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Background: It has been suspected that circadian rhythms may play a part in the pathogenesis of gastrointestinal diseases including gastroesophageal reflux disease (GERD). The present study aimed to examine the cross‐sectional association of the timing of sleep and meals with the presence of GERD in community‐dwelling women in Japan. Methods: In total, 605 women responded to a self‐administered questionnaire asking for information on GERD symptoms, sleep habits, sleep disturbances and the timing of meals. GERD symptoms were evaluated using the Frequency Scale for the Symptoms of GERD, and participants with a score of more than seven points were classified as having GERD. Results: In total, 104 (17.2%) women were found to have GERD. Later bedtime on both weekdays and weekends and later midpoint of sleep were significantly associated with the odds ratios (OR) of GERD after controlling for covariates: ORs for each 1 h delay were 1.31 (95% confidence interval [CI] = 1.03–1.68), 1.38 (95% CI = 1.08–1.75) and 1.43 (95% CI = 1.06–1.95). Having lunch at irregular times was significantly associated with the increased OR of GERD (1.99; 95% CI = 1.02–3.91). Longer overnight fasting duration and longer time intervals from the midpoint of sleep to breakfast and lunch were significantly associated with decreased OR of GERD (ORs for each 1 h increase were 0.73 [95% CI = 0.56–0.95], 0.64 [95% CI = 0.46–0.88] and 0.70 [95% CI = 0.51–0.96]). Conclusions: These data suggest that the timing of sleep and timing of meals relative to the sleep/wake cycle are associated with the presence of GERD. Key highlights: Later bedtime and later midpoint of sleep were associated with increased odds of gastroesophageal reflux disease (GERD).Longer overnight fasting duration and longer time intervals from the midpoint of sleep to breakfast and lunch were associated with decreased odds of GERD. The timing of meals relative to the sleep/wake cycle rather than clock time should be relevant to the risk of GERD. [ABSTRACT FROM AUTHOR]

It has been hypothesized that disruption of circadian rhythms affects human health. Shift work and sleep deprivation are thought to disrupt the normal light–dark cycle, although the disruption due to shiftwork may be dependent on sleep deprivation. Both conditions have been suggested to be associated with an increased risk of cardiometabolic disorders. Non-photic environmental factors, such as the timing of eating, are also thought to regulate circadian rhythm and thus, may have effects on health, but the evidence from human studies is scarce. Oxidative stress is a risk factor of cardiometabolic disorders. Some laboratory studies suggest an involvement of circadian clock genes in the regulation of the redox system. The present study aimed to examine the association of sleeping habits, nightshift work, and the timing of meals with urinary levels of 8-isoprostane, a marker of oxidative stress, and 6-sulfatoxymelatonin, the principal metabolite of melatonin. Study subjects were 542 women who had previously attended a breast cancer mass screening in a community in Japan. Information on bedtimes and wake-up times, history of nightshift work, and the timing of meals was obtained by a self-administered questionnaire. The 8-isoprostane and 6-sulfatoxymelatonin were measured using the first morning void of urine and expressed per mg of creatinine. The geometric mean of 8-isoprostane levels was 12.1% higher in women with ≤6 hours of sleep than that in those with >8 hours of sleep on weekdays, and longer sleep duration on weekdays was significantly associated with lower urinary levels of 8-isoprostane after controlling for covariates (pfor trend = 0.04). Women who were currently working the nightshift had a 33.3% higher geometric mean of 8-isoprostane levels than those who were not working nightshift (p = 0.03). Urinary 6-sulfatoxymelatonin levels were unrelated to sleep habits or nightshift work. Women who ate breakfast at irregular times had a 19.8% higher geometric mean of 8-isoprostane levels than those who ate breakfast at a regular time or who did not eat (p = 0.02). Women who ate nighttime snacks at irregular times had a 16.2% higher geometric mean of 8-isoprostane levels than those who did not eat nighttime snacks or who ate nighttime snacks at a regular time (p = 0.003). Among women who ate dinner at a regular time, earlier times for dinner were associated with higher 8-isoprostane and 6-sulfatoxymelatonin levels (pvalues for trends were 0.01 and 0.02, respectively). However, the times of dinner and nighttime snack are overlapping, and the time of last meal of the day was not associated with 8-isoprostane and 6-sulfatoxymelatonin levels. The time of breakfast or lunch was not associated with these biomarkers among women who ate the meal at regular times. Disturbing the rhythmicity of daily life may be associated with oxidative stress. [ABSTRACT FROM PUBLISHER]

Curebest™ 95GC breast (95GC) is a multigene classifier we developed for the prognostic prediction of patients with estrogen receptor (ER)-positive, human epidermal growth factor receptor 2 (HER2)-negative and node-negative (ER+/HER2-/n0) invasive breast cancer treated with adjuvant endocrine therapy alone. The aim of the preset study was to evaluate the clinical utility of 95GC in a multiinstitutional registry study. Patients (n=215) with ER+/HER2−/n0 invasive breast cancer who had undergone the 95GC assay in seven hospitals were consecutively recruited in the registry study at various postoperative times. At recruitment, no patients had disease recurrences and were prospectively followed up for a median of 62 (range, 6–91) postoperative months. Of the 124 patients classified as 95GC low risk, 118 received adjuvant endocrine therapy alone and six received adjuvant chemo-endocrine therapy. Only two patients developed distant recurrences, and the 5-year distant recurrence-free survival (DRFS) was as high as 98.0%. Of the 91 patients classified as 95GC high risk, 81 received adjuvant chemo-endocrine therapy and 10 received adjuvant endocrine therapy alone. A total of four of these patients developed distant recurrences (5-year DRFS=95.5%). Among the 95GC high-risk patients, prognosis was significantly improved for the 81 treated with adjuvant chemo-endocrine therapy compared with for the 77 (historical controls) treated with adjuvant endocrine therapy alone (P=0.0002; hazard ratio, 0.24). Compared with the St. Gallen 2013 guideline, a significant de-escalation from 73.1% (155/212) to 40.6% (86/212) in adjuvant chemotherapy was achieved. The excellent prognosis of patients with ER+/HER2−/n0 invasive breast cancer classified as 95GC low risk could be validated in the present registry study, indicating that 95GC is useful for safe de-escalation of adjuvant chemotherapy in patients with ER+/HER2−/n0 invasive breast cancer. [ABSTRACT FROM AUTHOR]

A significant increase in the number of volcano-tectonic (VT) and VB earthquakes preceded the 2007 and 2014 eruptions of Kelud volcano, Indonesia. The background seismicity rates at the volcano is generally <5 of VTs per month and other types of volcanic earthquakes are rarely recorded. After 17 years of quiescence, the 2007 eruption was preceded by an increase in VTs starting in September 2007, two months prior to the eruption. An intense VT swarm began in October 2007 and led to occurrence of VB, sometimes presenting as repetitive self-similar events. The final precursory seismicity included spasmodic bursts of VTs, repetitive self-similar VBs and low frequency tremor, prior to lava dome formation in the crater lake, on November 3, 2007. After just ~6 years, VTs began to increase again in December 2013. The number significantly intensified in mid January 2014, ~1 month before the eruption. Seismicity continued to intensify including VTs, VBs, and LFs into February 2014, with the final precursory seismicity consisting of a burst of over scale tremor, followed by a short burst of repetitive self-similar events that merged into harmonic, gliding tremor a couple hours prior to the explosive eruption on February 13, 2014. We examine the locations of VTs, the energy release rate, and the precursory seismic pattern prior to both eruptions to understand the differences in the eruptions' style and size. We found that epicentral locations of VTs are similar for both eruptions, but the depths were slightly deeper prior to the 2014 eruption. We also find that the cumulative energy released prior to 2014 is twice that of 2007 and in half the time. The migration of VTs in Kelud volcano may indicate magma intrusion from a deeper storage region in 2014 and at a faster rate, leading to a much more explosive eruption. • A significant increase on VT earthquake leads to effusive eruption and explosion eruptions of Kelud volcano, Indonesia. • Magnitudes of the VTs were larger in 2014 than in 2007. • The cumulative seismic energy released by VTs in 2014 is twice that of 2007, and occurred in half the time. • The rate of cumulative seismic energy release is greater in 2014 and the resulting explosion was greater (VEI 4 vs VEI 2). [ABSTRACT FROM AUTHOR]