A two-day CPET cannot be used to rule out chronic fatigue syndrome. : 216

Definitions
Notable definitions include:
Centers for Disease Control and Prevention (CDC) definition (1994), the most widely used clinical and research description of CFS, is also called the Fukuda definition and is a revision of the Holmes or CDC 1988 scoring system. The 1994 criteria require the presence of four or more symptoms beyond fatigue, while the 1988 criteria require six to eight. The ME/CFS 2003 Canadian Clinical working definition states: "A patient with ME/CFS will meet the criteria for fatigue, post-exertional malaise and/or fatigue, sleep dysfunction, and pain; have two or more neurological/cognitive manifestations and one or more symptoms from two of the categories of autonomic, neuroendocrine, and immune manifestations; and the illness persists for at least 6 months". The Myalgic Encephalomyelitis International Consensus Criteria (ICC) published in 2011 is based on the Canadian working definition  and has an accompanying primer for clinicians The ICC does not have a six months waiting time for diagnosis. The ICC requires post-exertional neuroimmune exhaustion (PENE) which has similarities with post-exertional malaise, plus at least three neurological symptoms, at least one immune or gastrointestinal or genitourinary symptom, and at least one energy metabolism or ion transportation symptom. Unrefreshing sleep or sleep dysfunction, headaches or other pain, and problems with thinking or memory, and sensory or movement symptoms are all required under the neurological symptoms criterion. According to the ICC, patients with post-exertional neuroimmune exhaustion but only partially meet the criteria should be given the diagnosis of atypical myalgic encephalomyelitis.
In the paired ventral part of the fin line, normally only the pectoral and pelvic fins survive (but the Devonian acanthodian fish Mesacanthus developed a third pair of paired fins); but along the non-paired parts of the fin line, other fins develop. In tetrapods, only the four paired fins normally persisted, and became the four legs. Notomelia and cephalomelia are atavistic reappearances of dorsal fins. Some other cases of polymelia are extra development along the paired part of the fin lines, or along the ventral posterior non-paired part of the fin line. Notable cases
Humans
1995: Somali baby girl born with three right arms. In the summer of 2005, a baby girl named Destiny was born with a fully formed extra leg in Detroit. This was the result of a conjoined twin scenario. In March 2006, a baby boy identified only as Jie-jie was born in Shanghai with a fully formed third arm: he had two full-sized left arms, one ventral to the other. This is the only documented case of a child born with a fully formed supernumerary arm. It is an example of an extra limb on a normal body axis.