The association between 'weekend warrior', regular exercise, and cognitive function in elderly individuals with and without depressive symptoms: A cross-sectional analysis from NHANES 2011-2014.

BACKGROUND: While previous studies have suggested that both 'Weekend Warrior' (WW) and Regular Exercise (RE) patterns confer health benefits, the relationship between different types of physical activity (PA) and cognitive function (CF) in elderly individuals with and without depressive symptoms remains unclear. METHODS: Our study leveraged the NHANES 2011-2014 dataset, focusing on older adults. We explore the relationship between PA and CF, stratifying by depressive status. Our statistical approach included multivariable regression analysis to identify relationships between PA levels and cognitive outcomes, along with advanced techniques such as smoothed curve fitting and threshold effect analysis to examine potential nonlinear associations and identify optimal PA pattern for cognitive health. RESULTS: Analysis revealed a positive correlation between PA time and CF across all participants (ß-depressive symptoms = 0.03, 95 % CI: 0.01-0.05; ß-non-depressive symptoms = 0.01, 95%CI: 0.00-0.02). When comparing against the inactive, non-depressed participants partaking in WW showed improved cognitive scores (ß-WW = 0.22, 95 % CI: 0.05-0.39), similar to those engaging in RE (ß-RE = 0.15, 95 % CI: 0.09-0.21). However, among the depressed participants, significant cognitive improvements were observed in the RE (ß-RE = 0.15, 95 % CI: 0.04-0.25), with the WW showing less definitive results (ß-WW = 0.22, 95 % CI: -0.02-0.47). LIMITATION: The cross-sectional nature limits causal inferences. CONCLUSION: Our findings affirm the potential role of PA in enhancing CF among older subjects without depressive symptoms. However, only RE was associated with improved CF in those with depressive symptoms. These results are critical for crafting personalized PA guidelines to enhance cognitive health in the aging population.

Weekend endoscopic retrograde cholangiopancreatography has similar outcomes as weekday procedures-a propensity score match analysis of the Hungarian ERCP Registry.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is essential for the minimally invasive management of biliary and pancreatic disorders. Under certain indications, performing ERCP without delay during the weekend can be important for improving outcomes. Objectives: To compare the outcomes of ERCP performed on weekends and holidays with those of regular weekday ERCPs. Design: Propensity score match analysis of the data from the Hungarian ERCP Registry. Methods: A total of 116 ERCPs were performed during weekends or holidays, and 3144 during weekday working hours. The analyses were performed on 1:2 propensity-matched groups (116 weekend and 232 weekday cases). Results: Weekend ERCPs were mostly performed for acute cholangitis and acute biliary pancreatitis (70% of cases), whereas in the weekday group, only 32% of cases were performed for these indications. No significant difference was found between weekday and weekend ERCPs in terms of the rates of successful (91.38% vs 93.1%, p = 0.565) and difficult (33.62% vs 36.64%, p = 0.511) biliary cannulations. We found no significant differences in the number of adverse events (bleeding, post-ERCP pancreatitis, and 30-day mortality) in ERCPs performed during weekends or weekdays. Moreover, no significant differences in the aforementioned outcomes were detected between the propensity-matched groups. Conclusion: In this propensity-matched study, no significant differences were found in the outcomes of weekend and weekday ERCPs.

Association between "weekend warrior" physical activity and the incidence of neurodegenerative diseases.

While guidelines recommend 150 â€‹min of moderate to vigorous physical activity (MVPA) weekly to enhance health, it remains unclear whether concentrating these activities into 1-2 days of the week, "weekend warrior" (WW) pattern, has the same benefit for neurodegenerative diseases (NDDs). This study aimed to evaluate the associations of WW pattern and the risk of NDDs. This prospective study was conducted using accelerometer-based physical activity data for a full week from June 2013 to December 2015 in the UK Biobank. These individuals were categorized into distinct physical activity patterns, including the WW pattern (i.e., over 50% or 75% of recommended MVPA achieved over 1-2 days), regular pattern, and inactive pattern. Cox proportional hazards model was used to evaluate the association between physical activity patterns and outcomes. Compared to inactive group, WW pattern and regular pattern was similarly linked to a reduced risk of all-cause dementia (WW: Hazard Ratio [HR]: 0.68, 95% Confidence Interval [CI]: 0.56-0.84; regular: HR: 0.86, 95% CI: 0.67-1.1) and all-cause Parkinsonism (WW: HR: 0.47, 95% CI: 0.35-0.63; regular: HR: 0.69, 95% CI: 0.5-0.95). When the exercise threshold was increased to 75% of MVPA, both patterns still were associated with decreased risk of incident all-cause dementia (WW: HR: 0.61, 95% CI: 0.41-0.91; regular: HR: 0.76, 95% CI: 0.63-0.92) and all-cause Parkinsonism (WW: HR: 0.22, 95% CI: 0.10-0.47; regular: HR: 0.59, 95% CI: 0.46-0.75). Concentrating recommended physical activities into 1-2 days per week is associated with a lower incidence of NDDs.

Weekend Effect and Mortality Outcomes in Aortic Dissection: A Prospective Analysis.

Background: Aortic dissection (AD) is a critical heart condition with potentially severe outcomes. Our study aimed to investigate the existence of a "weekend effect" in AD by examining the correlation between patient outcomes and whether their treatment occurred on weekdays versus weekends. Methods: Specifically, we prospectively analysed the effect of weekday and weekend treatment on acute AD patient outcomes, both before surgical intervention and during hospitalization, for 124 patients treated from 2019-2021, as well as during 6 months of follow-up. Results: The mean age of the study population was 62.5 years, and patient age exhibited a high degree of variability. We recorded a mortality rate before surgery of 8.65% for the weekend group and 15% for the weekday group, but this difference was not statistically significant. During hospitalization, mortality was 50% in the weekend group and 25% in the weekday group, but this difference was not statistically significant. Discharge mortality was 9.61% in the weekend group and 5% in the weekday group. Conclusions: Our findings suggest that there was no significant difference in mortality rates between patients admitted to the hospital on weekends versus weekdays. Therefore, the period of the week when a patient presents to the hospital with AD appears not to affect their mortality.

The weekend factor: the effect on healthcare quality. A medico-legal, retrospective study.

Background: In the healthcare system, in the last 30 years, the prognostically negative value of the so-called Weekend Effect (WE) has been internationally recognized. The WE is regarded as the increased risk a patient might incur when hospitalized during non-working days, of enduring severe complications in comparison to the same hospitalization that occur on working days. The aim of this study was to retrospectively verify whether, once a mistake was made during weekends or on holidays, in comparison to a mistake occurred on workdays, it subsequently implied a higher risk of complications, death included, in a statistical and medico-legal way. Methods: Three different evaluators independently examined a total of 378 medico-legal cases over a more than 20-year period. Eventual medical actions and omissions were labelled as 'mistake' when the AJ claimed that at least one occurred; 'alleged mistake' included the cases where the EW's report disagreed with the AJ's one; finally, 'no mistake' when both the AJ and the EW agreed in their evaluations. During weekends there is a higher risk that a mistake occurs (OR=3.3, 95% CI=1.6;7.4; p-value<0.001) compared to weekdays. When death occurs, delayed diagnosis is the main cause (p=0.02), whereas a damaging action is more frequently claimed in general. Conclusions: We verified as actual the impact of the WE on patients' outcome from a medico-legal point of view. The implications for an improvement of the several settings of the Italian NHS are various, and many are the consequences in the healthcare management.

Comparison of perioperative outcomes between colorectal operations performed on weekends vs those performed on weekdays.

BACKGROUND: Weekend surgical time is an underused asset. Concerns over a possible weekend effect (substandard care) may be a barrier. METHODS: This study examined whether a weekend effect applies to elective colorectal surgery via a single-center retrospective analysis comparing outcomes between patients who underwent elective colorectal surgery on a weekend vs a weekday. Demographics, length of stay (LOS), operative and anesthesia time, the rate of reoperation within 30 days, and the rate of major complications were compared between patient groups. RESULTS: Of the 2008 patients identified, 1721 (85.7%) underwent surgery on a weekday, and 287 (14.3%) underwent surgery on a weekend. The proportion of operations with an open approach was higher on weekends than weekdays (49.5% vs 41.8%, P = .017). Patients who underwent surgery on the weekend tended to have a shorter mean (SE) for LOS (4.2 [0.2] vs 6.1 [0.2], P < .001), anesthesia time (233.8 [6.5] vs 307.6 [3.3] minutes, P < .001), and operative time (225.4 [6.4] vs. 297.6 [3.3] minutes, P < .001). On multivariable analysis, patients who had an operation on a weekend had a 38% lower chance of having a prolonged LOS (>75th percentile of LOS) compared with those who had an operation on a weekday (adjusted odds ratio = 0.62; 95% CI 0.42-0.92). There were no differences in rates of complications or reoperation for patients undergoing surgery on a weekend compared with a weekday. CONCLUSION: At centers with experienced anesthesiologists, appropriately trained nursing staff, and expert surgeons, colorectal surgery performed on a weekend has similar safety outcomes as surgeries performed on a weekday.

Outcomes of Weekday Versus Weekend Admissions for Heart Block Requiring De Novo Intracardiac Device Implantation.

Even with comparable healthcare structure and staffing, patients presenting on weekends often face poorer outcomes, including longer wait times in the emergency department, extended hospital stays, and delays in major procedures. This discrepancy prompts questions about whether life-saving cardiac procedures, such as permanent pacemaker (PPM) implantation for atrioventricular block, also experience similar delays and differences in outcomes. We researched over 200,000 patients from the National Inpatient Sample (NIS) database to help study whether patients admitted on the weekend truly had worse outcomes than patients admitted on the weekday. Using the International Classification of Diseases, Tenth Revision (ICD-10) using STATA software (StataCorp LLC, College Station, TX), we found that 79.6% of patients were admitted on weekdays. Among these weekday admissions, 56.2% were males, with an average age of 75.8 years. Weekend admissions included 54.4% male patients, with an average age of 76.4 years. Key variables influencing outcomes were renal failure history, non-ST elevation myocardial infarction, diabetes mellitus, and percutaneous coronary intervention. Of the total patients, 1,315 died during hospitalization, with no significant difference in mortality between weekday and weekend admissions. However, weekend admissions had a higher rate of cardiac arrest, a greater likelihood of delayed pacer implantation, and longer hospital stays. Weekend admissions were linked to delays in PPM placement, longer hospital stays, and higher hospitalization costs. Mortality rates did not increase for patients admitted on weekends. Further research is needed to explore this issue in greater depth and to identify the specific factors contributing to the discrepancy between weekend and weekday admissions, which resulted in worse outcomes for weekend patients.

Association of accelerometer-derived "weekend warrior" moderate to vigorous physical activity, chronic kidney disease and acute kidney injury.

OBJECTIVE: To examine the relationship between an accelerometer-derived "weekend warrior" pattern, characterized by achieving the most moderate to vigorous physical activity (MVPA) over 1-2 days, as opposed to more evenly distributed patterns, with risk of chronic kidney disease (CKD) and acute kidney injury (AKI). METHODS: 77,977 participants without prior kidney diseases and with usable accelerometer data (collected between 2013 and 2015) were included from the UK Biobank. Three physical activity patterns were compared: active weekend warrior pattern (achieving ≥150 min MVPA per week and accumulating ≥50 % of total MVPA in 1-2 days), active regular pattern (achieving ≥150 min MVPA but not meeting active weekend warrior criteria per week), and inactive pattern (<150 min MVPA per week). The study outcomes included incident CKD and AKI, ascertained through self-report data and data linkage with primary care, hospital admissions, and death registry records. RESULTS: During a median follow-up of 6.8 years, 1324 participants developed CKD and 1515 developed AKI. In multivariable-adjusted models, when compared with inactive participants, individuals with active weekend warrior pattern (CKD: hazard ratio [HR], 0.79, 95 % confidence interval [CI], 0.69-0.89; AKI: HR, 0.70, 95 %CI, 0.62-0.79) and those with active regular pattern (CKD: HR, 0.81, 95 %CI, 0.69-0.95; AKI: HR, 0.79, 95 %CI, 0.68-0.91) exhibited a similar and significantly lower risk of incident CKD and AKI. Similar findings were observed at the median threshold of ≥230.4 min of MVPA per week. CONCLUSION: Concentrated MVPA within 1 to 2 days is as effective as distributed ones in decreasing the risk of renal outcomes.

[Spatiotemporal Distributions and Variations in Summertime Ozone Photochemical Production Regimes over Shanxi].

Satellite-based formaldehyde（HCHO）columns and tropospheric nitrogen dioxide columns were observed using the Ozone Monitoring Instrument（OMI），and groundbased observations of ozone（O3）for May-August from 2013 to 2022 were connected to calculate the threshold values of the HCHO to NO2 ratio（FNR）in Shanxi Province. Then，the spatiotemporal distributions and variations in summertime ozone photochemical production regimes were analyzed. The results showed that：① The volatile organic compound（VOC） -sensitive regime area（FNR < 2.3）was obviously reduced，while the VOCs-NOx transitional regime（FNR between 2.3-4.1）area increased in the early years and then decreased， and NO x -sensitive regime area expanded significantly in summer from 2013 to 2022 over Shanxi Province. ② The increased summertime FNR during 2013 to 2019 was associated with the co-effect of increased HCHO columns and decreased tropospheric NO2 columns. The Shanxi Province was generally under an NOx regime since 2016，which reflected the remarkable effect of NO x emission reductions；however，there was a shift from a VOC-sensitive regime to a VOCs-NOx transitional regime，in which O3 pollution aggravation was widespread under the background of decreased NOx emissions. The decrease in O3 concentration during 2020 to 2022 followed the synergistical declines in HCHO columns and tropospheric NO2 columns. ③ The O3 weekend effects were reversed in Linfen and Yuncheng but were persistent in the other nine cities. Satellite-based weekend HCHO and NO2 levels were higher than those on weekdays in some cities of Shanxi Province，indicating that the O3 weekend effect was not only dependent on the changes of precursors emissions but was also closely related to O3 photochemical production sensitivity. The results indicated the necessity of simultaneous controls in NOx emissions and VOCs emissions for ozone abatement plans over Shanxi Province. In addition，Taiyuan，Yangquan，Yuncheng，and Jincheng should continue to promote reduction in NOx emissions.

The weekend warrior effect: Consistent intermittent exercise induces persistent cognitive benefits.

Exercise provides a range of cognitive benefits, including improved memory performance. Previously, we demonstrated that 14 days of continuous voluntary wheel-running exercise enables learning in a hippocampus-dependent Object Location Memory (OLM) task under insufficient, subthreshold training conditions in adult mice. Whether similar exercise benefits can be obtained from consistent intermittent exercise as continuous exercise is unknown. Here, we examine whether intermittent exercise (the weekend warrior effect: 2 days of exercise a week for 7 weeks) displays similar or distinct cognitive benefits as previously examined with 14 days of continuous exercise. We find that both continuous and intermittent exercise parameters similarly enable hippocampus-dependent OLM compared to the 2-day exercise control group. Mice receiving intermittent exercise maintained cognitive benefits following a 7-day sedentary delay, whereas mice that underwent 14 continuous days of exercise showed diminished cognitive benefits as previously reported. Further, compared to continuous exercise, intermittent exercise mice exhibited persistently elevated levels of the genes Acvr1c and Bdnf which we know to be critically involved in hippocampus-dependent long-term memory in the dorsal hippocampus. Together findings suggest that consistent intermittent exercise persistently enables hippocampal-dependent long-term memory. Understanding the optimal parameters for persistent cognitive function and the mechanisms mediating persistent effects will aid in therapeutic pursuits investigating the mitigation of cognitive ailments.

Endovascular treatment for basilar artery occlusion: whether the "weekend effect" affects time metrics and clinical outcomes at a comprehensive stroke center.

Objectives: This study aimed to evaluate whether the "weekend effect" would affect the time metrics and the prognosis of acute ischemic stroke (AIS) patients who underwent endovascular treatment (EVT) due to basilar artery occlusion (BAO). Methods: Clinical data of AIS patients who underwent EVT due to BAO between December 2019 and July 2023 were retrospectively analyzed. At the time when the patients were admitted, the study population was divided into the weekdays daytime group and weekends nighttime group. In the subgroup analysis, the study cohort was divided into four groups: the weekdays daytime group, weekdays nighttime group, weekend daytime group, and weekend nighttime group. A good outcome was defined as a modified Rankin Scale score of ≤3 at 90 days after EVT. Time metrics [e.g. onset-to-door time (ODT) and door-to-puncture time (DPT)] and clinical outcomes were compared using appropriate statistical methods. Results: A total of 111 patients (88 male patients, mean age, 67.7 ± 11.7 years) were included. Of these, 37 patients were treated during weekdays daytime, while 74 patients were treated during nights or weekends. There were no statistically significant differences in ODT (P = 0.136), DPT (P = 0.931), and also clinical outcomes (P = 0.826) between the two groups. Similarly, we found no significant differences in the time metrics and clinical outcomes among the four sub-groups (all P > 0.05). Conclusion: This study did not reveal any influence of the "weekend effect" on the time metrics and clinical outcomes in AIS patients who underwent EVT due to BAO at a comprehensive stroke center.

Was there a weekend effect on mortality rates for hospitalized patients with COVID-19 and acute myocardial infarction? Insights from the National Inpatient Sample, 2020.

Our study aimed to assess the effect of weekend versus weekday hospital admissions on all-cause mortality in patients with acute myocardial infarction (AMI) and COVID-19 during the COVID-19 pandemic. We analyzed data from the National Inpatient Sample (NIS) 2020, identifying patients with co-existing AMI and COVID-19 admitted on weekdays and weekends. Baseline demographics, comorbidities, and outcomes were assessed. A multivariable regression analysis was conducted, adjusting for confounders to determine the odds of all-cause mortality. Among 74,820 patients, 55,145 (73.7%) were admitted on weekdays, while 19,675 (26.3%) were admitted on weekends. Weekend admissions showed slightly higher proportions of men (61.3% vs. 60%) and whites (56.3% vs. 54.9%) with a median age of 73 years (range: 62-82). The overall all-cause mortality had an odds ratio (OR) of 1.00 (95% CI, 0.92-1.09; P = 0.934). After adjusting for covariates, there was no significant associations between mortality and hospital type (rural: OR = 1.04; 95% CI, 0.78-1.39; P = 0.789; urban teaching: OR = 1.04; 95% CI, 0.94-1.14; P = 0.450) or geographic region (Northeast: OR = 1.16; 95% CI, 0.96-1.39; P = 0.12; Midwest: OR = 0.99; 95% CI, 0.83-1.17; P = 0.871; South: OR = 0.97; 95% CI, 0.85-1.12; P = 0.697; West: OR = 0.94; 95% CI, 0.77-1.15; P = 0.554). There was no significant difference in the rate of all-cause mortality among patients admitted for AMI and COVID-19 between weekdays and weekends.

Study on O3-NOx-VOCs combined air pollution and ozone health effects in the Hexi Corridor.

In order to study the ecological and atmospheric recovery of the Hexi Corridor region, this paper analyzes the migration changes of land use characteristics and utilizes multivariate data and BenMAP-CE software to study the pollution characteristics of ozone and its precursors and the impact on human health in the Hexi Corridor region. The results showed that the increase of cultivated land area in the Hexi Corridor mainly originated from grassland. The MDA8-O3 concentrations met the primary and secondary standards of the Ambient Air Quality Standards on 43% and 99% of the days, respectively. NO2 showed a negative weekend effect with O3, and HCHO was opposite to it. Temperature, barometric pressure, and vegetation were highly correlated with O3-NO2-HCHO. Ozone pollution in the study area caused about 60% of all-cause premature deaths due to cardiovascular diseases. The study suggests that controlling exogenous transport in Wuwei City during the high ozone period (except August) is mainly dominated by the west and northwest, and that synergistic management of VOCs and NOx emissions can reduce O3 pollution and, consequently, reduce the risk to human health.

Self-Reported Weekend Temporal Eating Patterns of American Adults Differ From Weekday: National Health and Nutrition Examination Surveys: 2015-2020 Prepandemic.

BACKGROUND: Weekend-weekday differences in time of ingestive events may be implicated in adverse metabolic and health outcomes. However, little is known about the nature of weekend-weekday differences in temporal eating behaviors of the US adult population. OBJECTIVE: The study aimed to examine weekend-weekday differences in temporal and energy characteristics of ingestive events self-reported by American adults. DESIGN: Observational; within-person comparative. PARTICIPANTS/SETTING: The data were from the National Health and Nutrition Examination Surveys (NHANES) 2015-March 2020 (pre-pandemic) for ≥20-year-old adults who provided 1 weekday (M-Th) and 1 weekend (F, S, Su) 24-h dietary recall (n = 3564 men and 3823 women). MAIN OUTCOME MEASURES: Prespecified primary temporal outcomes were recalled: time of ingestive events, and the duration of ingestive and fasting windows. Secondary outcomes included frequency and energy characteristics of ingestive events. STATISTICAL ANALYSIS PERFORMED: Gender-specific, survey-weighted, multiple linear regression models that accounted for complex survey design with dummy covariates for weekend/weekday, mode of recall administration (in-person on day 1 and telephone on day 2), and a respondent-specific fixed intercept. RESULTS: In both men and women, the weekend recalled time of first ingestive event, breakfast, and lunch were later than weekday (P ≤ .0008); however, no statistically significant differences were observed in time of dinner and the last eating episode. The mean weekend ingestive window (interval between the time of first and last eating events of the day) was shorter by 24 minutes (95% confidence interval [CI], -32, -11) in men and 18 minutes (95% CI, -20, -15) in women, and the mean overnight fasting window was correspondingly longer (P ≤ .0001). No statistically significant differences were observed between weekend and weekday frequency of ingestive events. Energy density of weekend food selections reported by women, and of beverages by men, was found to be higher than weekday (P ≤ .002). CONCLUSIONS: Weekend ingestive patterns were characterized by later time of first ingestive event, breakfast, and lunch, and selection of higher-energy-density foods and beverages.

Association of Physical Activity Patterns with the Metabolic Syndrome in Korean Adults: A Nationwide Cross-Sectional Study.

Background: Recent research has focused on a new group called the "weekend warriors". These individuals accumulate their recommended moderate to vigorous physical activity (MVPA) over just 1-2 days, often during weekends, while remaining relatively inactive during the rest of the week. However, the effects of engaging in low-frequency MVPA on the risk of metabolic syndrome (MetS) are not well understood. This study investigated the association between physical activity patterns and the risk of MetS among Korean adults. Methods: This study included 26,197 participants (11,804 male and 14,393 female) aged ≥ 20 years from the Korea National Health and Nutrition Examination Survey. MVPA was measured using a global physical activity questionnaire. MetS was defined as the presence of more than three risk factors. Results: The odds ratio (OR) for MetS was 0.60 (95% confidence interval [CI] = 0.52, 0.70) in the "regularly active" group and 0.82 (95% CI = 0.69, 0.98) in the "weekend warrior" group compared to that in the inactive group (reference), which controlled for all covariates. For sensitivity analyses, the results across all subgroups exhibited similar patterns, with more pronounced effects observed in women, middle-aged individuals, and non-drinkers/light drinkers. Conclusions: Our findings suggest that concentrated bouts of moderate to vigorous physical activity, even if undertaken infrequently, confer health benefits that align with the recommended guidelines. This study contributes to the growing evidence on the relationship between physical activity patterns and MetS risk in Korean adults. The study also emphasizes the potential of different activity patterns in mitigating metabolic risk.

Effect of Hospital Arrival Time on Functional Prognosis of Stroke Patients: Japan Stroke Data Bank Over 20 Years.

AIMS: The impact of weekend/holiday and nighttime hospitalization on functional outcomes and long-term trends in stroke patients is unclear. We examined functional and life outcomes and changes over time. METHODS: We analyzed the clinical data of 203,176patients for hospital arrival day of week and 76,442patients for arrival times using Japan Stroke Data Bank. The endpoints were favorable outcome (Modified Rankin Scale[mRS]0-2), unfavorable outcome(mRS 5-6), and in-hospital mortality. We calculated odds ratios(OR) and 95% confidence interval(CI) of weekends/holidays and off-hours versus weekdays and on-hours for 2000-2009 and 2010-2020 using a mixed-effect multivariate model adjusted for confounding factors and evaluated interactions. Thereafter, we performed to check for year trends. RESULTS: All endpoints were worse in weekend/holiday admissions for all stroke and in off-hours hospitalization for total stroke(TS), ischemic stroke(IS), and intracerebral hemorrhage(ICH). The adjusted ORs for favorable outcomes of weekend/holiday admissions were TS, 0.90(0.87-0.93); IS, 0.89(0.86-0.93); ICH, 0.91(0.84-0.98) and unfavorable outcome TS, 1.04(1.002-1.08) IS, 1.06(1.01-1.11). Off-hour hospitalization had adjusted ORs for favorable outcome(TS, 0.86 [95% CI: 0.82-0.91]; IS, 0.90 [0.84-0.95]; ICH, 0.85 [0.75-0.96]), unfavorable outcome(TS, 1.14 [1.07-1.22]; IS, 1.13 [1.04-1.23]; ICH, 1.15 [1.01-1.31]), and mortality (TS, 1.15 [1.05-1.26]; IS, 1.17 [1.04-1.32]). For IS, the incidence of unfavorable outcomes during off-hours was significantly lower in 2010-2020 than in 2000-2009; after adjusting for reperfusion therapy, it was no longer significant. CONCLUSION: Stroke patients admitted on weekends/holidays and off-hours had worse functional and life outcomes. Functional outcomes for off-hour admission for IS improved at 10-year intervals, possibly due to improvements in stroke care systems.

Physical activity patterns and cognitive function in elderly women: a cross-sectional study from NHANES 2011-2014.

Background: Amid the backdrop of global aging, the increasing prevalence of cognitive decline among the elderly, particularly within the female demographic, represents a considerable public health concern. Physical activity (PA) is recognized as an effective non-pharmacological intervention for mitigating cognitive decline in older adults. However, the relationship between different PA patterns and cognitive function (CF) in elderly women remains unclear. Methods: This study utilized data from National Health and Nutrition Examination Survey (NHANES) 2011-2014 to investigate the relationships between PA, PA patterns [inactive, Weekend Warrior (WW), and Regular Exercise (RE)], and PA intensity with CF in elderly women. Multivariate regression analysis served as the primary analytical method. Results: There was a significant positive correlation between PA and CF among elderly women (ß-PA: 0.003, 95% CI: 0.000-0.006, P = 0.03143). Additionally, WW and RE activity patterns were associated with markedly better cognitive performance compared to the inactive group (ß-WW: 0.451, 95% CI: 0.216-0.685, P = 0.00017; ß-RE: 0.153, 95% CI: 0.085-0.221, P = 0.00001). Furthermore, our results indicate a progressive increase in CF with increasing PA intensity (ß-MPA- dominated: 0.16, 95% CI: 0.02-0.09, P = 0.0208; ß-VPA-dominated: 0.21, 95% CI: 0.09-0.34, P = 0.0011; ß-Total VPA: 0.31, 95% CI: -0.01-0.63, P = 0.0566). Conclusion: Our study confirms a positive association between PA and CF in elderly women, with even intermittent but intensive PA models like WW being correlated with improved CF. These findings underscore the significant role that varying intensities and patterns of PA play in promoting cognitive health among older age groups, highlighting the need for adaptable PA strategies in public health initiatives targeting this population.

Reduced 30-day in-hospital but increased long-term mortality for weekend vs weekday acute medical admission.

BACKGROUND: Acute medical admission at the weekend has been reported to be associated with increased mortality. We aimed to assess 30-day in-hospital mortality and subsequent follow-up of all community deaths following discharge for acute medical admission to our institution over 21 years. METHODS: We employed a database of all acute medical admissions to our institution over 21 years (2002-2023). We compared 30-day in-hospital mortality by weekend (Saturday/Sunday) or weekday (Tuesday/Wednesday) admission. Outcome post-discharge was determined from the National Death Register to December 2021. Predictors of 30-day in-hospital and long-term mortality were analysed by logistic regression or Cox proportional hazards models. RESULTS: The study population consisted of 109,232 admissions in 57,059 patients. A weekend admission was associated with a reduced 30-day in-hospital mortality, odds ratio (OR) 0.70 (95%CI 0.65, 0.76). Major predictors of 30-day in-hospital mortality were acute illness severity score (AISS) OR 6.9 (95%CI 5.5, 8.6) and comorbidity score OR 2.4 (95%CI 1.2, 4.6). At a median follow-up of 5.9 years post-discharge, 19.0% had died. The strongest long-term predictor of mortality was admission AISS OR 6.7 (95%CI 4.6, 9.9). The overall survival half-life after hospital discharge was 16.6 years. Survival was significantly worse for weekend admissions at 20.8 years compared to weekday admissions at 13.3 years. CONCLUSION: Weekend admission of acute medical patients is associated with reduced 30-day in-hospital mortality but reduced long-term survival.

Device-Measured Weekend Catch-Up Sleep, Mortality, and Cardiovascular Disease Incidence in Adults.

STUDY OBJECTIVE: Attempting to recover a sleep debt by extending sleep over the weekend is a common compensatory behavior in the population and is recommended by sleep-focused organizations. However, the purported benefits of catch-up sleep are based on a limited number of cross-sectional studies that relied on self-reported sleep. The objective of this study was to examine the association between accelerometer-derived weekend catch-up sleep and mortality and incident cardiovascular disease (CVD) in adults. METHODS: A prospective cohort study of UK adults who wore wrist-attached accelerometers was conducted. Weekend catch-up sleep was defined as a longer average sleep duration on weekends compared to weekdays. Participants were categorized into four groups: no weekend catch-up sleep (reference); >0 to <1 hour; ≥1 to <2 hours; and ≥2 hours difference. Associations between weekend catch-up sleep and mortality and incident CVD were assessed using Cox proportional hazards regression, adjusted for potential confounders. RESULTS: A total of 73,513 participants (sample for mortality) and 70,518 participants (sample for CVD incidence) were included, with an average (SD) follow-up period of 8.0 (0.9) years. In multivariable-adjusted models, weekend catch-up sleep was not associated with mortality (≥2 hours group: hazard ratio [HR], 1.17 [95% CI, 0.97-1.41]) or incident CVD (HR, 1.05 [95% CI, 0.94-1.18]). Dose-response analyses treating catch-up sleep as a continuous measure or analyses restricted to adults sleeping less than 6 hours on weekdays at baseline were in agreement with these findings. CONCLUSION: Weekend catch-up sleep was not associated with mortality or CVD incidence. These findings do not align with previous evidence and recommendations by sleep authorities suggesting that extending sleep over the weekend may offer protective health benefits.