Previous research commonly emphasizes the positive effects of cross-functional integration on performance measures. However, cross-functional integration is a highly complex phenomenon which does not allow general conclusions in terms of performance impacts. Therefore, the present study assesses the impact of integrating the R&D, marketing, and manufacturing functions on the effectiveness and efficiency of new product development (NPD) projects. A multi-functional design is applied that considers three functions, including manufacturing, which has been often neglected in prior research on cross-functional integration. Further, the study distinguishes between two phases of the NPD process, namely the development and commercialization phases. In building the sample care was particularly taken to include a sufficient number of highly innovative NPD projects to cover the full range in terms of project innovativeness. This allows assessing the moderating role of project innovativeness on the effects of crossfunctional integration on NPD performance.A research model incorporating these ideas is theoretically developed and empirically validated by means of survey data. One hundred and eighteen NPD project managers participated in the survey (50 incremental and 68 radical innovation projects). Structural equation modeling was used to estimate the research model. More concretely, partial least squares (PLS) was used as the most accepted variance-based approach.Generally, the findings emphasize that the relationships between various facets of cross-functional integration and performance measures are highly complex. The integration between R&D and marketing positively impacts efficiency, but not effectiveness across different types of projects. Further, the impact of integration between marketing and R&D depends on the process stage and the degree of innovativeness. Findings regarding the integration between R&D and manufacturing show a strong positive impact on efficiency in the development phase. With respect to the integration between marketing and manufacturing, no significant effects on the performance dimensions can be observed for radical NPD projects. Overall, a positive impact of integration between these departments on effectiveness in the commercialization phase emerges.

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Background There is limited literature of venovenous extracorporeal membrane oxygenation use in a community, non-university, setting in the trauma population. Methods We reviewed our cases over 2 years from March 2018 to March 2020. This study was conducted in a community hospital with a General Surgery residency with no direct affiliation to a medical school. Primary outcome reviewed was survival to discharge. Secondary outcomes included duration of extracorporeal membranous oxygenation (ECMO) support, blood transfusion requirement, complications, and disposition. Results Five patients were cannulated during this time period. All patients survived to discharge. Mean time on ECMO was 153.4 h or 6.4 days (range 60–216 h). All patients required a transfusion while cannulated, with a mean of 10 units PRBC transfused (range 3–24). One patient required CPR, one required cessation of heparin drip for bleeding, and one had clinical signs of a stroke. Three patients were discharged to long-term acute care facilities and the other two to acute rehab. Conclusions Community level I trauma centers are capable of handling trauma patients requiring ECMO. It does require a multi-disciplinary team of surgical intensivists and cardiothoracic surgeons along with the support of nursing, respiratory therapists, and perfusionists. The outcomes in this limited series show that ECMO can be a tool utilized in the community setting.

Background Inferior vena cava thrombosis is cited to be a complication of inferior vena cava filter placement and post coronary artery bypass surgery. Often only mild symptoms arise from these thrombi; however, due to the chronic nature of some thrombi and the recanalization process, more serious complications can arise. Although anticoagulation remains the gold standard of treatment, some patients are unable to be anticoagulated. In this case, we present a 65-year-old male who underwent IVC filter placement and open-heart surgery who later developed extensive femoral and iliocaval thrombosis leading to right heart failure, which required thrombus extraction with an AngioVac suction device. Case presentation We present a 65-year-old male who presented with bilateral pulmonary emboli with extensive right lower extremity deep vein thrombosis. Upon investigation he had ischemic heart disease and underwent a five-vessel coronary artery bypass for which he had an IVC filter placed preoperatively. On post operative day 3 to 4, he was decompensated and was diagnosed with an IVC thrombus. He progressed to right heart failure and worsening cardiogenic shock despite therapeutic anticoagulation and was taken for a suction thrombectomy using the AngioVac (AngioDynamics, Latham, NY) aspiration thrombectomy device. The thrombectomy was successful and he was able to recover and was discharged from the hospital. Conclusion Despite being a rare complication, IVC thrombosis can have detrimental effects. This case is an example of how IVC thrombus in the post-operative setting can lead to mortality. The gold standard is therapeutic anticoagulation but despite that, this patient continued to have worsening cardiogenic shock. Other therapies have been described but because of its rarity, they are only described in case reports. This case shows that the AngioVac device is a successful treatment option for IVC thrombus and can have the possibility of future use.