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OBJECTIVE: The aim of this study was to document pooled evidence on the association between admission during offhours and/or weekends and the risk of mortality and poor functional outcome in patients with ischemic stroke, as compared to admission during regular working hours and/or weekdays. MATERIALS AND METHODS: We conducted a systematic search using PubMed, EMBASE, and Scopus databases. Observational studies published between 2013 and 2023 that investigated the association between weekend/off-hours admission and outcomes (mortality and functional outcomes) of ischemic stroke were considered for inclusion. A random effects model was used to conduct the analysis, and effect sizes were reported as pooled odds ratio (OR) or hazards ratio (HR) with corresponding 95% confidence intervals. RESULTS: The analysis consisted of 31 studies and found that patients admitted during weekend/off-hours had a higher risk of in-hospital (OR 1.12, 95% CI: 1.06, 1.18), and 1-month post-admittance mortality (OR 1.13, 95% CI: 1.06, 1.20). However, the risk of mortality after 3, 6, and 12 months was not statistically different between the two patient groups. Patients admitted during weekends/off-hours had a slightly higher risk of poor functional outcomes (modified Rankin Scale score of =3) at 1-month post-admittance (OR 1.06, 95% CI: 1.00, 1.11). However, after 3, 6, and 12 months, the risk of poor functional outcomes was similar in both patient groups. Egger's test did not suggest the presence of publication bias for any of the outcomes. CONCLUSIONS: Individuals who suffer from ischemic stroke and present outside of regular working hours or on weekends have a higher likelihood of experiencing short-term mortality and unfavorable functional outcomes. [ABSTRACT FROM AUTHOR]

Background: Increased 30-day mortality rates have been reported in patients undergoing elective surgery later compared with earlier in the week. However, these reports have been conflicting for esophageal surgery. We conducted a study to assess the differences in outcomes of patients undergoing surgery for esophageal cancer earlier in the week (Tuesday) versus later (Friday). Methods: This retrospective analysis of a prospectively maintained database included patients with esophageal cancer who underwent esophageal resection in a tertiary cancer center between 1 January 2005 and 31 December 2017. We compared patients operated on Tuesdays versus Fridays. The primary outcome was a composite of major morbidity (defined as Clavien-Dindo grade 3 or more) and/or mortality. Secondary outcomes included duration of post-operative ventilation, and length of ICU and hospital stay. Results: Among 1300 patients included, 733 were operated on a Tuesday and 567 on a Friday. Patient and surgery characteristics were similar in the two groups. The primary outcome (composite of major morbidity and mortality) was 23.6% in the Tuesday group versus 26.3% in the Friday group. Mortality was similar in the two groups (6.0%). Multivariable logistic regression analysis showed that the day of surgery was not a predictor of major morbidity or mortality. Conclusions: In patients undergoing esophagectomy at tertiary care high volume cancer center, there was no difference in major morbidity and mortality whether the surgery was performed early in the week (Tuesday) or closer to the weekend (Friday). [ABSTRACT FROM AUTHOR]

This study sought to evaluate the extent of the weekend effect of O3, NO2, SO2 and PM2.5, in Recife, a tropical Brazilian metropolis, taking into account a 2-year period of monitoring air pollutants, including a portion comprising the end of restrictions related to COVID-19. Our results show that Recife did not experience a weekend effect of air pollutants in both annual contexts, presenting magnitudes that can be considered practically null (− 2% ≥ or ≤ 2%) in the two annual scenarios evaluated. This finding is interesting because the behavior of air pollutants observed in this metropolis was fundamentally different from what previously found in other similar urban environments. However, seasonally this does not happen, existing seasonal discrepancies in the dynamics of all air pollutants. In addition, these seasonal changes in the weekend effect were not primarily associated with meteorological parameters and probably other factors are influencing this effect, especially the behavior and life habits of the population of this tropical city. In view of the two scenarios evaluated, there was an existence of an impact of the final moment of the COVID-19 restrictions and the beginning of the resumption of "normal" activities on the weekend effect in year 1. Furthermore, weekly SO2 levels were significantly correlated with NO2 and O3 levels, this implies that the majority of these pollutants were probably generated by the same source. We hope that the information provided in our findings will assist in defining and guiding policies aimed at dealing with air pollution control. [ABSTRACT FROM AUTHOR]

Variability in the timing of daily sleep is increasingly recognized as an important factor in sleep and general physical health. One potential driver of such daily variations in sleep timing is different work and social obligations during the “working week” and weekends. To investigate the nature of weekday/weekend differences in the timing of sleep offset, we examined actigraphy records of 79,161 adult participants in the UK Biobank who wore an actiwatch for 1 week. The time of sleep offset was found to be on average 36 min later on weekends than on weekdays, and when this difference was expressed as an absolute value (i.e., irrespective of sleep offset being either later or earlier on weekends), it was 63 min. Younger age, more socioeconomic disadvantage, currently being in employment, being a smoker, being male, being of non-white ethnicity and later chronotype were associated with greater differences in sleep offset between weekdays and weekend days. Greater differences in sleep offset timing were associated with age-independent small differences in cardiometabolic health indicators of BMI and diastolic blood pressure, but not HbA1c or systolic blood pressure. In a subset of participants with Type 2 Diabetes Mellitus, weekday/weekend sleep offset differences were associated weakly with BMI, systolic blood pressure and physical activity. Overall, this study demonstrates potentially substantive differences in sleep offset timings between weekdays and weekends in a large sample of UK adults, and that such differences may have public health implications.

The present study was aimed at analyzing differences between weekdays and weekends in psychological well-being, relationship satisfaction, and dyadic coping, as well as their associations, before and during the first COVID-19 lockdown in Italy. Individuals in a couple's relationship completed an online questionnaire before (N = 76) and during (N = 50) the COVID-19 lockdown. With regard to the first aim, participants in the COVID condition reported greater psychological well-being during weekends than during weekdays. In addition, participants showed greater relationship satisfaction during weekdays than during weekends, independently of the COVID-19 condition. As for the dyadic coping process, only in the Pre-COVID group, individuals communicated their stress more frequently during weekdays than during weekends. Finally, regardless of the COVID condition, they reported higher positive and common dyadic coping responses during weekends than during weekdays. As for the second aim, a positive effect of common dyadic coping responses on both psychological well-being and relationship satisfaction emerged during weekdays and weekends. Positive dyadic coping positively predicted relationship satisfaction during weekdays and weekends. Higher negative dyadic coping was associated with lower psychological well-being (in the Pre-COVID group only) and lower relationship satisfaction during weekends. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate daily physical activity (PA) patterns of 8- to 9-year-old Irish children from socially disadvantaged areas. Methods: Children (N = 408) were asked to wear an ActiGraph accelerometer for a minimum of 4 days. Based on mean daily moderate- to vigorous-intensity PA accumulation, participants were grouped into sex-specific quartiles (Q4, most active; Q1, least active). Principal component analysis was used to identify distinct time blocks for weekdays and weekend days. Results: Overall, 213 participants (8.7 [0.5] y) met accelerometer inclusion criteria. Of these, 56.7% met the 60 minutes of moderate- to vigorous-intensity PA per day guidelines, with males statistically significantly more likely to do so than females (P <.01). Principal component analysis revealed 3 distinct time periods on weekdays and 4 distinct periods on weekends that children were active. The total difference in moderate- to vigorous-intensity PA accumulation between Q4 (most active) and Q1 (least active) was greatest in the after-school time period (male: 49 min and female: 33 min) on weekdays and in the evening time period on weekends (male: 33 min and female: 19 min). Conclusions: After-school and weekend evenings are critical "activity rich" time periods in terms of the gap between our most and least active disadvantaged children. [ABSTRACT FROM AUTHOR]

Cancer surgery conducted late during the working week might decrease long-term survival for some tumours. Studies on how weekday of gastrectomy influences long-term survival following gastric cancer are few and show conflicting results, which prompted the present investigation. This population-based cohort study included almost all patients who underwent gastrectomy for gastric adenocarcinoma in Sweden between 2006 and 2015, with follow-up throughout 2020. Associations between weekday of gastrectomy and 5-year all-cause mortality (main outcome) and 5-year disease-specific mortality (secondary outcome) were analysed using multivariable Cox regression. The hazard ratios (HR) with 95% confidence intervals (CI) were adjusted for age, sex, education, comorbidity, pathological tumour stage, tumour sub-location, neoadjuvant therapy, annual surgeon volume of gastrectomy, and calendar year. Among 1678 patients, surgery on Thursday-Friday was not associated with any statistically significantly increased risk of 5-year all-cause mortality (HR 1.05, 95% CI 0.91–1.22) or 5-year disease-specific mortality (HR 1.04, 95% CI 0.89–1.23) compared to Monday-Wednesday. No associations were found when each weekday was analysed separately, with point estimates close to 1.00 (range 0.98–1.00) Monday-Thursday, but increased for Friday (HR 1.22, 95% CI 0.89–1.68) when fewer patients underwent surgery (4% of all). Stratified analyses by age, comorbidity, tumour stage, neoadjuvant therapy, surgeon volume, and tumour sub-location did not reveal any associations between weekday of surgery on Thursday-Friday compared with Monday-Wednesday and risk of 5-year all-cause mortality. Weekday of gastrectomy might not influence the 5-year survival in patients with gastric adenocarcinoma. [ABSTRACT FROM AUTHOR]

Variability in the timing of daily sleep is increasingly recognized as an important factor in sleep and general physical health. One potential driver of such daily variations in sleep timing is different work and social obligations during the "working week" and weekends. To investigate the nature of weekday/weekend differences in the timing of sleep offset, we examined actigraphy records of 79,161 adult participants in the UK Biobank who wore an actiwatch for 1 week. The time of sleep offset was found to be on average 36 min later on weekends than on weekdays, and when this difference was expressed as an absolute value (i.e., irrespective of sleep offset being either later or earlier on weekends), it was 63 min. Younger age, more socioeconomic disadvantage, currently being in employment, being a smoker, being male, being of non-white ethnicity and later chronotype were associated with greater differences in sleep offset between weekdays and weekend days. Greater differences in sleep offset timing were associated with age-independent small differences in cardiometabolic health indicators of BMI and diastolic blood pressure, but not HbA1c or systolic blood pressure. In a subset of participants with Type 2 Diabetes Mellitus, weekday/weekend sleep offset differences were associated weakly with BMI, systolic blood pressure and physical activity. Overall, this study demonstrates potentially substantive differences in sleep offset timings between weekdays and weekends in a large sample of UK adults, and that such differences may have public health implications. [ABSTRACT FROM AUTHOR]

Supracondylar fracture of the humerus is one of the most common fractures in children. The purpose of our study was to analyze the temporal variations and mechanisms of paediatric supracondylar fractures presented to our hospital during the COVID-19 pandemic lockdown period. As the schools and parks were closed and children were confined to their homes, they were thus more prone to injuries while playing inside. We claim that this would be the first study in Pakistan to provide unique information about these fractures. We conducted this descriptive study in the Accident and Emergency Department at Lady Reading Hospital in Peshawar, Pakistan from 18th March 2020 to 18th June 2020. In the enrolled children data regarding day and time of fracture occurrence, mechanism of fracture, height of furniture or play equipment from which the children fall and types of landing surfaces were all noted. Important variables were compared and a Chi-square test was applied to calculate P value (P

This study had two aims: (1) to identify the levels of physical activity, screen time and sleep time of adolescents according to the sex of the participant and the day of the week; (2) to find out the relationships between physical activity, screen time and sleep time according to the sex of the participant and the day of the week. The study design was non-experimental, descriptive-correlational and cross-sectional. The sample consisted of 694 adolescents in Compulsory Secondary Education from Soria (Spain). Four by One-Day Physical Activity Questionnaires were used to measure levels of physical activity, screen time and sleep time. Levene's test and Student's t-test were used to calculate the difference between the means of the variables. Pearson's test was used to calculate bivariate correlations between variables. Results showed higher levels of screen time in males (136.93 min/day ± 81.548). Screen time, sleep time and moderate–vigorous physical activity are higher during the weekend. Positive relationships were found between screen time and light physical activity (rmales = 0.274; p ≤ 0.01; rfemales = 0.065; p > 0.05). The correlations between moderate–vigorous physical activity and screen time were negative (rmales = −0.282; p ≤ 0.01; rfemales = −0.187; p ≤ 0.05). The relationship between screen time and sleep time was negative in males (r = −0.135; p ≤ 0.05). In conclusion, the levels of physical activity, screen time and sleep time vary according to the sex of the participants and the day of the week. [ABSTRACT FROM AUTHOR]

Objective: In some studies, it has been shown that the concept of office hours (OH) and out-of-office hours (OFH) at intensive care unit (ICU) admission has an effect on ICU mortality. In this study, we aimed to examine the effect of this concept on ICU mortality in a medical ICU (MICU). Material and Method: After retrospectively examining the general characteristics of the patients hospitalized in Gazi University Hospital MICU between January 1, 2017 and December 31, 2018, patients were divided into two groups as admitted ICU in OH (Monday-Friday; 08.00 am to 04.59 pm) or in OFH (Monday-Friday; 05.00 pm to 07.59 am, weekends, and all public holidays). These two groups were then compared in terms of patient characteristics and ICU mortality. Results: Five hundred and twenty seven patients were included in the study. 238 of these patients were admitted to MICU in OH and 289 of them in OFH. The median age of the patients was 70 (57-79) years, 52% of them were male. There was no difference between the patients admitted ICU in OH and OFH in terms of age, gender, acute illness severity scores, reasons for hospitalization, length of ICU stay, interventions and treatments in the ICU. Patients admitted to ICU in OFH had higher organ failure scores (SOFA score) (p =0.026). In terms of comorbidities, there was a difference between those admitted to ICU in OH and those admitted to ICU in OFH. More acute kidney injury (AKI) developed during their ICU stay in patients admitted to ICU in OFH. A total of 212 patients (40.23%) died during ICU hospitalization. Of these, 131 (61.79%) were admitted to ICU in OFH, 81 (38.21%) were admitted to ICU in OH and this difference was statistically significant (p =0.008). Conclusion: In this study, admission to ICU in OFH increased the ICU mortality. Having higher organ failure scores and different comorbidities in patients admitted to ICU in OFH were found to be the factors explaining this mortality difference. New studies with broad participation are needed to verify this result and explain its reasons. [ABSTRACT FROM AUTHOR]

Radiotherapy is one of the definitive treatments for head and neck squamous cell carcinoma, especially early-stage glottic squamous cell carcinoma. Although there are several studies on the initiation weekday of cancer treatment, there are very few studies in the radiotherapy field. Thus, the present study investigated whether the initiation weekday of radiotherapy affects the local control rate for stage 1 glottic squamous cell carcinoma. A total of 105 patients with stage 1 glottic squamous cell carcinoma underwent definitive radiotherapy alone between 2007 and 2021. The group in which radiotherapy was started between Monday and Wednesday was compared with the group in which radiotherapy was started on Thursday or Friday. Sixty-seven patients started radiotherapy between Monday and Wednesday and 38 on Thursday or Friday. The 5-year local control rate was 98% (95% confidence interval: 94-100%) in the Monday-Wednesday group and 83% (95% confidence interval: 71-96%) in the Thursday-Friday group, with a significant difference (P = 0.005). On multivariate analysis including age, overall administration time (days), fractionation, irradiation field size and initiation weekday of radiotherapy, no factors other than initiation weekday affecting local control were identified. Radiotherapy toxicity did not differ between the two groups. For stage 1 glottic squamous cell carcinoma, starting radiotherapy on Thursday or Friday is associated with a lower local control rate; therefore, radiotherapy should be started by Wednesday., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Japanese Radiation Research Society and Japanese Society for Radiation Oncology.)

Context: The timing of sleep, physical activity, and dietary intake show variation over the week, with different timings in the weekend compared to the weekdays, which may potentially lead to impaired glucose and lipid regulation on Mondays compared to other weekdays. Objective: The aim of the study was to investigate differences in glucose metabolism and fasting triglyceride concentrations on Mondays compared to the rest of the week. Design, setting and participants: This cross-sectional study is based on data from the Maastricht Study, including 6067 participants without known diabetes and 1568 previously diagnosed with type 2 diabetes. Main outcome measures: Confounder-adjusted linear regression analysis was applied to study the associations of day of the week of examination with glucose and insulin responses to an oral glucose tolerance test and fasting triglyceride concentrations. Results. In fully confounder-adjusted models, mean (95% CI) concentrations of fasting glucose, insulin, and triglycerides were slightly higher on Mondays compared with the other weekdays [glucose: 1% (0-2); insulin: 9% (1-18); triglycerides: 5% (2-8)]. Interaction analyses revealed that the association of weekday with insulin was only pronounced in men [18% (3-35)], but not in women [1% (−8-10)], whereas the associations with glucose and triglycerides were only apparent for individuals with known type 2 diabetes [glucose: 4% (0-7); triglycerides: 14% (6-23)] compared to the background population [glucose: 0% (0-1); triglycerides: 3% (0-6)]. Discussion: Being examined on a Monday was associated with higher fasting insulin concentrations among men but not women. [ABSTRACT FROM AUTHOR]

Purpose: Major abdominal surgery carried out in the later part of the week has been associated with increased complication rates. The aim of this study was to explore whether the weekday of surgery affects the 30-day complication risks after primary Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). Material and Methods: Prospectively collected data, extracted from the Scandinavian Obesity Surgery Registry (SOReg), of all patients who underwent primary laparoscopic RYGB or SG between 2010 and 2017 were included in this retrospective cohort study. Multivariate logistic regression adjusted for differences in case-mix and operating center by weekday of surgery. Results: In total, 49,349 patients were included in this study. The overall 30-day complication rate was 7.2% (n = 3574), whereof 2.9% (n = 1428) had a severe complication, i.e., requiring intervention in general anesthesia or more. The 30-day mortality rate and readmission rate were 0.02% (n = 12) and 7.6% (n = 3726), respectively. The highest overall complication rate was seen in patients operated on Wednesdays and Thursdays (7.7%), while severe complications were most common on Wednesdays (3.3%). However, a large variation in severe complications was seen between centers, from 0.4 to 8.0%. After adjustment for case-mix and operating center, there was no significant increased risk of overall complications, severe complications, or readmission rates by weekday of surgery, except for a lower readmission rate in patients operated on Tuesdays. Conclusion: The result of the present study supports the notion that bariatric surgery can be performed safely on all weekdays. [ABSTRACT FROM AUTHOR]

Lili Wu,1 Guiyu Lei,1 Ying Liu,2 Zheng Wei,1 Yue Yin,1 Yanru Li,3 Guyan Wang1 1Department of Anesthesiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Operating Room, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology, Head and Neck Surgery (Ministry of Education of China), Beijing, People’s Republic of ChinaCorrespondence: Guyan WangDepartment of Anesthesiology, Beijng Tongren Hospital, Capital Medical University, Beijing, People’s Republic of ChinaTel +8613910985139Email guyanwang2006@163.comPurpose: Current data on the occurrence of EFBs in relation to different time periods are scant. The purpose of this study was to compare the occurrence, type and location of EFBs in people who presented at our center on weekdays, weekends and holidays.Patients and Methods: A retrospective analysis of patients (n=1353) received rigid esophagoscopy for foreign body extraction under general anesthesia from January 2018 to 2020 December.Results: The occurrence of EFB ingestion was significantly higher (p< 0.05) on holidays (2.75/day) than on weekdays (0.91/day) and weekends (1.46/day). Patients were much older on holidays, with a mean age of 58.18 ± 17.34 years, than patients on weekdays (54.71 ± 16.71 years) and weekends (55.05 ± 17.36 years).Conclusion: Our findings demonstrate that EFB ingestion is most likely to occur on weekends and holidays, and elderly patients should be advised to chewing slowly and eating non-nuclear jujube, especially during holidays, to minimize their risk.Keywords: esophageal foreign body, weekday, weekend, holiday

Abstract Background Several studies have found a so-called weekend effect that patients admitted at the weekends had worse clinical outcomes than patients admitted at the weekdays. We performed this retrospective cohort study to explore the weekend effect in four major cardiovascular emergencies in Taiwan. Methods The Taiwan National Health Insurance (NHI) claims database between 2005 and 2015 was used. We extracted 3811 incident cases of ruptured aortic aneurysm, 184,769 incident cases of acute myocardial infarction, 492,127 incident cases of ischemic stroke, and 15,033 incident cases of pulmonary embolism from 9,529,049 patients having at least one record of hospitalization in the NHI claims database within 2006 ~ 2014. Patients were classified as weekends or weekdays admission groups. Dates of in-hospital mortality and one-year mortality were obtained from the Taiwan National Death Registry. Results We found no difference in in-hospital mortality between weekend group and weekday group in patients with ruptured aortic aneurysm (45.4% vs 45.3%, adjusted odds ratio [OR] 1.01, 95% confidence interval [CI] 0.87–1.17, p = 0.93), patients with acute myocardial infarction (15.8% vs 16.2%, adjusted OR 0.98, 95% CI 0.95–1.00, p = 0.10), patients with ischemic stroke (4.1% vs 4.2%, adjusted OR 0.99, 95% CI 0.96–1.03, p = 0.71), and patients with pulmonary embolism (14.6% vs 14.6%, adjusted OR 1.02, 95% CI 0.92–1.15, p = 0.66). The results remained for 1 year in all the four major cardiovascular emergencies. Conclusions We found no difference in either short-term or long-term mortality between patients admitted on weekends and patients admitted on weekdays in four major cardiovascular emergencies in Taiwan.

Abstract Purpose The Structured Days Hypothesis (SDH) posits that children’s behaviors associated with obesity – such as physical activity – are more favorable on days that contain more ‘structure’ (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children’s moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset. Methods Data were received from the International Children’s Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status. Results/findings Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively. Conclusions Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.

Abstract Introduction Previous longitudinal studies indicate that physical activity (PA) significantly declines from primary-to secondary school, and report both changes in individual and environmental determinants of PA. In order to understand this transition and to prevent this negative trend, it is important to gather contextually rich data on possible mechanisms that drive this decline. Therefore, the aim of this study was to investigate changes of PA patterns in transition between primary and secondary school, and to add domain-specific insights of how, where, and when these changes occur. Methods In total, 175 children participated in a 7-day accelerometer- and Global Positioning System (GPS) protocol at their last year of primary and their first year of secondary school. GPS data-points were overlaid with Geographical Information Systems (GIS) data using ArcGIS 10.1 software. Based on the GPS locations of individual data-points, we identified child’s PA at home, school, local sports grounds, shopping centers, and other locations. Also, trips in active and passive transport were identified according to previously validated GPS speed-algorithms. Longitudinal multi-level linear mixed models were fitted adjusting for age, gender, meteorological circumstances, and the nested structure of days within children and children within schools. Outcome measures were minutes spent in light PA and moderate-to-vigorous PA, specified for the time-segments before school, during school, after school and weekend days. Results Total PA significantly declined from primary to secondary school. Although transport-related PA increased before- and during school, decreases were found for especially afterschool time spent at sports grounds and transport-related PA during weekends. Conclusions This is the first study that demonstrated longitudinal changes of context- and domain-specific PA patterns in transition between primary and secondary school, based on device-assessed PA. Given the importance of this transition-period for the development of long-term PA patterns, results from this study warrant the development of evidence-based PA programs in this transition period, while acknowledging the integrative role of schools, parents, and afterschool sports providers. More specifically, the results underline the need to increase children’s PA levels in primary schools, promote afterschool PA at secondary schools, and to prevent the drop-out in sports participation at secondary schools.

Fasting duration has been associated with lower fasting blood glucose levels, but higher 2-h post-load levels, and research has indicated an adverse effe ct of ‘weekend behavior’ on human metabolism. We investigated associations of fasting duration and weekday of examination with glucose, insulin, glucagon and incretin responses to an oral glucose tolerance test (OGTT). This cross-sectional study is based on data from the ADDITION-PRO study, where 2082 individuals attended a health examination including an OGTT. Linear regression analysis was applied to study the associations of overnight fasting duration and day of the week with glucose, insulin, glucagon, glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) responses to an OGTT. We found that a 1 h longer fasting duration was associated with 1.7% (95% CI: 0.8,2.5) higher 2-h glucose levels, as well as a 3.0% (95% CI: 1.3,4.7) higher GIP and 2.3% (95% CI: 0.3,4.4) higher GLP-1 response. Fasting insulin levels were 20.6% (95% CI: 11.2,30.7) higher on Mondays compared to the other weekdays, with similar fasting glucose levels (1.7%, 95% CI: 0.0,3.4). In this study, longer overnight fasting duration was associated with a worsening of glucose tolerance and increased incretin response to oral glucose. We found higher fasting insulin levels on Mondays compared to the other days of the week, potentially indicating a worsened glucose regulation after the weekend.

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., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Mohamed et al.)

Purpose: Evidence of shared physical activity (PA) habits within families is inconsistent. The present study aimed at examining intrafamily resemblance in PAduring different time segments of the week. Method: This cross-sectional study used data from the Danish household-based population study Lolland--Falster Health Study.We assessed time spent in various PA intensities and behaviors using a dual-accelerometer system (Axivity AX3). At least one parent and one child per household provided data for a minimum of three weekdays and one weekend day. We analyzed three time segments: early weekdays, late weekdays, and weekends. A linear mixed model regression analysis was used to estimate intraclass correlation coefficients (ICC) of the total family, parent--child dyads, siblings, and parent--parent dyads for PA outcomes, adjusting for sex, age, parental education, and the interaction between sex and age. Results: We included 774 parents (57.9% female, 42.8 ± 7 yr) and 802 children (54.2% girls, 11.1 ± 4.3 yr) nested within 523 families. The clustering among the total family was stronger during late weekdays (ICC = 0.11--0.31) and weekends (ICC = 0.14--0.29) than during early weekdays (ICC = 0.02--0.19). We found stronger clustering among siblings (ICC = 0.08--0.47) and between parents (ICC = 0.02--0.52) than between parents and children (ICC < 0.01--0.37). Generally, the clustering was strongest for light PA, and among PA behaviors, walking showed the highest resemblance across all subgroups. Conclusion: Initiatives to promote children's PA that involve parent or sibling coparticipation may focus on the time segment and activity types with the highest resemblance. For the family as a whole, promoting walking or limiting sedentary activities may be a potential target for interventions during late weekdays and weekends. Trial registration: Clinicaltrials.gov (NCT02482896). [ABSTRACT FROM AUTHOR]

Complete macroscopic resection without any residual tumour after completion of surgery is a strong prognostic factor in advanced epithelial ovarian cancer (EOC). It has previously been reported that surgery performed later in the week is associated with failure to achieve complete macroscopic resection. Our objective was to examine if weekday of surgery influences oncologic outcome. This population-based observational study included 100% of all women diagnosed with advanced-stage invasive epithelial ovarian cancer between 2009–2011 and 2014–2016 in the Stockholm/Gotland County of Sweden. The association between weekday of surgery and survival was analysed with proportional hazards regression yielding hazard ratios (HR) with 95% confidence intervals (CI), adjusted for predefined confounders. Out of 1066 identified women, 524 with advanced stage EOC treated with surgery were included in the final analysis. Surgery performed Wednesday to Thursday was associated with an increased hazard of death (HR 1.28, 95% CI 1.04–1.58, p-value 0.02). The trend of the hazard of surgery performed throughout the week from Monday through Thursday was also significant (p = 0.01). The increased mortality associated with surgery that is performed later in the week suggests that surgery for advanced ovarian cancer is best conducted early in the week. [ABSTRACT FROM AUTHOR]

This study had two aims: (1) to identify the levels of physical activity, screen time and sleep time of adolescents according to the sex of the participant and the day of the week; (2) to find out the relationships between physical activity, screen time and sleep time according to the sex of the participant and the day of the week. The study design was non-experimental, descriptive-correlational and cross-sectional. The sample consisted of 694 adolescents in Compulsory Secondary Education from Soria (Spain). Four by One-Day Physical Activity Questionnaires were used to measure levels of physical activity, screen time and sleep time. Levene’s test and Student’s t-test were used to calculate the difference between the means of the variables. Pearson’s test was used to calculate bivariate correlations between variables. Results showed higher levels of screen time in males (136.93 min/day ± 81.548). Screen time, sleep time and moderate–vigorous physical activity are higher during the weekend. Positive relationships were found between screen time and light physical activity (rmales = 0.274; p ≤ 0.01; rfemales = 0.065; p > 0.05). The correlations between moderate–vigorous physical activity and screen time were negative (rmales = −0.282; p ≤ 0.01; rfemales = −0.187; p ≤ 0.05). The relationship between screen time and sleep time was negative in males (r = −0.135; p ≤ 0.05). In conclusion, the levels of physical activity, screen time and sleep time vary according to the sex of the participants and the day of the week.

Background: NHS England’s 7-day services policy comprised 10 standards to improve access to quality health care across all days of the week. Six standards targeted hospital specialists on the assumption that their absence caused the higher mortality associated with weekend hospital admission: the ‘weekend effect’. The High-intensity Specialist-Led Acute Care (HiSLAC) collaboration investigated this using the implementation of 7-day services as a ‘natural experiment’. Objectives: The objectives were to determine whether or not increasing specialist intensity at weekends improves outcomes for patients undergoing emergency hospital admission, and to explore mechanisms and cost-effectiveness. Design: This was a two-phase mixed-methods observational study. Year 1 focused on developing the methodology. Years 2–5 included longitudinal research using quantitative and qualitative methods, and health economics. Methods: A Bayesian systematic literature review from 2000 to 2017 quantified the weekend effect. Specialist intensity measured over 5 years used self-reported annual point prevalence surveys of all specialists in English acute hospital trusts, expressed as the weekend-to-weekday ratio of specialist hours per 10 emergency admissions. Hospital Episode Statistics from 2007 to 2018 provided trends in weekend-to-weekday mortality ratios. Mechanisms for the weekend effect were explored qualitatively through focus groups and on-site observations by qualitative researchers, and a two-epoch case record review across 20 trusts. Case-mix differences were examined in a single trust. Health economics modelling estimated costs and outcomes associated with increased specialist provision. Results: Of 141 acute trusts, 115 submitted data to the survey, and 20 contributed 4000 case records for review and participated in qualitative research (involving interviews, and observations using elements of an ethnographic approach). Emergency department attendances and admissions have increased every year, outstripping the increase in specialist numbers; numbers of beds and lengths of stay have decreased. The reduction in mortality has plateaued; the proportion of patients dying after discharge from hospital has increased. Specialist hours increased between 2012/13 and 2017/18. Weekend specialist intensity is half that of weekdays, but there is no relationship with admission mortality. Patients admitted on weekends are sicker (they have more comorbid disease and more of them require palliative care); adjustment for severity of acute illness annuls the weekend effect. In-hospital care processes are slightly more efficient at weekends; care quality (errors, adverse events, global quality) is as good at weekends as on weekdays and has improved with time. Qualitative researcher assessments of hospital weekend quality concurred with case record reviewers at trust level. General practitioner referrals at weekends are one-third of those during weekdays and have declined further with time. Limitations: Observational research, variable survey response rates and subjective assessments of care quality were compensated for by using a difference-in-difference analysis over time. Conclusions: Hospital care is improving. The weekend effect is associated with factors in the community that precede hospital admission. Post-discharge mortality is increasing. Policy-makers should focus their efforts on improving acute and emergency care on a ‘whole-system’ 7-day approach that integrates social, community and secondary health care. Future work: Future work should evaluate the role of doctors in hospital and community emergency care and investigate pathways to emergency admission and quality of care following hospital discharge. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 13. See the NIHR Journals Library website for further project information.

Purpose: The Structured Days Hypothesis (SDH) posits that children's behaviors associated with obesity – such as physical activity – are more favorable on days that contain more 'structure' (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children's moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset. Methods: Data were received from the International Children's Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status. Results/findings: Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively. Conclusions: Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active. [ABSTRACT FROM AUTHOR]

Objective: We sought to compare clinical outcomes in patients with acute type A aortic dissection that undergone surgical repair during in‐hours (IH) versus out‐of‐hours (OOH). Methods: An electronic literature search was done till March 2020 to include studies with comparative cohorts of IH versus OOH. Primary outcomes were 30‐day mortality, stroke, and reoperation for bleeding; secondary outcomes were acute kidney injury, total hospital stay, and intensive care unit stay. Results: Six articles with a total of 3744 patients met the inclusion criteria. Mean age was similar, 60 ± 12 versus 60 ± 13 in IH versus OOH (p =.25). Aortic root and total arch replacement were similar in both cohorts, 22% in IH versus 25% in OOH (risk ratio [RR], 1.10; 95% confidence interval [CI: 0.78, 1.55]; p =.58) and 29% in IH versus 32% in OOH (RR, 0.96; 95% CI [0.89, 1.04], p =.37) respectively. Reoperation for bleeding and stroke rate were similar, with 18% in IH versus 23% in OOH (RR, 0.89; 95% CI [0.73, 1.08]; p =.24), and 12% in IH versus 13% in OOH (RR, 0.83; 95% CI [0.66, 1.03]; p =.09) respectively. Thirty‐day mortality was significantly lower in IH (RR, 0.81; 95% CI [0.72, 0.90]; p =.0001). Conclusion: There was higher 30‐day mortality rate during OOH surgery, yet this difference diminished following sensitivity analysis. There were no significant differences in major postoperative outcomes. Therefore, operating on such cases should be decided on clinical priority without delay. [ABSTRACT FROM AUTHOR]

A new path for hydroxyl radical formation via photo-excitation of nitrogen dioxide (NO2) and the reaction of photo-excited NO2 with water is evaluated using the UCI-CIT model for the South Coast Air Basin of California (SoCAB). Two separate studies predict different reaction rates, which differ by nearly an order of magnitude, for the reaction of photo-excited NO2 with water. Impacts of this new chemical mechanism on ozone and particulate matter formation, while utilizing both reaction rates, are quantified by simulating two summer episodes. First, sensitivity simulations are conducted to evaluate the uncertainty in the rate of reaction of photo-excited NO2 with water reported in the literature. Results indicate that the addition of photo-excited NO2 chemistry increases peak 8-h average ozone and particulate matter concentrations. The importance of this new chemistry is then evaluated in the context of pollution control strategies. A series of simulations are conducted to generate isopleths for ozone and particulate matter concentrations, varying baseline nitrogen oxides (NOx) and volatile organic compounds (VOC) emissions. Isopleths are obtained using 1987 emissions, to represent past conditions, and 2005, to represent current conditions in the SoCAB. Results show that the sensitivity of modeled pollutant control strategies due to photoexcitation decreases with the decrease in baseline emissions from 1987 to 2005. Results show that including NO2 photo-excitation, increases the sensitivity of ozone concentration with respect to changes in NOx emissions for both years. In particular, decreasing NOx emissions in 2005 when NO2 photo-excitation is included, while utilizing the higher reaction rate, leads to ozone relative reduction factors that are 15% lower than in a case without photo-excited NO2. This implies that photoexcitation increases the effectiveness in reducing ozone through NOx emissions reductions alone, which has implications for the assessment of future emission control strategies. However, there is still disagreement with respect to the reaction rate constant for the formation of OH. Therefore, further studies are required to reduce the uncertainty in the reaction rate constant before this new mechanism is fully implemented in regulatory applications.

Objective: To compare dietary intake and physical activity (PA) between days of the week in a large sample of the Danish population; furthermore, to investigate the influence of gender and age as determinants for weekly variation.Design: Analysis was based on cross-sectional data from the Danish National Survey of Diet and Physical Activity 2011-2013. Dietary intake and PA were assessed by 7 d of pre-coded food diaries and pedometer-determined step counts. Dietary intake and PA on weekdays (Monday-Thursday), Friday, and weekend days (Saturday and Sunday) were compared using linear mixed models.Setting: Survey with national representation, conducted in Denmark between 2011 and 2013.Participants: A random sample of 4-75-year-old Danes, n 3934 and n 3530 in analysis of dietary intake and PA, respectively.Results: Energy intake during Friday and weekend days was 7-20 % higher compared with weekdays, while step counts were 10 and 17 % lower on Saturday and Sunday, respectively (all P < 0·001). Energy density of liquids and solids, consumption of added sugar, alcohol, discretionary foods, beer, wine and sugar-sweetened beverages were substantially higher, and consumption of dietary fibre, vegetables, fruit and wholegrain products were lower, during Friday and weekend days compared with weekdays (all P < 0·001). The observed patterns were present across gender and age, although weekly variation was most pronounced among children and relatively modest among the elderly.Conclusions: Weekend health behaviours of Danes display less favourable eating and PA behaviour compared with weekdays, making the weekend an important target for public health interventions aiming to improve dietary intake and PA behaviour. [ABSTRACT FROM AUTHOR]

Introduction: Previous longitudinal studies indicate that physical activity (PA) significantly declines from primary-to secondary school, and report both changes in individual and environmental determinants of PA. In order to understand this transition and to prevent this negative trend, it is important to gather contextually rich data on possible mechanisms that drive this decline. Therefore, the aim of this study was to investigate changes of PA patterns in transition between primary and secondary school, and to add domain-specific insights of how, where, and when these changes occur. Methods: In total, 175 children participated in a 7-day accelerometer- and Global Positioning System (GPS) protocol at their last year of primary and their first year of secondary school. GPS data-points were overlaid with Geographical Information Systems (GIS) data using ArcGIS 10.1 software. Based on the GPS locations of individual data-points, we identified child's PA at home, school, local sports grounds, shopping centers, and other locations. Also, trips in active and passive transport were identified according to previously validated GPS speed-algorithms. Longitudinal multi-level linear mixed models were fitted adjusting for age, gender, meteorological circumstances, and the nested structure of days within children and children within schools. Outcome measures were minutes spent in light PA and moderate-to-vigorous PA, specified for the time-segments before school, during school, after school and weekend days. Results: Total PA significantly declined from primary to secondary school. Although transport-related PA increased before- and during school, decreases were found for especially afterschool time spent at sports grounds and transport-related PA during weekends. Conclusions: This is the first study that demonstrated longitudinal changes of context- and domain-specific PA patterns in transition between primary and secondary school, based on device-assessed PA. Given the importance of this transition-period for the development of long-term PA patterns, results from this study warrant the development of evidence-based PA programs in this transition period, while acknowledging the integrative role of schools, parents, and afterschool sports providers. More specifically, the results underline the need to increase children's PA levels in primary schools, promote afterschool PA at secondary schools, and to prevent the drop-out in sports participation at secondary schools. [ABSTRACT FROM AUTHOR]

• Children were most active and less sedentary during weekdays in comparison with weekend days. • Children were highly sedentary and spent little of their time at school in moderate-to-vigorous physical activity (MVPA), especially girls. • The afterschool period constituted the greatest accumulation of (MVPA) for both boys and girls during the week. This finding highlights the need for appropriate school-based interventions that can increase activity levels whilst minimizing time being sedentary. • Routine breaks in school elicit increases in light physical activity and (MVPA). Future work should consider the use of more active breaks within school time to encourage physical activity and reduce sedentary time. This study examined the volume and patterns of physical activity (PA) and sedentary time (ST) across different segments of the week among boys and girls. A total of 188 children aged 7–12 years wore a wrist-mounted ActiGraph GT3X+ accelerometer for 7 days. Time spent in PA and ST was calculated using ActiLife software. The mean number of minutes of light PA, moderate PA, vigorous PA, moderate-to-vigorous PA (MVPA), and ST were calculated per weekday (before school, during school, and after school) and per weekend day (morning and afternoon–evening). After school represented the greatest accumulation of ST compared with before school and during school segments. Boys engaged in 225.4 min/day of ST (95% confidence interval (CI): 216–235), and girls engaged in 222.2 min/day of ST (95%CI: 213–231). During school, boys engaged in significantly more MVPA than girls (46.1 min/day (95%CI: 44–48) vs. 40.7 min/day (95%CI: 39–43)). Across the whole weekday, boys participated in significantly more MVPA than girls (103.9 min/day (95%CI: 99–109) vs. 95.7 min/day (95%CI: 90–101)). The weekend afternoon–evening segment represented the larger accumulation of ST, where boys were significantly more sedentary than girls (367.5 min/day (95%CI: 353–382) vs. 339.8 min/day (95%CI: 325–355), respectively). Our findings suggest that children are highly sedentary and spend little of their time in school in MVPA, especially girls. Routine breaks in school elicit increases in light PA and MVPA. Future work should consider the use of more active breaks within school time to encourage PA and reduce ST. [ABSTRACT FROM AUTHOR]

No study has investigated secular changes in both total steps and moderate-to-vigorous physical activity (MVPA) among Japanese children. This study examined the secular changes of total steps and MVPA among fourth-grade students in Japan in 2003/2004 and 2016/2017. It was performed at a school in Okayama Prefecture in Japan. A total of 452 participants (226 boys and 226 girls; mean age, 9.6 ± 0.5 years) participated in the study. We measured total steps and MVPA of the participants by using the same methods in 2003/2004 and 2016/2017. An uniaxial accelerometer was used to measure total steps and MVPA. On weekdays and weekends, the total steps and MVPA were lowered by approximately 1,000–3,000 steps/day and 10 min/day, respectively, in boys and by 1,000 steps/day and 5 min/day, respectively, in girls in 2016/2017 in comparison to 2003/2004. In both boys and girls, the percentage of children meeting 60 minutes/day of MVPA decreased in 2016/2017(weekdays: boys 21.8%, girls 6.0%; weekends: boys 3.8%, girls 4.1%) compared with 2003/2004 (weekdays: boys 48.2%, girls 11.6%; weekends: boys 7.8%, girls 7.6%). In conclusion, the results demonstrated that total steps and MVPA of fourth-grade students in Japan were lower in 2016/2017 than in 2003/2004. [ABSTRACT FROM AUTHOR]

Daily routines may influence children and adolescents’ eating patterns, however the influence of days of the week on dietary intake has rarely been explored. This study aimed to examine discretionary choices intake in the context of diet quality on weekdays versus weekends. A secondary analysis was conducted using the Australian National Nutrition and Physical Activity Survey 2011–2012. Differences in discretionary choices intake and diet quality on weekdays versus weekends, were examined using ANCOVA analyses. Associations between child and parent-proxy characteristics and weekday/weekend discretionary choices intake were examined using multivariable regression models. Primary analyses included 2584 Australian 2–17-year-olds. There were small differences in discretionary choices intake and diet quality between weekdays and weekends in all age subgroups. Compared to weekdays, intakes on weekends were characterized by a higher intake of discretionary choices, and lower total Dietary Guidelines Index for Children and Adolescents (DGI-CA) scores across the age subgroups (all p < 0.01). Parent-proxy discretionary choices intake and child age were predictors of weekday and weekend discretionary choices intake. Parent-proxy obesity weight status compared with healthy weight status was a predictor of weekend intake, while parent-proxy education level was a predictor of weekday discretionary choices intake. Future intervention strategies should target discretionary choices intake on both weekdays and weekends.

Background: Energy and dietary quality are known to differ between weekdays and weekends. Data-driven approaches that incorporate time, amount, and duration of dietary intake have previously been used to partition participants' daily weekday dietary intake time series into clusters representing weekday temporal dietary patterns (TDPs) linked to health indicators in United States adults. Yet, neither the relationship of weekend day TDPs to health indicators nor how the TDP membership may change from weekday to weekend is known., Objectives: This study was conducted to determine the association between TDPs on weekdays and weekend days and health indicators [diet quality, waist circumference (WC), body mass index (BMI), and obesity] and their overlap among participants., Methods: A weekday and weekend day 24-hour dietary recall of 9494 nonpregnant United States adults aged 20-65 years from the cross-sectional National Health and Nutrition Examination Survey 2007-2018 was used to determine the timing and amount of energy intake. Modified dynamic time warping and kernel k-means algorithm clustered participants into 4 TDPs on weekdays and weekend days. Multivariate regression models determined the associations between TDPs and health indicators, controlling for potential confounders and adjusting for the survey design and multiple comparisons. The percentages of overlap in cluster membership between TDPs on weekdays and weekend days were also determined., Results: United States adults with a TDP of evenly spaced, energy-balanced eating occasions, representing the TDP of more than one-third of all adults on weekdays and weekends, had significantly higher diet quality, lower BMI, WC, and odds of obesity when compared to those with other TDPs. Membership of most United States adults to TDPs varied from weekdays to weekends., Conclusions: Both weekday and weekend TDPs were significantly associated with health indicators. TDP membership of most United States adults was not consistent on weekdays and weekends., (Copyright © 2023 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Background: Cardiac arrests are a leading cause of mortality with survival of only 12%. In the United States, cardiac arrests were significantly more likely to occur on Saturdays. Hospitals experience a decrease in staffing on weekends. This study aims to assess the relationship between weekend vs weekday admission and outcomes of patients presenting with out of hospital cardiac arrests (OHCA) in the United States.Methods: This retrospective study utilized the 2014 US National Emergency Department Sample (NEDS) database. Patients who sustained out of hospital cardiac arrests were included using ICD-9-CM codes. Descriptive analysis was conducted, followed by bivariate analysis to compare the collected variables by admission day. Multivariate analysis was done to assess the impact of weekday vs weekend admission on survival of cardiac arrests patients after adjusting for confounders.Results: A total of 145,774 patients with cardiac arrest were included in this study. Mean age was 65.9 years with male predominance of 61.8%. Almost 71% of cardiac arrests took place on a weekday. As an overall outcome, only 5.7% patients survived to hospital discharge. After adjusting for significant confounders, patients presenting on weekends were less likely to survive compared to those admitted on weekdays (OR = 0.833, 95% CI: 0.727-0.954).Conclusion: In this study, patients with OHCA admitted to the ED on weekends had slightly lower survival compared to those admitted on weekdays. Modifiable factors should be identified in future studies to reduce outcome discrepancies and improve survival in this patient population. [ABSTRACT FROM AUTHOR]

Background: The quality of stroke care may diminish on weekends. Aims: We aimed to compare the quality of care and outcomes for patients with stroke/transient ischemic attack discharged on weekdays compared with those discharged on weekends. Methods: Data from the Australian Stroke Clinical Registry from January 2010 to December 2015 (n = 45 hospitals) were analyzed. Differences in processes of care by the timing of discharge are described. Multilevel regression and survival analyses (up to 180 days postevent) were undertaken. Results: Among 30,649 registrants, 2621 (8.6%) were discharged on weekends (55% male; median age 74 years). Compared to those discharged on weekdays, patients discharged on weekends were more often patients with a transient ischemic attack (weekend 35% vs. 19%; p < 0.001) but were less often treated in a stroke unit (69% vs. 81%; p < 0.001), prescribed antihypertensive medication at discharge (65% vs. 71%; p < 0.001) or received a care plan if discharged to the community (47% vs. 53%; p < 0.001). After accounting for patient characteristics and clustering by hospital, patients discharged on weekends had a 1 day shorter length of stay (coefficient = −1.31, 95% confidence interval [CI] = −1.52, −1.10), were less often discharged to inpatient rehabilitation (aOR = 0.39, 95% CI = 0.34, 0.44) and had a greater hazard of death within 180 days (hazard ratio = 1.22, 95% CI = 1.04, 1.42) than those discharged on weekdays. Conclusions: Patients with stroke/transient ischemic attack discharged on weekends were more likely to receive suboptimal care and have higher long-term mortality. High quality of stroke care should be consistent irrespective of the timing of hospital discharge. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of our study was to evaluate outcomes in patients who are admitted on weekend compared with those admitted on a weekday for acute gallstone pancreatitis. Methods We performed a 3-y (2010-2012) analysis of the Nationwide Inpatient Sample database. Patients with acute gallstone pancreatitis who underwent endoscopic retrograde cholangiopancreatography (ERCP) were included and were divided into two groups: admission on the weekend versus the weekday. Primary outcome measures were time to ERCP, adverse events, and mortality. Secondary outcome measures were hospital length of stay and total cost. Results A total of 5803 patients with acute gallstone pancreatitis who underwent ERCP were included in our study; of which 22.6% were admitted on the weekend, whereas 77.4% were admitted on a weekday. Mean age was 57 ± 18 y and 57.1% were female. Within 24 h, the rate of ERCP was higher in patients admitted on the weekday compared with those admitted on the weekend (40% versus 24%; P < 0.001). Similarly, by 48 h, the rate of ERCP was higher in the weekday group (69% versus 49%, P < 0.001). Patients admitted over the weekends had higher complications rate (P = 0.03), hospital length of stay (P < 0.001), and the total cost of hospitalization (P < 0.001) compared with the weekday group with no difference in in-hospital mortality. Conclusions Patients admitted on weekends for acute gallstone pancreatitis experience a delay in getting ERCP and have higher complications, prolonged hospital stay, and increased hospital costs compared with those admitted on weekdays. [ABSTRACT FROM AUTHOR]

Introduction: In spite of heterogeneous manifestation of traumatic brain injury (TBI), it is affected by multiple factors at the time of admission. This pilot study aims to detect the effect of admission time, day, and month with outcome at discharge, among patients with TBI. Materials and Methods: It is a prospective study conducted in the Department of Neurosurgery at Narayana Medical Health Hospital, Nellore. The head injury patient data were documented on a standard proforma. FileMaker Pro Advanced 13 was used for electronic data entry interface. The analysis was done using Stats Direct version 3.0.150. The variables in categories and continuous were evaluated with descriptive and frequencies, respectively. Results: In the study, 337 head injury patients were reported with 7.12% (n = 24) mortality. The hospital discharge outcome was significant with age, gender, severity of injury, and seasons. More number of patients were admitted during 9 pm to 7 am, but was not significant. During all the seasons of a year, there was significance with admittance of head injury patients in working days of a week and patients' undergoing intracranial surgery. Conclusion: The pilot study reports that the outcome at discharge of a head injury patient has significance with admission at week, day, and season.

Background: The "weekend" effect resulting in increased complication rates in patients admitted on weekends has been noted in many diseases., Objective: This systematic review and meta-analysis aimed to collate adjusted data from published studies to assess if admission on weekends as compared to weekdays increases mortality rates in hip fracture patients., Methods: Databases of PubMed, CENTRAL, Scopus, Web of Science, and Embase were searched up to 31 st December 2022 for studies comparing mortality between weekend versus weekday admission of hip fracture patients. Adjusted hazard ratios (HR) were pooled., Results: Fourteen studies including 1,487,986 patients were analyzed. Most studies were from Europe and North America. Results showed no difference in mortality rates of hip fracture patients admitted on weekends versus weekdays (HR: 1.00 95% 0.96, 1.04 I 2  = 75%). There was no publication bias and results did not change on the leave-one-out analysis. Subgroup analysis based on sample size and treatment did not change outcomes., Conclusion: This meta-analysis has shown no apparent weekend effect in cases of hip fractures. Patients admitted on weekends had similar mortality rates as compared to those admitted on weekdays. Current data has high heterogeneity and is mostly from developed countries., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Abstract: Rationale, aims, and objectives: A reduction in the provision of hospital services on the weekend probably explains higher mortality for patients who are either admitted to hospital or undergo procedures on the weekend. The aim was to examine the effect of the day of the week of admission (DOWOA) upon the efficiency and quality of care for a cohort of General Medical inpatients. Methods: Electronic records were selected for unplanned adult admissions to 2 large public hospitals in Adelaide, South Australia, July 2012 to June 2017. Results: The cohort consisted of 50 323 records. The number of admissions on each day of the week differed significantly from 6389 on Sundays to 7548 on Thursdays (P < 0.001). Discharges were most frequent on Fridays, and fewest occurred on weekends (P < 0.001) especially if aged over 80 years, if they had significant comorbidity or if they were discharged to a residential aged care facility. The DOWOA did not significantly influence the proportion of cases who died in hospital (5.6% to 6.4%; P = 0.47). The DOWOA significantly affected median inpatient length of stay (IPLOS; 3.1 to 3.9 days; P < 0.001). The median inpatient length of stay (IPLOS) matched the number of days from the ensuing weekend to the DOWOA with the longest median IPLOS. Conclusions: General Medicine has an inpatient mortality unaffected by the DOWOA. Care efficiency, however, follows a weekly cycle. The “weekend effect” for General Medical inpatients is a prolongation in their IPLOS as a result of fewer weekend discharges. [ABSTRACT FROM AUTHOR]

Introduction: Forecasting emergency department (ED) visits is a well-studied topic. The importance of understanding the complexity of patients along with the days and times of varying patient volumes is critical for planning medical and ancillary staffing. Though multiple studies stratify their results based on severity of disease, severity was determined by triage status. The goal of this study was to utilize a novel method to evaluate the correlation between daily emergency department patient complexity, based on Current Procedure Terminology (CPT) code, and day of the week.Methods: This was a retrospective study of subjects presenting to the ED between January 1, 2010 and December 31, 2015. We identified the correlation between subjects with each CPT code who were evaluated on a specific day of the week and evaluated the day before, the day of and the day after a legal holiday.Results: During the study period 312,550 (48%) male and 336,348 (52%) female subjects were identified. No correlation between daily ED patient complexity, based on CPT code, and day of the week (p=0.75) or any legal holidays were identified. Individual significant differences were noted among day of the week and particular CPT code as well as legal holiday and particular CPT code with no appreciable trend or pattern.Conclusions: There was no correlation between daily ED patient complexity based on CPT code and day of the week or daily ED patient acuity and legal holiday. In light of these data, emergency department staffing and resource allocation patterns may need to be revisited. [ABSTRACT FROM AUTHOR]

Background In-hospital care may be constrained during the weekend due to lesser resources. Impact on outcomes of weekend versus weekday care in congestive heart failure (HF) needs further study. Methods Admissions with a primary diagnosis of HF using ICD-9CM codes were studied. 22,287 HF-admissions from Einstein Medical Center (2003 − 2013) and 2,248,482 HF-admissions from the 2002–2012 Nationwide Inpatient Sample (NIS) were analyzed separately. Primary outcomes were 30-day HF-readmission and in-hospital mortality. Logistic regression models were used to evaluate outcomes. Results Weekends experienced lower rates of admission and discharge. Mondays experienced the highest admission rate and Fridays experienced the highest discharge rate. Friday was independently associated with highest 30-day HF-readmission rates (Adjusted OR 1.12, CI 1.01–1.23; p = 0.02) in addition to risk factors such as African-American race, hypertension, diabetes, hyperlipidemia, end-stage renal disease and coronary artery disease. Within the NIS sample, 85,479 in-hospital deaths (3.8%) were recorded. Compared to weekdays, patients admitted over the weekend had greater comorbidities, higher incidence of acute myocardial infarction (AMI) (15.8% vs. 16.8%; p < 0.01), higher Charlson-comorbidity index and underwent less procedures such as echocardiography, right heart catheterization, coronary angiography, coronary revascularization or mechanical circulatory support. Weekend HF admission predicted higher in-hospital mortality (aOR 1.07, 95%CI 1.05–1.08; p < 0.01) on multivariate analysis. This relationship was applicable for teaching and non-teaching hospitals. Conclusion Friday was associated with the highest discharge and 30-day HF-readmission rate. Weekend HF admissions experienced more AMI, had greater comorbidities, received less cardiac procedures and predicted higher in-hospital mortality. Higher weekend mortality may be related to the greater degree of severity of illness among admitted patients. [ABSTRACT FROM AUTHOR]