The Impact of Altered Timing of Eating, Sleep and Work Patterns on Human Health

Some 20% of the population is required to work outside the regular 9:00 a.m.–5:00 p.m. working day, and this number is likely to increase as economic demands push work hours into the night for many companies. These irregular schedules mean workers often have to sleep during the day and be awake at night. This causes a misalignment between normal day-light entrained internal physiological processes, such as metabolism and digestion, and the external environment. As a direct consequence, night workers have poorer health than day workers, even after controlling for lifestyle and socioeconomic status. The purpose of this Special Issue is to highlight the interrelationships between timing of food intake and diet quality with sleep and work patterns in humans with an emphasis on randomized controlled trials or meta-analyses of data from published studies

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Prevalence and Interrelationships between Cardio-Metabolic Risk Factors in Abdominally Obese Individuals

OBJECTIVES: The aim of this study was to examine the prevalence of metabolic syndrome and identify relationships between clustering and severity of cardio-metabolic risk factors in abdominally obese adults. METHODS: Cardio-metabolic risk factors were assessed in a sample of 300 abdominally obese volunteers (233 females, 67 males, mean age 43.7 years) who were not being treated for diabetes, hypertension or dyslipidemia. Waist circumference (WC), blood pressure, fasting lipids, and glucose were measured and prevalence of metabolic syndrome was determined according to International Diabetes Federation (IDF) criteria. Correlation analysis and Poisson regression were used to examine associations between the presence of a particular risk factor and the propensity for clustering and derangement of other risk factors, using continuous data for risk factors and categorical data for number of metabolic syndrome components. RESULTS: In all, 53% had metabolic syndrome and only 16% were free of cardio-metabolic abnormalities. In order of importance, diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL), and triglycerides (TGs) were most strongly associated with greater clustering of risk factors, with a one standard deviation difference being associated with a respective difference of 9.65, 1.23, and 0.12 in the number of risk factors present. A greater number of risk factors was associated with an increased derangement for any given risk factor, with this effect being greatest for dyslipidemia, as represented by the TG:HDL ratio. DISCUSSION: In abdominally obese individuals, DBP was strongly associated with metabolic syndome component clustering, which may reflect the pathogenic progression of metabolic syndrome, as DBP is likely to be elevated following establishment of other risk factors. Also, dyslipidemia was strongly related to the magnitude of derangement of cardio-metabolic risk factors which may indicate that increases in dyslipidemia may drive the pathogenic progression of metabolic syndrome once acquired.Tahna L. Pettman, Jonathan D. Buckley, Alison M. Coates, Gary M.H. Misan, John Petkov and Peter R.C. How

Effect of Noninvasive Respiratory Strategies on Intubation or Mortality Among Patients With Acute Hypoxemic Respiratory Failure and COVID-19: The RECOVERY-RS Randomized Clinical Trial.

Importance Continuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) have been recommended for acute hypoxemic respiratory failure in patients with COVID-19. Uncertainty exists regarding the effectiveness and safety of these noninvasive respiratory strategies. Objective To determine whether either CPAP or HFNO, compared with conventional oxygen therapy, improves clinical outcomes in hospitalized patients with COVID-19-related acute hypoxemic respiratory failure. Design, Setting, and Participants A parallel group, adaptive, randomized clinical trial of 1273 hospitalized adults with COVID-19-related acute hypoxemic respiratory failure. The trial was conducted between April 6, 2020, and May 3, 2021, across 48 acute care hospitals in the UK and Jersey. Final follow-up occurred on June 20, 2021. Interventions Adult patients were randomized to receive CPAP (n = 380), HFNO (n = 418), or conventional oxygen therapy (n = 475). Main Outcomes and Measures The primary outcome was a composite of tracheal intubation or mortality within 30 days. Results The trial was stopped prematurely due to declining COVID-19 case numbers in the UK and the end of the funded recruitment period. Of the 1273 randomized patients (mean age, 57.4 [95% CI, 56.7 to 58.1] years; 66% male; 65% White race), primary outcome data were available for 1260. Crossover between interventions occurred in 17.1% of participants (15.3% in the CPAP group, 11.5% in the HFNO group, and 23.6% in the conventional oxygen therapy group). The requirement for tracheal intubation or mortality within 30 days was significantly lower with CPAP (36.3%; 137 of 377 participants) vs conventional oxygen therapy (44.4%; 158 of 356 participants) (absolute difference, -8% [95% CI, -15% to -1%], P = .03), but was not significantly different with HFNO (44.3%; 184 of 415 participants) vs conventional oxygen therapy (45.1%; 166 of 368 participants) (absolute difference, -1% [95% CI, -8% to 6%], P = .83). Adverse events occurred in 34.2% (130/380) of participants in the CPAP group, 20.6% (86/418) in the HFNO group, and 13.9% (66/475) in the conventional oxygen therapy group. Conclusions and Relevance Among patients with acute hypoxemic respiratory failure due to COVID-19, an initial strategy of CPAP significantly reduced the risk of tracheal intubation or mortality compared with conventional oxygen therapy, but there was no significant difference between an initial strategy of HFNO compared with conventional oxygen therapy. The study may have been underpowered for the comparison of HFNO vs conventional oxygen therapy, and early study termination and crossover among the groups should be considered when interpreting the findings. Trial Registration isrctn.org Identifier: ISRCTN16912075