class="sc-b8778340-2 kUyIkJ"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1280px) 20vw, (min-width: 1008px) 25vw, (min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0f3rlk4.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0f3rlk4.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0f3rlk4.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0f3rlk4.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0f3rlk4.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0f3rlk4.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0f3rlk4.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0f3rlk4.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0f3rlk4.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0f3rlk4.jpg.webp" alt="Getty Images 864564598" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">The enigmatic far side of the Moon<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Why is the far side of the Moon so completely different from the surface we see?</p><div class="sc-6fba5bd4-0 hMFMgw"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 gRptTt">19 May 2023</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 gNUyZj"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 leA-DQf">Science</span></div></div></div></a></div></div></div><div class="sc-8a8cf983-2 jupLmo"><div data-testid="edinburgh-card"><div data-testid="anchor-inner-wrapper"><a href="/reel/video/p0fnnr0q/why-is-adhd-so-surrounded-by-myth-" 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1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0fnnvs3.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0fnnvs3.jpg.webp" alt="A young girl attempts to do a hand-stand on a sofa while her mother sits next to her looking unhappy." class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" icon="play" type="playback-avkx:play" class="sc-1097f7fe-0 jmthjj"><path d="M29 16 5.8 1v30L29 16z"></path></svg></div></div></div><div data-testid="card-text-wrapper" class="sc-b8778340-3 eTiihu"><div class="sc-8ea7699c-1 hxRodh"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 knMbnp">Why is ADHD so surrounded by myth?<!-- --></h2></div></div><p data-testid="card-description" class="sc-b8778340-4 fsrXqA">Do social media, some common assumptions and 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(min-width: 800px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0fhd9kg.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0fhd9kg.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0fhd9kg.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0fhd9kg.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0fhd9kg.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0fhd9kg.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0fhd9kg.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0fhd9kg.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0fhd9kg.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0fhd9kg.jpg.webp" alt="Getty Images 961375412" class="sc-a34861b-0 efFcac"/></div></div><div data-testid="content-type-label" class="sc-a05a8833-0 kYlOvy"><div data-testid="content-type-icon-wrapper" class="sc-a05a8833-1 dMNBUc"><svg viewBox="0 0 32 32" width="30" height="30" category="playback-avkx" 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data-analytics_group_name="More" data-analytics_group_type="alaska-5" data-analytics_group_position="2" data-analytics_group_item_count="5" data-analytics_group_link="" class="sc-ba42a659-1 GdVOW"><div data-testid="alaska-section" class="sc-ba42a659-2 jqWjKw"><div class="sc-7a382a26-2 lhbHDZ"><div class="sc-7a382a26-1 vyVNI"><hr data-testid="alaska-line" class="sc-7a382a26-0 iphYZF"/></div><div data-testid="section-title-wrapper" class="sc-7a382a26-3 gOPBZn"><div><div class="sc-7a382a26-7 jlJwDB"><span data-testid="alaska-title" class="sc-7a382a26-4 gQxUVz">More<!-- --></span></div></div></div></div><div class="sc-da05643e-0 kbaPPZ"><div data-testid="alaska-grid" class="sc-93223220-0 sc-da05643e-1 fiJvSm djXsFQ"><div data-testid="liverpool-card"><div data-testid="anchor-inner-wrapper"><a href="/travel/article/20241120-shenseeas-guide-to-jamaica" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div class="sc-ae29827d-4 ypQFr"><div class="sc-ae29827d-1 hAmwyA"><div 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1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0k5rscj.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0k5rscj.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0k5rscj.jpg.webp" alt="Kingston, Jamaica (Credit: Getty Images)" class="sc-a34861b-0 efFcac"/></div></div></div><div data-testid="card-text-wrapper" class="sc-ae29827d-6 dzMUxv"><div class="sc-8ea7699c-1 gTeoVH"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 gRBdkE">A Jamaican dancehall superstar's guide to Jamaica<!-- --></h2></div></div><p data-testid="card-description" class="sc-ae29827d-0 cNPpME">From hiking Dunn's River Falls to having bun and cheese, here are international pop artist Shenseea's picks for how to experience the best of her island.</p><div class="sc-6fba5bd4-0 kZsXRf"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 bffMcX">7 hrs ago</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 eQhLId"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 bHkTZK">Travel</span></div></div></div></div></a></div></div><div data-testid="liverpool-card"><div data-testid="anchor-inner-wrapper"><a href="/culture/article/20241122-wicked-author-gregory-maguire-on-the-real-meaning-of-the-story-that-captivated-the-world" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div class="sc-ae29827d-4 ypQFr"><div class="sc-ae29827d-1 hAmwyA"><div class="sc-6fba5bd4-0 bFzmvn"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 bCFJJn">10 hrs ago</span></div></div><div data-testid="liverpool-article" class="sc-ae29827d-3 khCtOO"><div data-testid="card-media-wrapper" class="sc-ae29827d-5 jVhDCQ"><div data-testid="card-media" class="sc-ae29827d-2 bgogNC"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1008px) 25vw, (min-width: 600px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0k6c70p.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0k6c70p.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0k6c70p.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0k6c70p.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0k6c70p.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0k6c70p.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0k6c70p.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0k6c70p.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0k6c70p.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0k6c70p.jpg.webp" alt="Cynthia Erivo as Elphaba in the 2024 Wicked film (Credit: Universal Pictures)" class="sc-a34861b-0 efFcac"/></div></div></div><div data-testid="card-text-wrapper" class="sc-ae29827d-6 dzMUxv"><div class="sc-8ea7699c-1 gTeoVH"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 gRBdkE">The real meaning of Wicked according to its author<!-- --></h2></div></div><p data-testid="card-description" class="sc-ae29827d-0 cNPpME">Before it was a Hollywood blockbuster it was a megahit musical, and before that it was a 1995 novel. Author Gregory Maguire tells the BBC about the inspiration behind Wicked.</p><div class="sc-6fba5bd4-0 kZsXRf"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 bffMcX">10 hrs ago</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 eQhLId"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 bHkTZK">Culture</span></div></div></div></div></a></div></div><div data-testid="liverpool-card"><div data-testid="anchor-inner-wrapper"><a href="/future/article/20241119-antarcticas-upside-down-ice-scape-we-had-no-idea-existed" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div class="sc-ae29827d-4 ypQFr"><div class="sc-ae29827d-1 hAmwyA"><div class="sc-6fba5bd4-0 bFzmvn"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 bCFJJn">11 hrs ago</span></div></div><div data-testid="liverpool-article" class="sc-ae29827d-3 khCtOO"><div data-testid="card-media-wrapper" class="sc-ae29827d-5 jVhDCQ"><div data-testid="card-media" class="sc-ae29827d-2 bgogNC"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1008px) 25vw, (min-width: 600px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0k5lpw4.png.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0k5lpw4.png.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0k5lpw4.png.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0k5lpw4.png.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0k5lpw4.png.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0k5lpw4.png.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0k5lpw4.png.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0k5lpw4.png.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0k5lpw4.png.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0k5lpw4.png.webp" alt="Sand dune-like ice structures found under the Dotson Ice Shelf in Antarctica (Credit: Filip 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href="/future/article/20221026-what-if-polluters-paid-for-climate-change-loss-and-damage" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div class="sc-ae29827d-4 ypQFr"><div class="sc-ae29827d-1 hAmwyA"><div class="sc-6fba5bd4-0 bFzmvn"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 bCFJJn">1 day ago</span></div></div><div data-testid="liverpool-article" class="sc-ae29827d-3 khCtOO"><div data-testid="card-media-wrapper" class="sc-ae29827d-5 jVhDCQ"><div data-testid="card-media" class="sc-ae29827d-2 bgogNC"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1008px) 25vw, (min-width: 600px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0d9psc1.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0d9psc1.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0d9psc1.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0d9psc1.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0d9psc1.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0d9psc1.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0d9psc1.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0d9psc1.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0d9psc1.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0d9psc1.jpg.webp" alt="" class="sc-a34861b-0 efFcac"/></div></div></div><div data-testid="card-text-wrapper" class="sc-ae29827d-6 dzMUxv"><div class="sc-8ea7699c-1 gTeoVH"><div class="sc-8ea7699c-0 hcpAqY"><h2 data-testid="card-headline" class="sc-8ea7699c-3 gRBdkE">The world's greatest unpaid debt?<!-- --></h2></div></div><p data-testid="card-description" class="sc-ae29827d-0 cNPpME">Should rich countries and fossil fuel companies pay for the climate losses and damages they have caused?</p><div class="sc-6fba5bd4-0 kZsXRf"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 bffMcX">1 day ago</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 eQhLId"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 bHkTZK">Future</span></div></div></div></div></a></div></div><div data-component="ad-slot" data-testid="ad-unit" class="sc-d2ebd0a7-0 iayHyW"><div data-testid="dotcom-mid_7" id="dotcom-mid_7" class="dotcom-ad"></div></div><div data-testid="liverpool-card"><div data-testid="anchor-inner-wrapper"><a href="/travel/article/20241121-where-to-discover-new-york-citys-native-american-roots" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><div class="sc-ae29827d-4 ypQFr"><div class="sc-ae29827d-1 hAmwyA"><div class="sc-6fba5bd4-0 bFzmvn"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 bCFJJn">1 day ago</span></div></div><div data-testid="liverpool-article" class="sc-ae29827d-3 fKfpeF"><div data-testid="card-media-wrapper" class="sc-ae29827d-5 jVhDCQ"><div data-testid="card-media" class="sc-ae29827d-2 bgogNC"><div class="sc-a34861b-1 jxzoZC"><img src="/bbcx/grey-placeholder.png" class="sc-a34861b-0 cOpVbP hide-when-no-script"/><img sizes="(min-width: 1008px) 25vw, (min-width: 600px) 33vw, 50vw" srcSet="https://ichef.bbci.co.uk/images/ic/160x90/p0k648tl.jpg.webp 160w,https://ichef.bbci.co.uk/images/ic/240x135/p0k648tl.jpg.webp 240w,https://ichef.bbci.co.uk/images/ic/320x180/p0k648tl.jpg.webp 320w,https://ichef.bbci.co.uk/images/ic/480x270/p0k648tl.jpg.webp 480w,https://ichef.bbci.co.uk/images/ic/640x360/p0k648tl.jpg.webp 640w,https://ichef.bbci.co.uk/images/ic/800x450/p0k648tl.jpg.webp 800w,https://ichef.bbci.co.uk/images/ic/1024x576/p0k648tl.jpg.webp 1024w,https://ichef.bbci.co.uk/images/ic/1376x774/p0k648tl.jpg.webp 1376w,https://ichef.bbci.co.uk/images/ic/1920x1080/p0k648tl.jpg.webp 1920w" src="https://ichef.bbci.co.uk/images/ic/480x270/p0k648tl.jpg.webp" alt="Person performing a traditional dance at a Native American powwow at Queens Farm Museum (Credit: Getty Images)" class="sc-a34861b-0 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Here's where travellers can learn about the area's original residents.</p><div class="sc-6fba5bd4-0 kZsXRf"><span data-testid="card-metadata-lastupdated" class="sc-6fba5bd4-1 bffMcX">1 day ago</span><div data-testid="card-metadata-separator" class="sc-6fba5bd4-3 eQhLId"></div><span data-testid="card-metadata-tag" class="sc-6fba5bd4-2 bHkTZK">Travel</span></div></div></div></div></a></div></div></div></div></div></aside><div class="zephr_meter_beta"></div><div class="zephr_story_beta"></div></main><hr data-testid="main-footer-divider" class="sc-be00b565-2 cxZZfa"/><footer data-testid="main-footer" class="sc-be00b565-0 hfihLu"><div class="sc-be00b565-3 bMDFAT"><div data-testid="anchor-inner-wrapper"><a href="/" data-testid="internal-link" class="sc-2e6baa30-0 gILusN"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 112 32" category="logo" icon="bbc" style="height:30px" class="sc-1097f7fe-0 jbvZzi"><title>British Broadcasting Corporation</title><path d="M111.99999,4.44444577e-05 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All rights reserved. <!-- --><i id="" class="sc-7dcfb11b-0 kKcaog"> <!-- --></i>The<!-- --><i id="bbc" class="sc-7dcfb11b-0 kKcaog"> BBC <!-- --></i>is<!-- --><i id="not-responsible-for-the-content-of-external-sites." class="sc-7dcfb11b-0 kKcaog"> not responsible for the content of external sites.<!-- --></i> <!-- --><a target="_self" href="https://www.bbc.co.uk/editorialguidelines/guidance/feeds-and-links" class="sc-c9299ecf-0 bZUiKB"><b id="read-about-our-approach-to-external-linking." class="sc-7dcfb11b-0 kVRnKf">Read about our approach to external linking.<!-- --></b></a></p><p class="sc-eb7bd5f6-0 fYAfXe"> <!-- --></p></div></footer></div></div><script id="__NEXT_DATA__" type="application/json">{"props":{"pageProps":{"page":{"@\"future\",\"article\",\"20241119-long-fatigue-the-exhaustion-that-lingers-after-an-infection\",":{"id":"urn:pubpipe:wwverticals:article:future/article/20241119-long-fatigue-the-exhaustion-that-lingers-after-an-infection","contents":[{"type":"headline","model":{"blocks":[{"type":"fragment","model":{"text":"Long Fatigue: The exhaustion that lingers after an infection","attributes":[]}}]}},{"type":"timestamp","model":{"timestamp":1732096800000}},{"type":"byline","model":{"blocks":[{"type":"contributor","model":{"topicUrl":"future/author/david-cox","blocks":[{"type":"name","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"By David Cox","blocks":[{"type":"fragment","model":{"text":"By David Cox","attributes":[]}}]}}]}}]}}]}},{"type":"timestamp","model":{"timestamp":1732096800000}}]}},{"type":"image","model":{"blocks":[{"type":"altText","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"A man standing in a woodland (Credit: Getty Images)","blocks":[{"type":"fragment","model":{"text":"A man standing in a woodland (Credit: Getty Images)","attributes":[]}}]}}]}}]}},{"type":"rawImage","model":{"height":1080,"width":1920,"locator":"/p0k5m7z2.jpg","originCode":"ic","copyrightHolder":"Getty Images"}}],"emphasiseImage":true}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Before long Covid there was post-viral fatigue – a mysterious set of illnesses caused by other infections. Now scientists are starting to unravel its secrets.","blocks":[{"type":"fragment","model":{"text":"Before long Covid there was post-viral fatigue – a mysterious set of illnesses caused by other infections. Now scientists are starting to unravel its secrets.","attributes":["bold"]}}]}}],"bodyIntro":true}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Since an acute infection with Covid-19 in the summer of 2023, Rachael Edwards has been battling a fatigue so crippling that it has left her bedridden for weeks at a time. A previously healthy 31-year-old marketing manager living in Amsterdam, she describes feeling like she is \"weighted down by an anchor\".","blocks":[{"type":"fragment","model":{"text":"Since an acute infection with Covid-19 in the summer of 2023, Rachael Edwards has been battling a fatigue so crippling that it has left her bedridden for weeks at a time. A previously healthy 31-year-old marketing manager living in Amsterdam, she describes feeling like she is \"weighted down by an anchor\".","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"\"Long Covid fatigue differs from the exhaustion of parenting newborns or long days at the office in a number of ways,\" says Edwards. \"Imagine you've completed the hardest marathon of your life with poor sleep and no fuel. Then after the adrenaline has worn off, try walking up a flight of 100 stairs. That is how my body feels. My muscles won't move. I can't even hold my hand above my head,\" she says.","blocks":[{"type":"fragment","model":{"text":"\"Long Covid fatigue differs from the exhaustion of parenting newborns or long days at the office in a number of ways,\" says Edwards. \"Imagine you've completed the hardest marathon of your life with poor sleep and no fuel. Then after the adrenaline has worn off, try walking up a flight of 100 stairs. That is how my body feels. My muscles won't move. I can't even hold my hand above my head,\" she says.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"With the Covid-19 pandemic came long Covid, the lingering symptoms after an infection with the virus has cleared. Now it is long Covid which has opened a new window into the study of post-viral fatigue – a similar illness of persistent exhaustion which some people experience after recovering from other kinds of infection.","blocks":[{"type":"fragment","model":{"text":"With the Covid-19 pandemic came long Covid, the lingering symptoms after an infection with the virus has cleared. 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But this long-term fatigue with varying degrees of severity has been linked to infections ranging from Sars to Ebola, Epstein-Barr virus and influenza, as well as infections with tick-borne pathogens such as the bacteria Borrelia burgdorferi, which causes Lyme disease.","blocks":[{"type":"fragment","model":{"text":"Post-viral fatigue has long been poorly understood, and for many years was often ","attributes":[]}},{"type":"urlLink","model":{"text":"dismissed as psychological","locator":"https://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1011523","blocks":[{"type":"fragment","model":{"text":"dismissed as psychological","attributes":[]}}]}},{"type":"fragment","model":{"text":". But this long-term fatigue with varying degrees of severity has been linked to infections ranging from ","attributes":[]}},{"type":"urlLink","model":{"text":"Sars","locator":"https://link.springer.com/article/10.1186/1471-2377-11-37","blocks":[{"type":"fragment","model":{"text":"Sars","attributes":[]}}]}},{"type":"fragment","model":{"text":" to ","attributes":[]}},{"type":"urlLink","model":{"text":"Ebola","locator":"https://www.tandfonline.com/doi/full/10.1586/14787210.2015.1079128","blocks":[{"type":"fragment","model":{"text":"Ebola","attributes":[]}}]}},{"type":"fragment","model":{"text":", ","attributes":[]}},{"type":"urlLink","model":{"text":"Epstein-Barr virus","locator":"https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2021.656797/full","blocks":[{"type":"fragment","model":{"text":"Epstein-Barr virus","attributes":[]}}]}},{"type":"fragment","model":{"text":" and ","attributes":[]}},{"type":"urlLink","model":{"text":"influenza","locator":"https://www.tandfonline.com/doi/abs/10.1080/21641846.2020.1778227","blocks":[{"type":"fragment","model":{"text":"influenza","attributes":[]}}]}},{"type":"fragment","model":{"text":", as well as infections with tick-borne pathogens such as the bacteria ","attributes":[]}},{"type":"urlLink","model":{"text":"Borrelia burgdorferi","locator":"https://www.bmj.com/content/333/7568/575","blocks":[{"type":"fragment","model":{"text":"Borrelia burgdorferi","attributes":["italic"]}}]}},{"type":"fragment","model":{"text":", which causes Lyme disease.","attributes":[]}}]}}]}},{"type":"advertisement","model":{"adType":"horizontal"},"incrementedType":"mid_1"},{"type":"subheadline","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"An enigmatic issue ","blocks":[{"type":"fragment","model":{"text":"An enigma","attributes":["bold","h1"]}},{"type":"fragment","model":{"text":"tic issue ","attributes":["bold","h1"]}}]}},{"type":"paragraph","model":{"text":"","blocks":[]}}]}}],"level":2}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"As a GP based in Aberdeen, Scotland, Rosalind Adam is familiar with seeing patients suffering from problematic fatigue. But over time, she has been increasingly struck by the generic nature of the term, and how we use this single phrase to encompass everything from everyday weariness to crippling energy deficits which leave people housebound and unable to work.","blocks":[{"type":"fragment","model":{"text":"As a GP based in Aberdeen, Scotland, Rosalind Adam is familiar with seeing patients suffering from problematic fatigue. But over time, she has been increasingly struck by the generic nature of the term, and how we use this single phrase to encompass everything from everyday weariness to crippling energy deficits which leave people housebound and unable to work.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"\"I don't think we should think of fatigue as a single entity and I'd like to understand whether different patterns of fatigue respond differently to different approaches,\" says Adam.","blocks":[{"type":"fragment","model":{"text":"\"I don't think we should think of fatigue as a single entity and I'd like to understand whether different patterns of fatigue respond differently to different approaches,\" says Adam.","attributes":[]}}]}}]}},{"type":"image","model":{"blocks":[{"type":"caption","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"There are many conditions that involve long-term post-viral fatigue, including ME, CFS, and long Covid (Credit: Getty Images)","blocks":[{"type":"fragment","model":{"text":"There are many conditions that involve long-term post-viral fatigue, including ME, CFS, and long Covid (Credit: Getty Images)","attributes":[]}}]}}]}}]}},{"type":"altText","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"There are many conditions that involve long-term post-viral fatigue, including ME, CFS, and long Covid (Credit: Getty Images)","blocks":[{"type":"fragment","model":{"text":"There are many conditions that involve long-term post-viral fatigue, including ME, CFS, and long Covid (Credit: Getty Images)","attributes":[]}}]}}]}}]}},{"type":"rawImage","model":{"height":1080,"width":1920,"locator":"/p0k5m94v.jpg","originCode":"ic","copyrightHolder":"Getty Images"}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"As an academic researcher at the University of Aberdeen, Adam has launched a study of 40 people suffering from varying forms of problematic fatigue, from long Covid patients to those with heart failure or cancer. 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She hopes that the findings could ultimately lead to more tailored clinical trials for fatigue, and potentially pave the way for new medicines.","attributes":[]}}]}}]}},{"type":"advertisement","model":{"adType":"horizontal"},"incrementedType":"mid_2"},{"type":"image","model":{"blocks":[{"type":"caption","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Many people with long Covid experience debilitating post-exertional malaise, where minimal exertion can lead to an energy ‘crash’ (Credit: Getty Images)","blocks":[{"type":"fragment","model":{"text":"Many people with long Covid experience debilitating post-exertional malaise, where minimal exertion can lead to an energy ‘crash’ (Credit: Getty Images)","attributes":[]}}]}}]}}]}},{"type":"altText","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Many people with long Covid experience debilitating post-exertional malaise, where minimal exertion can lead to an energy ‘crash’ (Credit: Getty Images)","blocks":[{"type":"fragment","model":{"text":"Many people with long Covid experience debilitating post-exertional malaise, where minimal exertion can lead to an energy ‘crash’ (Credit: Getty Images)","attributes":[]}}]}}]}}]}},{"type":"rawImage","model":{"height":1080,"width":1920,"locator":"/p0k5m7th.jpg","originCode":"ic","copyrightHolder":"Getty Images"}}]}},{"type":"subheadline","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"A daily challenge ","blocks":[{"type":"fragment","model":{"text":"A ","attributes":["bold","h1"]}},{"type":"fragment","model":{"text":"daily challenge ","attributes":["bold","h1"]}}]}}]}}],"level":2}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"This kind of physiological shutdown is intrinsic to post-exertional malaise or PEM, a much more severe and complex phenomenon compared with ordinary post-viral fatigue. With PEM, patients like Edwards find themselves locked into a state in which the tiniest overexertion can result in a crash which lasts for months and sometimes even years.","blocks":[{"type":"fragment","model":{"text":"This kind of physiological shutdown is intrinsic to post-exertional malaise or PEM, a much more severe and complex phenomenon compared with ordinary post-viral fatigue. With PEM, patients like Edwards find themselves locked into a state in which the tiniest overexertion can result in a crash which lasts for months and sometimes even years.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"David Putrino, a professor in the department of rehabilitation and human performance at the Icahn School of Medicine at Mount Sinai, believes that there are at least 10 different plausible explanations for why people develop PEM, which range from sleep disruption to hormonal impairments and inflammation of the lining of blood vessels. But at the heart of many of these theories are tubular, energy-creating structures called mitochondria which can be found in every single one of our cells.","blocks":[{"type":"fragment","model":{"text":"David Putrino, a professor in the department of rehabilitation and human performance at the Icahn School of Medicine at Mount Sinai, believes that there are at least 10 different plausible explanations for why people develop PEM, which range from ","attributes":[]}},{"type":"urlLink","model":{"text":"sleep disruption","locator":"https://pmc.ncbi.nlm.nih.gov/articles/PMC3501671/","blocks":[{"type":"fragment","model":{"text":"sleep disruption","attributes":[]}}]}},{"type":"fragment","model":{"text":" to ","attributes":[]}},{"type":"urlLink","model":{"text":"hormonal impairments","locator":"https://link.springer.com/article/10.1007/s12035-016-0170-2","blocks":[{"type":"fragment","model":{"text":"hormonal impairments","attributes":[]}}]}},{"type":"fragment","model":{"text":" and ","attributes":[]}},{"type":"urlLink","model":{"text":"inflammation of the lining of blood vessels","locator":"https://link.springer.com/article/10.1186/s12967-022-03244-7","blocks":[{"type":"fragment","model":{"text":"inflammation of the lining of blood vessels","attributes":[]}}]}},{"type":"fragment","model":{"text":". But at the heart of many of these theories are tubular, energy-creating structures called mitochondria which can be found in every single one of our cells.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"When viruses invade our cells, they hijack mitochondria and leach some of the energy which is being generated for our benefit and use it to help them replicate and pump more virus through the body. \"Now you have a cell that is working way over capacity to produce energy for both viral replication as well as the general functions it needs to perform,\" says Putrino.","blocks":[{"type":"fragment","model":{"text":"When viruses invade our cells, they hijack mitochondria and leach some of the energy which is being generated for our benefit and use it to help them replicate and pump more virus through the body. \"Now you have a cell that is working way over capacity to produce energy for both viral replication as well as the general functions it needs to perform,\" says Putrino.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"According to Putrino, this means that while we're trying to recover from an infection, the body is also coping with what he calls an \"energy debt\", having been generating twice the customary amount of energy during the infection phase. One of the theories for why Sars-CoV-2 and other viruses can lead to PEM is because small amounts of virus can persist in parts of the body. As such, returning to normal activities before the body has recovered from its energy debt can causes a crash, during which time the virus can flare up or reactivate dormant viruses and induce further mitochondrial damage.","blocks":[{"type":"fragment","model":{"text":"According to Putrino, this means that while we're trying to recover from an infection, the body is also coping with what he calls an \"energy debt\", having been generating twice the customary amount of energy during the infection phase. One of the theories for why Sars-CoV-2 and other viruses can lead to PEM is because small amounts of virus ","attributes":[]}},{"type":"urlLink","model":{"text":"can persist","locator":"https://www.nature.com/articles/s41590-023-01601-2","blocks":[{"type":"fragment","model":{"text":"can persist","attributes":[]}}]}},{"type":"fragment","model":{"text":" in parts of the body. As such, returning to normal activities before the body has recovered from its energy debt can causes a crash, during which time the virus can ","attributes":[]}},{"type":"urlLink","model":{"text":"flare up or reactivate dormant viruses","locator":"https://elifesciences.org/articles/86015","blocks":[{"type":"fragment","model":{"text":"flare up or reactivate dormant viruses","attributes":[]}}]}},{"type":"fragment","model":{"text":" and ","attributes":[]}},{"type":"urlLink","model":{"text":"induce further mitochondrial damage","locator":"https://www.mdpi.com/2227-9059/10/12/3113","blocks":[{"type":"fragment","model":{"text":"induce further mitochondrial damage","attributes":[]}}]}},{"type":"fragment","model":{"text":".","attributes":[]}}]}}]}},{"type":"advertisement","model":{"adType":"horizontal"},"incrementedType":"mid_3"},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"In other cases, the muscle weakness and physical impairments which many people with severe post-viral fatigue and PEM describe, are thought to be due to the initial infection inducing a state of autoimmunity, changing the behaviour of immune cells and triggering them to attack the very nerve fibres which enable muscles to contract. In Ebola disease survivors, severe autoimmunity has been shown to be connected to the symptoms of prolonged fatigue which many experience, while similar processes were also linked to the chronic fatigue and disability experienced by survivors of the Sars outbreak in the early 2000s.","blocks":[{"type":"fragment","model":{"text":"In other cases, the muscle weakness and physical impairments which many people with severe post-viral fatigue and PEM describe, are thought to be due to the initial infection ","attributes":[]}},{"type":"urlLink","model":{"text":"inducing a state of autoimmunity","locator":"https://link.springer.com/article/10.1007/s15010-024-02386-8?trk=public_post_comment-text","blocks":[{"type":"fragment","model":{"text":"inducing a state of autoimmunity","attributes":[]}}]}},{"type":"fragment","model":{"text":", changing the behaviour of immune cells and triggering them to attack the very nerve fibres which enable muscles to contract. In Ebola disease survivors, severe autoimmunity ","attributes":[]}},{"type":"urlLink","model":{"text":"has been shown","locator":"https://pmc.ncbi.nlm.nih.gov/articles/PMC7381622/","blocks":[{"type":"fragment","model":{"text":"has been shown","attributes":[]}}]}},{"type":"fragment","model":{"text":" to be connected to the symptoms of prolonged fatigue which many experience, while ","attributes":[]}},{"type":"urlLink","model":{"text":"similar processes","locator":"https://pmc.ncbi.nlm.nih.gov/articles/PMC7162060/","blocks":[{"type":"fragment","model":{"text":"similar processes","attributes":[]}}]}},{"type":"fragment","model":{"text":" were also linked to the chronic fatigue and disability experienced by survivors of the Sars outbreak in the early 2000s.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"\"Viral infections may trigger long-term and persistent impairment in one's immune system,\" says Avik Roy, chief scientific officer at the non-profit Simmaron Research, which conducts research into the treatment of neuroimmune diseases. \"Autoimmune responses due to the altered behaviour of immune cells such as T lymphocytes, natural killer cells and macrophages may cause damage in the myelin layer of peripheral nerves, resulting in muscle weakness and fatigue.\"","blocks":[{"type":"fragment","model":{"text":"\"Viral infections may trigger long-term and persistent impairment in one's immune system,\" says Avik Roy, chief scientific officer at the non-profit Simmaron Research, which conducts research into the treatment of neuroimmune diseases. \"Autoimmune responses due to the altered behaviour of immune cells such as T lymphocytes, natural killer cells and macrophages may cause damage in the myelin layer of peripheral nerves, resulting in muscle weakness and fatigue.\"","attributes":[]}}]}}]}},{"type":"image","model":{"blocks":[{"type":"caption","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Post-viral fatigue sometimes lasts a few weeks, but it can also last years or be lifelong (Credit: Getty Images)","blocks":[{"type":"fragment","model":{"text":"Post-viral fatigue sometimes lasts a few weeks, but it can also last years or be lifelong (Credit: Getty Images)","attributes":[]}}]}}]}}]}},{"type":"altText","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Post-viral fatigue sometimes lasts a few weeks, but it can also last years or be lifelong (Credit: Getty Images)","blocks":[{"type":"fragment","model":{"text":"Post-viral fatigue sometimes lasts a few weeks, but it can also last years or be lifelong (Credit: Getty Images)","attributes":[]}}]}}]}}]}},{"type":"rawImage","model":{"height":1080,"width":1920,"locator":"/p0k5m9qb.jpg","originCode":"ic","copyrightHolder":"Getty Images"}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"A third idea which Putrino and others have been studying, is related to impaired waste clearance. Working overtime means that mitochondria generate a lot of oxidative stress, yet the body is unable to adequately clear up after itself, because the immune system is in a state of prolonged exhaustion after battling the virus. This in itself may contribute to physical symptoms such as brain fog and muscle fatigue, impacting the ability to move and function normally. One study even showed that long Covid patients have an accumulation of toxic waste products in their muscle fibres.","blocks":[{"type":"fragment","model":{"text":"A third idea which Putrino and others have been studying, is related to ","attributes":[]}},{"type":"urlLink","model":{"text":"impaired waste clearance.","locator":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10179190/","blocks":[{"type":"fragment","model":{"text":"impaired waste clearance.","attributes":[]}}]}},{"type":"fragment","model":{"text":" Working overtime means that mitochondria generate a lot of oxidative stress, yet the body is unable to adequately clear up after itself, because the immune system is in a state of prolonged exhaustion after battling the virus. This in itself may contribute to physical symptoms such as brain fog and muscle fatigue, impacting the ability to move and function normally. ","attributes":[]}},{"type":"urlLink","model":{"text":"One study","locator":"https://www.nature.com/articles/s41467-023-44432-3#Sec8","blocks":[{"type":"fragment","model":{"text":"One study","attributes":[]}}]}},{"type":"fragment","model":{"text":" even showed that long Covid patients have an accumulation of toxic waste products in their muscle fibres.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Because of all this, an approach known as \"graded exercise\" (sometimes known as \"pacing\"), by which patients attempt to slowly work their way back to normal levels of physical activity by progressively pushing themselves to do more and more, does not always work. In some Lyme disease, ME/CFS and long Covid patients, their underlying dysfunction means that graded exercise can actually make them worse.","blocks":[{"type":"fragment","model":{"text":"Because of all this, an approach known as \"graded exercise\" (sometimes known as \"pacing\"), by which patients attempt to slowly work their way back to normal levels of physical activity by progressively pushing themselves to do more and more, does not always work. In some Lyme disease, ME/CFS and long Covid patients, their underlying dysfunction ","attributes":[]}},{"type":"urlLink","model":{"text":"means that graded exercise can actually make them worse","locator":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10576275/","blocks":[{"type":"fragment","model":{"text":"means that graded exercise can actually make them worse","attributes":[]}}]}},{"type":"fragment","model":{"text":".","attributes":[]}}]}}]}},{"type":"advertisement","model":{"adType":"horizontal"},"incrementedType":"mid_4"},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"\"Long Covid patients need to achieve some improvement in functional status by virtue of medication before embarking on any form of graded exercise,\" says David Systrom, a pulmonologist at Brigham \u0026 Women's Hospital.","blocks":[{"type":"fragment","model":{"text":"\"Long Covid patients need to achieve some improvement in functional status by virtue of medication before embarking on any form of graded exercise,\" says David Systrom, a pulmonologist at Brigham \u0026 Women's Hospital.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"But finding the right medication involves identifying the underlying cause of their symptoms.","blocks":[{"type":"fragment","model":{"text":"But finding the right medication involves identifying the underlying cause of their symptoms.","attributes":[]}}]}}]}},{"type":"subheadline","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"A possible solution ","blocks":[{"type":"fragment","model":{"text":"A possible solution ","attributes":["bold","h1"]}}]}}]}}],"level":2}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Over several decades of studying people with ME/CFS, Betsy Keller, a professor in the department of exercise and sport sciences at Ithaca College in New York, has heard the phrase \"mitochondrial dysfunction\" cited repeatedly as a possible cause of their prolonged fatigue. However, she says the key question is what is causing the mitochondria to be impaired.","blocks":[{"type":"fragment","model":{"text":"Over several decades of studying people with ME/CFS, Betsy Keller, a professor in the department of exercise and sport sciences at Ithaca College in New York, has heard the phrase \"mitochondrial dysfunction\" cited repeatedly as a possible cause of their prolonged fatigue. However, she says the key question is what is causing the mitochondria to be impaired.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"In some cases of post-viral fatigue stemming from Ebola, Zika and influenza viruses, research has suggested that the cause is direct viral damage to mitochondria DNA. Studies delving into possible mechanisms have found that viral invasion can inhibit the production of phosphocreatine, a crucial chemical in the energy creation process. But there are other cases where mitochondria may simply be suffering from a lack of oxygen.","blocks":[{"type":"fragment","model":{"text":"In some cases of post-viral fatigue stemming from Ebola, Zika and influenza viruses, ","attributes":[]}},{"type":"urlLink","model":{"text":"research has","locator":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10779395/","blocks":[{"type":"fragment","model":{"text":"research has","attributes":[]}}]}},{"type":"fragment","model":{"text":" suggested that the cause is ","attributes":[]}},{"type":"urlLink","model":{"text":"direct viral damage","locator":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10779395/","blocks":[{"type":"fragment","model":{"text":"direct viral damage","attributes":[]}}]}},{"type":"fragment","model":{"text":" to mitochondria DNA. Studies delving into possible mechanisms have found that viral invasion can ","attributes":[]}},{"type":"urlLink","model":{"text":"inhibit the production of phosphocreatine","locator":"https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00123-2/fulltext","blocks":[{"type":"fragment","model":{"text":"inhibit the production of phosphocreatine","attributes":[]}}]}},{"type":"fragment","model":{"text":", a crucial chemical in the energy creation process. But there are other cases where mitochondria may simply be suffering from a lack of oxygen.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Sars-CoV-2 and other viruses appear to be capable of driving the formation of micro-clots, tiny particles which move through blood vessels entrapping various proteins and impairing oxygen flow, while in other cases, viral damage can affect normal heart rate, respiratory function and blood flow.","blocks":[{"type":"fragment","model":{"text":"Sars-CoV-2 and other viruses appear to be capable of ","attributes":[]}},{"type":"urlLink","model":{"text":"driving the formation of micro-clots","locator":"https://portlandpress.com/bioscirep/article/41/8/BSR20210611/229418/SARS-CoV-2-spike-protein-S1-induces-fibrin-ogen","blocks":[{"type":"fragment","model":{"text":"driving the formation of micro-clots","attributes":[]}}]}},{"type":"fragment","model":{"text":", tiny particles which move through blood vessels entrapping various proteins and impairing oxygen flow, while in other cases, viral damage can affect ","attributes":[]}},{"type":"urlLink","model":{"text":"normal heart rate","locator":"https://www.mdpi.com/1660-4601/20/2/909","blocks":[{"type":"fragment","model":{"text":"normal heart rate","attributes":[]}}]}},{"type":"fragment","model":{"text":", ","attributes":[]}},{"type":"urlLink","model":{"text":"respiratory function","locator":"https://www.nature.com/articles/s41579-021-00542-7","blocks":[{"type":"fragment","model":{"text":"respiratory function","attributes":[]}}]}},{"type":"fragment","model":{"text":" and ","attributes":[]}},{"type":"urlLink","model":{"text":"blood flow","locator":"https://journals.physiology.org/doi/full/10.1152/ajpheart.00897.2020","blocks":[{"type":"fragment","model":{"text":"blood flow","attributes":[]}}]}},{"type":"fragment","model":{"text":".","attributes":[]}}]}}]}},{"type":"advertisement","model":{"adType":"horizontal"},"incrementedType":"mid_5"},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"If the mitochondria can't get enough oxygen to function normally, Keller says that the body shifts to anaerobic energy production, a means of generating energy which is usually only required for short, intense bursts of activity such as sprinting at high speed. \"When this shift towards anaerobic energy production occurs prematurely during low-level exertion, even simple activities of daily living will result in fatigue,\" says Keller.","blocks":[{"type":"fragment","model":{"text":"If the mitochondria can't get enough oxygen to function normally, Keller says that the body shifts to ","attributes":[]}},{"type":"urlLink","model":{"text":"anaerobic energy production","locator":"https://link.springer.com/chapter/10.1007/978-3-030-94305-9_4","blocks":[{"type":"fragment","model":{"text":"anaerobic energy production","attributes":[]}}]}},{"type":"fragment","model":{"text":", a means of generating energy which is usually only required for short, intense bursts of activity such as sprinting at high speed. \"When this shift towards anaerobic energy production occurs prematurely during low-level exertion, even simple activities of daily living will result in fatigue,\" says Keller.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"At Mount Sinai, Putrino is now leading a clinical trial looking at whether an enzyme called lumbrokinase, which breaks down fibrin, a protein which is thought to be at the core of micro-clots, can help improve mitochondrial function and energy levels in long Covid and ME/CFS patients.","blocks":[{"type":"fragment","model":{"text":"At Mount Sinai, Putrino is now leading ","attributes":[]}},{"type":"urlLink","model":{"text":"a clinical trial","locator":"https://polybio.org/projects/lumbrokinase-longcovid-me-cfs-clinical-trial/","blocks":[{"type":"fragment","model":{"text":"a clinical trial","attributes":[]}}]}},{"type":"fragment","model":{"text":" looking at whether an enzyme called lumbrokinase, which breaks down fibrin, a protein ","attributes":[]}},{"type":"urlLink","model":{"text":"which is thought","locator":"https://portlandpress.com/biochemj/article/479/4/537/230829/A-central-role-for-amyloid-fibrin-microclots-in","blocks":[{"type":"fragment","model":{"text":"which is thought","attributes":[]}}]}},{"type":"fragment","model":{"text":" to be at the core of micro-clots, can help improve mitochondrial function and energy levels in long Covid and ME/CFS patients.","attributes":[]}}]}}]}},{"type":"image","model":{"blocks":[{"type":"caption","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Long Covid can be difficult to diagnose (Credit: Getty Images)","blocks":[{"type":"fragment","model":{"text":"Long Covid can be difficult to diagnose (Credit: Getty Images)","attributes":[]}}]}}]}}]}},{"type":"altText","model":{"blocks":[{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Long Covid can be difficult to diagnose (Credit: Getty Images)","blocks":[{"type":"fragment","model":{"text":"Long Covid can be difficult to diagnose (Credit: Getty Images)","attributes":[]}}]}}]}}]}},{"type":"rawImage","model":{"height":1080,"width":1920,"locator":"/p0k5m7hw.jpg","originCode":"ic","copyrightHolder":"Getty Images"}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"This is just one of an entire range of possible solutions being explored. In long Covid patients where viral persistence or reactivated viruses seem to be behind PEM, Putrino is exploring whether various repurposed HIV medications can help restore these infections to a dormant form. Simmaron Research along with the Mayo Clinic and the Center for Chronic Diseases, have launched a clinical trial of low-dose rapamycin in people with ME/CFS to see whether it can improve mitochondrial function and quality of life by stimulating a key bodily process called autophagy, encouraging cells to remove and recycle damaged components. \"So far, the trial has produced very promising initial results,\" says Roy.","blocks":[{"type":"fragment","model":{"text":"This is just one of an entire range of possible solutions being explored. In long Covid patients where viral persistence or reactivated viruses seem to be behind PEM, Putrino is exploring whether various ","attributes":[]}},{"type":"urlLink","model":{"text":"repurposed HIV medications","locator":"https://polybio.org/projects/a-clinical-trial-of-repurposed-hiv-antivirals-in-longcovid/","blocks":[{"type":"fragment","model":{"text":"repurposed HIV medications","attributes":[]}}]}},{"type":"fragment","model":{"text":" can help restore these infections to a dormant form. Simmaron Research along with the Mayo Clinic and the Center for Chronic Diseases, have launched ","attributes":[]}},{"type":"urlLink","model":{"text":"a clinical trial","locator":"https://clinicaltrials.gov/study/NCT06257420?cond=NCT06257420\u0026rank=1","blocks":[{"type":"fragment","model":{"text":"a clinical trial","attributes":[]}}]}},{"type":"fragment","model":{"text":" of low-dose rapamycin in people with ME/CFS to see whether it can improve mitochondrial function and quality of life by stimulating a key bodily process called autophagy, encouraging cells to remove and recycle damaged components. \"So far, the trial has produced very promising initial results,\" says Roy.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"This wealth of research is also identifying supplements which may help people with less severe forms of post-viral fatigue recover more quickly in the wake of an infection. Coenzyme Q10, a compound used by mitochondria to generate energy which has been found to be depleted in ME/CFS patients, is now available over the counter in the US and the UK – it's regulated as a dietary supplement – and has been shown in some studies to reduce fatigue.","blocks":[{"type":"fragment","model":{"text":"This wealth of research is also identifying supplements which may help people with less severe forms of post-viral fatigue recover more quickly in the wake of an infection. Coenzyme Q10, a compound used by mitochondria to generate energy which has been ","attributes":[]}},{"type":"urlLink","model":{"text":"found to be depleted","locator":"https://pubmed.ncbi.nlm.nih.gov/20010505/","blocks":[{"type":"fragment","model":{"text":"found to be depleted","attributes":[]}}]}},{"type":"fragment","model":{"text":" in ME/CFS patients, is now available over the counter in the US and the UK – it's regulated as a ","attributes":[]}},{"type":"urlLink","model":{"text":"dietary supplement","locator":"https://www.ncbi.nlm.nih.gov/books/NBK531491/","blocks":[{"type":"fragment","model":{"text":"dietary supplement","attributes":[]}}]}},{"type":"fragment","model":{"text":" – and has been shown in ","attributes":[]}},{"type":"urlLink","model":{"text":"some studies","locator":"https://pmc.ncbi.nlm.nih.gov/articles/PMC9449413/","blocks":[{"type":"fragment","model":{"text":"some studies","attributes":[]}}]}},{"type":"fragment","model":{"text":" to reduce fatigue.","attributes":[]}}]}}]}},{"type":"advertisement","model":{"adType":"horizontal"},"incrementedType":"mid_6"},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Keller says that this research is also helping to identify subgroups of people who seem to be more at risk of post-viral fatigue. She believes that people who already have underlying muscle or nerve tension due to lifestyle habits, chronic injuries or surgeries could be more vulnerable because these underlying factors will already be inhibiting oxygen delivery around the body.","blocks":[{"type":"fragment","model":{"text":"Keller says that this research is also helping to identify subgroups of people who seem to be more at risk of post-viral fatigue. She believes that people who already have ","attributes":[]}},{"type":"urlLink","model":{"text":"underlying muscle or nerve tension","locator":"https://translational-medicine.biomedcentral.com/articles/10.1186/s12967-024-05410-5","blocks":[{"type":"fragment","model":{"text":"underlying muscle or nerve tension","attributes":[]}}]}},{"type":"fragment","model":{"text":" due to lifestyle habits, chronic injuries or surgeries could be more vulnerable because these underlying factors will already be inhibiting oxygen delivery around the body.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"\"We've found that tension from frequent or prolonged sitting, or in the muscles of the neck, chest and shoulders due to excessive screen time, surfing on cell phones and low strength and endurance of the core muscles that support correct spinal alignment may be a contributing factor,\" she says. \"Injuries or surgeries that cause scarring of the connective tissue such as C-section or breast reduction, may also contribute to this tension.\"","blocks":[{"type":"fragment","model":{"text":"\"We've found that tension from frequent or prolonged sitting, or in the muscles of the neck, chest and shoulders due to excessive screen time, surfing on cell phones and low strength and endurance of the core muscles that support correct spinal alignment may be a contributing factor,\" she says. \"Injuries or surgeries that cause scarring of the connective tissue such as C-section or breast reduction, may also contribute to this tension.\"","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"Putrino says it is vital that we get better at identifying the precise factors which can cause people to end up in a state of prolonged fatigue, as this will enable the development of better diagnostics and ultimately more targeted treatments aimed at various subgroups of individuals.","blocks":[{"type":"fragment","model":{"text":"Putrino says it is vital that we get better at identifying the precise factors which can cause people to end up in a state of prolonged fatigue, as this will enable the development of better diagnostics and ultimately more targeted treatments aimed at various subgroups of individuals.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"\"There are many drivers, and it's naive to think that a single drug or a single intervention will address everything,\" Putrino says. \"But as long as we're methodical in investigating potential target drugs, and understanding why they don't work in different people, then we stand a chance of getting more sophisticated combination drug trials within the next 12 to 24 months. That could lead to some real hope for people living with these infection-associated chronic conditions,\" he says.","blocks":[{"type":"fragment","model":{"text":"\"There are many drivers, and it's naive to think that a single drug or a single intervention will address everything,\" Putrino says. \"But as long as we're methodical in investigating potential target drugs, and understanding why they don't work in different people, then we stand a chance of getting more sophisticated combination drug trials within the next 12 to 24 months. That could lead to some real hope for people living with these infection-associated chronic conditions,\" he says.","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"--","blocks":[{"type":"fragment","model":{"text":"--","attributes":[]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"For essential climate news and hopeful developments to your inbox, sign up to the Future Earth newsletter, while The Essential List delivers a handpicked selection of features and insights twice a week.","blocks":[{"type":"fragment","model":{"text":"For essential climate news and hopeful developments to your inbox, sign up to the ","attributes":["italic"]}},{"type":"urlLink","model":{"text":"Future Earth newsletter,","locator":"https://cloud.email.bbc.com/FutureEarth_Newsletter_Signup?\u0026at_bbc_team=studios\u0026at_medium=Onsite\u0026at_objective=acquisition\u0026at_ptr_name=bbc.com\u0026at_link_origin=futurearticle\u0026at_campaign=futureearth\u0026at_campaign_type=owned\u0026\u0026","blocks":[{"type":"fragment","model":{"text":"Future Earth newsletter,","attributes":["italic"]}}]}},{"type":"fragment","model":{"text":" while ","attributes":["italic"]}},{"type":"urlLink","model":{"text":"The Essential List","locator":"https://cloud.email.bbc.com/SignUp10_08?\u0026at_bbc_team=studios\u0026at_medium=Onsite\u0026at_objective=acquisition\u0026at_ptr_name=bbc.com\u0026at_link_origin=featuresarticle\u0026at_campaign=essentiallist\u0026at_campaign_type=owned","blocks":[{"type":"fragment","model":{"text":"The Essential List","attributes":["italic"]}}]}},{"type":"fragment","model":{"text":" delivers a handpicked selection of features and insights twice a week.","attributes":["italic"]}}]}}]}},{"type":"text","model":{"blocks":[{"type":"paragraph","model":{"text":"For more science, technology, environment and health stories from the BBC, follow us on Facebook and X and Instagram.","blocks":[{"type":"fragment","model":{"text":"For more science, technology, environment and health stories from the BBC, follow us on ","attributes":["italic"]}},{"type":"urlLink","model":{"text":"Facebook","locator":"https://www.facebook.com/BBCFuture/","blocks":[{"type":"fragment","model":{"text":"Facebook","attributes":["italic"]}}]}},{"type":"fragment","model":{"text":" and ","attributes":["italic"]}},{"type":"urlLink","model":{"text":"X","locator":"https://x.com/BBC_Future","blocks":[{"type":"fragment","model":{"text":"X","attributes":["italic"]}}]}},{"type":"fragment","model":{"text":" and ","attributes":["italic"]}},{"type":"urlLink","model":{"text":"Instagram","locator":"https://www.instagram.com/bbcfuture_official/","blocks":[{"type":"fragment","model":{"text":"Instagram","attributes":["italic"]}}]}},{"type":"fragment","model":{"text":".","attributes":["bold","italic"]}}]}}]}}],"topics":[{"title":"Health","url":"/worklife/tags/health","isEvent":false},{"title":"Science","url":"/reel/topic/science","isEvent":false},{"title":"Features","url":"/culture/tags/features","isEvent":false},{"title":"Flu","url":"/news/topics/cvenzmgyg2vt","isEvent":false}],"onwardJourney":[{"type":"texas","content":[{"title":"Earth tides: Why our planet's crust has tides too","href":"/reel/video/p0jt8x5z/earth-tides-why-our-planet-s-crust-has-tides-too","isLiveNow":false,"metadata":{"contentType":"video","subtype":"reels","lastUpdated":1727481600000,"firstUpdated":1727481600000,"topics":["Weather \u0026 science"]},"tags":[],"description":"How do they differ from the ocean? 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