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In line with this, a study in rotating shift workers from the automotive industry found that NSW significantly reduced plasma concentrations of multiple immune markers, including pro- and anti-inflammatory cytokines (TNF-, IL-2R, IL-1RA, IL-4, IL-12, IL-17), chemokines (IP-10, MIP-1, MIP-1, RANTES), and growth factors (EGF, FGF, VEGF), indicating a broad suppression of immune pathways linked to circadian disruption and higher susceptibility to infection and cancer 113

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Background In the United States, the prevalence of obesity is rapidly increasing with 65% of adults and 17% of adolescents and children classified as being overweight or obese ( Behavioral intervention with lifestyle and dietary modification usually achieves modest weight loss ( 2 or a BMI 27kg/m 2 in the presence of comorbidities such as diabetes ( Bariatric surgery, sometimes referred to as metabolic surgery, is usually considered for patients who have a BMI 40 kg/m 2 or a BMI 35 kg/m 2 associated with comorbidities such as type 2 diabetes ( Observational and prospective studies have suggested that bariatric surgery is the most effective intervention for weight loss producing an average weight loss of 3035% that is maintained in ~60% of patients at 5 years (1)