Teamwork has been recognized as a potentially important organizational factor associated with nurse- and patient-related outcomes. Previous studies have been conducted to examine the association between nurses' perceptions of teamwork and various outcomes in hospital settings. However, no systematic review has yet summarized this evidence. Therefore, this study aimed to summarize the available evidence on the association between nurses' perceptions of teamwork and nurse and patient outcomes in hospital settings.

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted using the keywords "teamwork," "group work," and "nurse," along with their synonyms, across PubMed, Scopus, Web of Science, CINAHL, and the Google Scholar search engine. The quality of selected studies was assessed using the Critical Appraisal Skills Programme (CASP) checklists. The narrative synthesis method was used to summarize and classify the results.

A total of 33 studies met the inclusion criteria for this systematic review. The analysis identified two overarching themes: nurse-related outcomes and patient outcomes. Twenty-two studies (66.7%) reported that nurses' positive attitudes toward teamwork were associated with more favorable levels in 17 nurse outcomes, which were categorized into four groups: (1) job attitudes and retention; (2) patient safety attitudes and competency; (3) occupational stress, fatigue, and conflict; and (4) ethical values and moral practice. Additionally, fourteen studies (42.4%) reported that such attitudes were linked to more favorable patient-related outcomes, categorized as (1) nursing care processes; (2) adverse events reporting and occurrence; (3) quality and safety of care; and (4) patient-centered and caring behaviors.

Teamwork may be considered an important factor associated with more favorable nurse and patient outcomes. To promote collaboration, hospital administrators and nursing educators may consider implementing strategies to support teamwork within clinical settings. Nevertheless, further research employing longitudinal and interventional designs is necessary to clarify causal pathways and better understand the relationship between teamwork and these outcomes.

In many rural regions of developing countries, increasing market access is reshaping local food systems. Traditional diets rooted in local agriculture are being replaced by market-driven alternatives. It is suspected that this dietary transition will contribute to rising risks of non-communicable diseases through increased chronic inflammation. This study, conducted in northern Lao People's Democratic Republic, investigated the association between dietary transition and concentrations of C-reactive protein (CRP) as a biomarker of chronic inflammation in three villages with varying levels of market exposure.

Data were collected from 380 adults in three villages with different degrees of market integration. Questionnaires recorded individual characteristics and weekly intake frequency of 28 food groups. Dried blood spots were analyzed for CRP using enzyme-linked immunosorbent assay. Dietary patterns were identified using principal component analysis, and scores were compared among villages. Associations between dietary patterns and CRP were examined using multivariable logistic regression. To account for seasonality, analyses were conducted within same-season subgroups: rainy (Na Lae, Na Savang) and dry (Na Savang, Nam Nyon).

CRP concentrations were higher in villages with a higher degree of market integration. A dietary pattern was identified, characterized by high consumption of foraged wild plants and a low intake of market-related foods. This pattern was negatively associated with elevated CRP in the dry season subsample.

Higher CRP concentrations were found in residents of villages with a higher degree of market integration. This trend may partly be explained by a dietary transition from a foraging-based to a market-dependent diet.

Left ventricular structural assessment is fundamental in heart failure (HF). However, the independent prognostic value of left ventricular size beyond its association with ejection fraction remains poorly defined in real-world, large-scale populations.

To investigate the association between left ventricular dimension and mortality risk within a large, nationwide cohort with HF.

This was a nationwide cohort study using data from the Chinese Cardiovascular Association Database-Heart Failure Center Registry. Patients were enrolled from January 1, 2018, to May 31, 2022. The multicenter study involved 723 centers across 31 provincial-level administrative regions in mainland China. The study included patients hospitalized with HF. Patients were categorized into groups with a small, normal, or large left ventricle (LV) according to American Society of Echocardiography criteria for LV end-diastolic diameter (LVEDD). Data analysis was conducted from March to June 2025.

LVEDD measured by echocardiography.

The primary and secondary end points were all-cause mortality and cardiovascular mortality, respectively.

A total of 273 921 patients (median [IQR] age, 71.0 [62.0-79.0] years; 161 589 male [59.0%]) hospitalized with HF were included in this study. A significant U-shaped association was found between LVEDD and both all-cause and cardiovascular mortality (P for nonlinearity <.001). Both a small LV (adjusted HR [aHR], 1.32; 95% CI, 1.28-1.37; P < .001) and a large LV (aHR, 1.38; 95% CI, 1.35-1.40; P < .001) were independently associated with elevated all-cause mortality. Sex-specific optimal LVEDD thresholds were identified (47 mm for male patients, 43 mm for female patients), with each 1-mm deviation associated with a significant increase in mortality risk. These findings were consistent across prespecified subgroups and were further corroborated by analysis of LVEDD indexed to body surface area and by extensive sensitivity analyses, including competing risk models and complete-case analyses.

This large-scale study established that a U-shaped association exists between LVEDD and mortality in HF, suggesting that both abnormally small and abnormally large ventricles signify high risk, likely through distinct mechanisms. These findings support the integration of LV size assessment into routine risk stratification to guide personalized management.

Poor adherence to oral antipsychotics is an important challenge in schizophrenia, highlighting long-acting injectables (LAIs) as an alternative. This study aimed to compare the clinical and demographic profiles of patients with schizophrenia with prior LAI exposure versus those maintained exclusively on oral antipsychotics.

This cross-sectional, observational study enrolled eligible schizophrenia inpatients aged 18-65 diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition criteria from June 2022 to October 2023. Participants were divided into two groups: those with prior LAI exposure and those who had maintained only oral antipsychotics. Demographic data, clinical history, and baseline laboratory parameters were collected. The primary outcome was the severity of psychotic symptoms, assessed using the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression Severity (CGI-S) Scale upon admission.

A total of 70 patients were included in the final analysis, with 36 patients having a history of LAI and 34 on only oral treatment. Demographically, both groups were comparable across most characteristics. Baseline PANSS score and its subscales, CGI-S scores, and laboratory markers showed no statistical difference. However, the LAI group showed a significantly longer duration of illness (P = 0.017), more hospitalizations (P < 0.001), and greater prior exposure to first-generation antipsychotics (P < 0.001) with higher chlorpromazine equivalent doses (P < 0.001) compared to the oral-only group.

This study highlights treatment patterns among Iranian schizophrenia patients, showing that patients on LAIs generally have a history of longer illness durations, more hospitalizations, and more expose to first generation antipsychotics. Further studies should be conducted to investigate the efficacy of early versus delayed initiation of LAI and their long-term outcomes.

People living with HIV (PLWH) face an increased risk of developing comorbidities involving HIV and non-communicable diseases (NCDs) caused by a mix of modifiable and non-modifiable risk factors. This study aimed to quantify the burden of NCD-HIV comorbidities and examine their determinants among HIV-positive adults aged ≥15 years using data from the 2022-2023 Tanzania HIV Impact Survey (THIS).

The 2022-2023 THIS enrolled 33 663 individuals who underwent HIV testing, of whom 1850 tested positive. Key variables, including socioeconomic, demographic and behavioural risk factors and clinical characteristics, were extracted from the main survey database. These variables were modelled as potential determinants of HIV-NCD comorbidities. HIV-NCD comorbidity was defined as being HIV-positive and having at least one non-communicable disease. χ² tests and logistic regression analyses were performed to identify the determinants of HIV-NCD comorbidity.

Among the 1850 PLWH included in the analysis, 70.2% were female, 63.0% resided in rural areas and 70.0% had attained primary education. Hypertension was the most prevalent chronic condition (3.3%), followed by lung disease (1.1%), cancer/tumour (1.0%) and heart disease (1.0%), respectively. The overall prevalence of HIV-NCD comorbidity was 6.7% (95% CI 5.4% to 8.3%). Female participants had significantly higher odds of HIV-NCD comorbidity (adjusted OR (aOR)=1.9; 95% CI 1.2 to 3.1; p=0.010). Age was also strongly linked to comorbidity, with individuals aged 45-54 years (aOR=9.4; 95% CI 2.7 to 33.4; p=0.001) and those aged ≥55 years (aOR=16.1; 95% CI 4.4 to 58.3; p<0.001) showing higher odds than those aged 15-24 years.

HIV-NCD comorbidities are common among PLWH. Female sex and older age significantly increase the risk, emphasising the importance of tailored interventions for prevention, early detection and integrated care strategies.

Some atopic dermatitis (AD) treatments have been linked to an increased risk of herpes zoster (HZ). Limited evidence suggests an independent association between atopic dermatitis and herpes zoster. The study aimed to investigate the association between atopic dermatitis and herpes zoster in the UK and to explore the role of treatments in this relationship.

We conducted a matched cohort study using routinely collected primary care data from the UK Clinical Practice Research Datalink (CPRD) Aurum database (1997-2023) and applied Cox regression models. Age, behavioral factors, several comorbid diseases and different treatment exposures were included as covariates.

Individuals with atopic dermatitis had an adjusted hazard ratio of 1.28 (95% CI: 1.27-1.29) for HZ. Adjustments for different definitions of oral corticosteroid exposure as well as other traditional immunosuppressants led to minimal reductions in the association. The risk of herpes zoster increased with AD severity (aHR for mild AD: 1.22 [95% CI: 1.20-1.23]; aHR for moderate AD: 1.28 [95% CI: 1.27-1.30]; aHR for severe AD: 2.33 [95% CI: 2.22-2.45]).

The risk of HZ is increased in individuals with atopic dermatitis, independent of comorbidities and the use of oral corticosteroids or immunosuppressants. This elevated baseline risk is particularly relevant because herpes zoster is also a known adverse effect of newer therapies such as Janus kinase (JAK) inhibitors. These findings may inform vaccination guidelines.

Obesity is a major risk factor for metabolic dysfunction and cognitive decline, yet the influence of age of onset and sex on neurovascular outcomes remains unclear. We examined how the age at initiation and duration of diet-induced obesity influence metabolism, cognition, and cerebrovascular perfusion in male and female mice. A high-fat diet increased body weight and impaired glucose regulation, particularly in females. Obesity selectively impaired recognition memory while sparing spatial working memory. Cerebrovascular effects were region- and age-specific. Early- and mid-life obesity produced localized perfusion changes despite preserved global cortical blood flow. In contrast, early-life obesity was associated with reduced cortical perfusion and decreased hippocampal vascular complexity, including fewer branch points and smaller vessel diameters. These alterations parallel recognition memory deficits, suggesting a vascular mechanism linking early metabolic stress to cognitive impairment. Together, our findings identify early-life obesity as a critical window of vulnerability for long-term neurovascular and cognitive dysfunction.

Background Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition defined by sustained elevated blood glucose and impaired insulin action, conditions that frequently give rise to diabetic dyslipidemia. This lipid disorder encompasses dangerous alterations in blood fat levels, most notably elevated triglycerides and depressed high-density lipoprotein (HDL) cholesterol, which together substantially heighten cardiovascular disease risk. Since abdominal adiposity amplifies these metabolic disturbances, structured lifestyle changes, especially exercise, are considered essential pillars of clinical management. The present investigation was designed to assess the effects of a 12-week hybrid exercise protocol combining aerobic and resistance modalities on obesity-related indices and health-related quality of life (HRQoL) in individuals with T2DM-associated dyslipidemia. Objective The study's objective is to determine the effectiveness of a 12-week hybrid exercise protocol on obesity indices and HRQoL in diabetic dyslipidemia. Study design and methodology This randomized controlled trial was conducted over one year at Krishna College of Physiotherapy. Fifty-seven participants aged 45-60 years with T2DM-associated dyslipidemia and BMI >25 kg/m² were randomly allocated to a control group (n = 28) or an experimental group (n = 29). Outcomes included body weight, BMI, waist and hip circumference, waist-to-hip (WHR) ratio, suprailiac skinfold thickness, and Centers for Disease Control and Prevention (CDC) HRQoL-4 scores. Assessments were performed at baseline and after 12 weeks. The control group continued routine activities and walking, while the experimental group underwent a 12-week hybrid exercise protocol comprising aerobic, resistance, and flexibility exercises. Results and comparative analysis Pre-intervention assessments confirmed that both groups were broadly equivalent at baseline, though the experimental cohort displayed comparatively higher central adiposity and lower HRQoL scores. After completing the 12-week program, participants in the experimental group demonstrated statistically significant reductions across all obesity-related measures, including BMI (p < 0.0001), waist circumference (p < 0.0001), and WHR (p < 0.0001). Marked improvements were also recorded across all HRQoL domains, with notable declines in activity-limiting days and total unhealthy days (p < 0.0001 for most outcomes). Between-group comparisons validated that the hybrid exercise protocol yielded substantially greater benefits than standard management in both body composition and perceived quality of life. Conclusion These results establish that a 12-week hybrid exercise protocol is highly effective in improving metabolic parameters, decreasing central fat deposition, and promoting psychological well-being in patients with diabetic dyslipidemia. The observed benefits are likely attributable to the complementary mechanisms of aerobic exercise, which enhances fat oxidation, and resistance training, which preserves lean muscle and elevates metabolic efficiency. Future investigations should incorporate larger, multi-site cohorts and more comprehensive inflammatory biomarkers to evaluate whether these gains are sustained over the long term.

Bloom syndrome is a rare autosomal recessive disorder caused by pathogenic variants in the BLM gene and is characterized by early-onset malignancy, growth deficiency, metabolic abnormalities, and cutaneous findings. We report the case of a 33-year-old woman with bilateral early-onset breast cancer, lipodystrophy, severe hypertriglyceridemia complicated by pancreatitis, and type 2 diabetes mellitus. Initial targeted genetic testing did not identify a causative variant. Comprehensive multigene testing subsequently revealed a homozygous likely pathogenic splice-site variant in BLM (c.98+1G>T), establishing the diagnosis of Bloom syndrome. This case expands the clinical and genetic spectrum of Bloom syndrome and illustrates that targeted cancer gene panels can fail to detect syndromic cancer predisposition disorders, leading to diagnostic delay. Expanded genetic testing should be considered early in patients with multiple primary malignancies accompanied by suggestive syndromic features, as timely diagnosis enables syndrome-adapted management, tumor surveillance, and family counseling.

Background Atypical endometrial hyperplasia (AEH) is a premalignant lesion of the endometrium with a substantial risk of coexisting endometrial carcinoma (EC). Identification of concurrent carcinomas is important for appropriate surgical planning and patient management. This study evaluated the prevalence of concurrent EC in patients diagnosed with AEH and investigated associated clinicopathological risk factors. Methodology This retrospective observational study included 260 women with a histopathological diagnosis of AEH based on preoperative endometrial sampling, who subsequently underwent hysterectomy between January 2020 and December 2024. Demographic, clinical, radiological, and pathological data were retrieved from medical records. Continuous variables were compared using the independent-samples t-test, whereas categorical variables were analyzed using the chi-squared test. Binary logistic regression analysis was performed to identify independent predictors of concurrent EC. Results The mean age of the study population was 52.4 ± 9.8 years, and the mean body mass index (BMI) was 28.6 ± 5.4 kg/m². Concurrent EC was identified in 98 of the 260 patients, with a prevalence of 37.7%. Patients with concurrent EC were significantly older (56.3 ± 9.6 vs. 50.1 ± 9.3 years; p < 0.001), had higher BMI (30.7 ± 5.4 vs. 27.4 ± 5.1 kg/m²; p < 0.001), and greater endometrial thickness (17.1 ± 6.1 vs. 12.6 ± 4.9 mm; p < 0.001) than those without carcinoma. Postmenopausal status (p = 0.041), diabetes mellitus (p = 0.010), obesity (p = 0.002), abnormal uterine bleeding (p = 0.025), and endometrial thickness ≥15 mm (p < 0.001) were significantly associated with concurrent EC. Endometrioid adenocarcinoma was the predominant subtype, with most tumors classified as grade 1 and International Federation of Gynecology and Obstetrics (FIGO) stage IA. Multivariate analysis identified increasing age (adjusted odds ratio (aOR) = 1.05; p = 0.007), obesity (aOR = 1.94; p=0.027), and endometrial thickness ≥15 mm (aOR = 4.12; p < 0.001) as independent predictors of concurrent carcinoma. Conclusions More than one-third of patients with AEH harbored concurrent EC during hysterectomy. Advanced age, obesity, and increased endometrial thickness are significant independent predictors of occult malignancy and may aid in preoperative risk stratification and clinical decision-making.