Planning and performance in teams: A Bayesian meta-analytic structural equation modeling approach.

We meta-analyzed the relationship between team planning and performance moderated by task, team, context, and methodological factors. For testing our hypothesized model, we used a meta-analytic structural equation modeling approach. Based on K = 33 independent samples (N = 1,885 teams), a mixed-effects model indicated a non-zero moderate positive effect size (ρ = .31, 95% CI [.20, .42]). Methodological quality, generally rated as adequate, was unrelated to effect size. Sensitivity analyses suggest that effect sizes were robust to exclusion of any individual study and publication bias. The statistical power of the studies was generally low and significantly moderated the relationship, with a large positive relationship for studies with high-powered (k = 42, ρ = .40, 95% CI [.27, .54]) and a smaller, significant relationship for low-powered studies (k = 54, ρ = .16, 95% CI [.01, .30]). The effect size was robust and generally not qualified by a large number of moderators, but was more pronounced for less interdependent tasks, less specialized team members, and assessment of quality rather than quantity of planning. Latent class analysis revealed no qualitatively different subgroups within populations. We recommend large-scale collaboration to overcome several methodological weaknesses of the current literature, which is severely underpowered, potentially biased by self-reporting data, and lacks long-term follow-ups.

Longitudinal Effects of a sit-stand desk intervention - persistence, Fade-Out, and psychological momentum: a Randomized Controlled Trial.

BACKGROUND: This study examined whether the effects of a sit-stand desk (SSD) intervention on employees' musculoskeletal complaints (i.e., intensity and prevalence) and activation (i.e., vigilance and vitality) persist or fade out and whether velocity and acceleration of health improvements can predict medium-term (six-month) and long-term (24-month) improvements. Drawing from dynamic models of self-regulation, as well as the psychological momentum theory, we hypothesized that velocity and acceleration of health improvements in the early stages of the intervention would predict medium-term health improvements, which sustain long-term. METHODS: We used data from a six-month seven-wave randomized controlled trial with employees in mostly sedentary occupations and supplemented this by follow-up data from the same participants 18 months later, resulting in eight waves. RESULTS: Bayesian structural equational modeling revealed no significant intervention effect after 24 months implying a fade-out. But more importantly, velocity and, partially, acceleration of health improvements at earlier stages predicted medium-term improvements in musculoskeletal complaints and long-term improvements in vigilance. CONCLUSION: The findings of this study suggest that positive intervention effects fade out over time and health effects benefit from prompt progresses at the beginning of the intervention, warranting exploration in prolonged longitudinal studies.

Fate of Asymptomatic Limb after Kissing Stents in Aortoiliac Occlusive Disease.

Purpose: Kissing stent angioplasty is an established endovascular treatment strategy for stenosis at the aortic bifurcation but not without its detractors. This study aimed to analyze the outcomes of kissing stents with regard to stent occlusion and complications in which an asymptomatic limb was treated. Materials and Methods: A total of 106 patients undergoing aortic bifurcation intervention from January 2015 to November 2020 were retrospectively reviewed. Only patients with at least one common iliac artery (CIA) ostium and undergoing bilateral CIA intervention were included in the study. Results: Patients were followed up for a median period of 26 months (interquartile range, 21-51 months). The TransAtlantic InterSociety Consensus (TASC)-II classification of lesions was as follows: A, 49%; B, 41%; C, 6%; and D, 5%. The treatment indication was limited to one side in 53% of patients. Technical and procedural success rates were 99% and 90%, respectively. Ischemic events in an asymptomatic limb occurred in 6% of cases, 3% due to late stent thrombosis >30 days, and 3% due to progression of downstream infrainguinal disease. Primary and secondary patency rates at 1, 3, and 5 years were 98%, 87%, and 85%, and 99%, 94%, and 94%, respectively. Periprocedural mortality developed in two patients with no amputation. Conclusion: Kissing stent deployment is a safe and effective strategy for the treatment of aortoiliac bifurcation disease. Unfavorable outcomes due to stenting in the asymptomatic iliac artery are very rare. Long-term surveillance is necessary due to the risk of late thrombosis or downstream disease progression.

Litigation claims relating to venous thromboembolism in the NHS.

AIM: Litigation costs for clinical negligence in the management of venous thromboembolism have escalated in the last five years. The National Health Service Litigation Authority estimates these claims have cost in excess of £112 million. Our aim is to identify the areas of practice where these claims are most likely to arise to help improve patient outcome. METHODS: The National Health Service Litigation Authority provided de-identified data on individual medical negligence claims against the NHS since 2007. We subcategorised the data into (a) the nature of the venous thromboembolism event, (b) the area of specialist practice and (c) the damages incurred. Inter-group differences were evaluated using ANOVA, Kruskal-Wallis test and Mann-Whitney U Test. RESULTS: Failure to prevent and to diagnose pulmonary emboli and deep vein thrombosis occurs across the spectrum of clinical specialties. In the study period 189 claims were made. The majority of claims were in surgical specialties and the financial burden was significantly greater than in the medical specialities (£3,257,394 vs. £1,532,996). The amounts paid out by specialty was not significantly different but had significant variance (p < 0.0001). CONCLUSIONS: The National Institute of Clinical Excellence provides comprehensive guidelines on venous thromboembolism risk assessment. Poor compliance has contributed to morbidity and mortality while the cost has continued to escalate. A multimodal approach to education is needed to improve patient outcome. Improved venous thromboembolism prevalence data are also needed.

Multiple mycotic aneurysms infected with Haemophilus influenzae.

Mycotic aneurysms are a relatively uncommon phenomenon that can pose a distinct treatment dilemma for the treating surgeon. It is rare to find Haemophilus influenzae as the causative organism, and it is even more rare to find multiple aneurysms in the same patient. We present the first case to our knowledge to be described in the literature of multiple mycotic aneurysms caused by H. influenzae. The treatment presented-using high-dose antibiotics and cryopreserved homografts-has worked well in this instance. This approach is supported in the literature.

A prospective comparison of bilateral photoplethysmography versus the ankle-brachial pressure index for detecting and quantifying lower limb peripheral arterial disease.

OBJECTIVE: This study prospectively assessed the diagnostic accuracy of a novel bilateral photoplethysmography toe pulse measurement technique for the detection of significant lower limb peripheral arterial disease. METHOD: Bilateral photoplethysmography toe pulse measurements were compared with the ankle-brachial pressure index (ABPI) gold standard reference. Pulse wave analysis techniques extracted timing, amplitude, and shape characteristics for the great toes and their right-to-left side differences. These characteristics were compared with previously obtained normative ranges, and the accuracy was assessed for all significant disease (ABPI <0.9) and higher-grade disease (ABPI <0.5). Measurements were collected in a controlled environment within a tertiary vascular surgical unit for 111 subjects (age range, 42-91 years), of whom 48 had significant lower limb peripheral arterial disease and 63 were healthy. Subjects were matched in age, sex, height, body mass index, and heart rate. Diagnostic performance was assessed using diagnostic sensitivity, specificity, accuracy, negative-predictive and positive-predictive value, and the kappa statistic representing agreement between techniques beyond chance. RESULTS: The degree that pulse shape fell beyond the normal range of normalized pulse shapes was at the threshold of substantial to almost perfect agreement compared with ABPI for significant disease detection (diagnostic accuracy, 91% [kappa = 0.80]; sensitivity, 93%; specificity, 89%), and with 90% accuracy (kappa = 0.65) for higher-grade disease detection. Pulse transit time differences between right and left toes also had substantial agreement with ABPI, with diagnostic accuracy of 86% for significant disease detection (pulse transit time to pulse foot [kappa = 0.71] and to pulse peak [kappa = 0.70]) and reached at least 90% for these for the higher-grade disease. The performance ranking for the different pulse features mirrored an earlier pilot study. With the shape and pulse transit time measurements, the negative-predictive values of the 5% disease population screening-prevalence level were at least 99% and had positive-predictive values of at least 98% for the 90% disease-prevalence level for vascular laboratory referrals. CONCLUSION: This simple-to-use technique could offer significant benefits for the diagnosis of peripheral arterial disease in settings such as primary care where noninvasive, accurate, and diagnostic techniques not requiring specialist training are desirable. Improved diagnosis and screening for peripheral arterial disease has the potential to allow identification and risk factor management for this high-risk group.