Successful Transfer Research Articles

Comparative assessment of a COVID-19 vaccine after technology transfer to Iran from critical quality attributes to clinical and immunogenicity aspects

During COVID-19 pandemic, international pharmaceutical companies put effort to build global manufacturing networks for vaccines. Soberana Plus vaccine, a recombinant protein based vaccine (RBD dimer), with the trade name of PastoCovac Plus in Iran, is based on a protein subunit platform in Cuba and completed preclinical and toxicological assessments. This study aimed at presenting the steps of vaccine technology transfer from Cuba to Iran. This study provides the first practical comparability results in Iran to ensure the quality, safety and efficacy of a protein subunit vaccine against COVID-19 after a successful technology transfer from Cuba. PastoCovac Plus was transferred to Iran at the formulation stage. The assessment of the active ingredient pharmaceutical (API) was achieved through physicochemical and clinical data collection and tests to assure if there was any adverse impact on the vaccination results. In order to assess the quality of the vaccine product after technology transfer, we sought different properties including regulatory features, physicochemical quality, vaccine potency and stability as well as its immunogenicity and safety. Following the evaluation of the clinical quality attributes (CQAs) based on the standard protocols, the results showed that the two vaccines are highly similar and comparable, with no considerable effect on safety or efficacy profiles. The CQAs were all in the acceptance limits in terms of safety and efficacy as well as clinical evaluation results. The immunogenicity evaluation also confirmed no significant differences between the vaccines regarding reinfection (P = 0.199) or vaccine breakthrough (P = 0.176). Furthermore, the level of anti-spike and neutralizing antibodies in the both vaccine groups was not significantly different indicating the equality of performance between the two vaccines. According to the results of the quality and clinical assessment of this study, we achieved an acceptable quality attributes and acceptant limits in terms of safety and efficacy of the vaccines pre and post technology transfer.

Robust evaluation of big data-driven winter weather traffic models using six weigh-in-motion sites as testbeds in Alberta's highway network

ABSTRACT This study assesses the temporal transferability of winter traffic models using dummy variable regression at six Weigh-in-Motion (WIM) sites on Alberta's highway network. Models for two vehicle classes were developed using five years of traffic and weather data. To evaluate transferability, an additional year of data was collected, and two model structures—dummy variable and naive—were tested. The models’ estimation accuracy was measured using R² and five error metrics. Results indicate successful transferability of the models to a different year, with performance varying by road function and vehicle class. The study highlights that different model types might be needed for each vehicle class to ensure high temporal transferability. Additionally, the quality of the test data is crucial for obtaining reliable transfer results. This research addressed gaps in previous studies by collectively testing the temporal transferability of winter traffic models across an entire highway network.

A universal resist-assisted metal transfer method for 2D semiconductor contacts

Abstract With the explosive exploration of two-dimensional (2D) semiconductors for device applications, ensuring effective electrical contacts has become critical for optimizing device performance. Here, we demonstrate a universal resist-assisted metal transfer method for creating nearly free-standing metal electrodes on the SiO2/Si substrate, which can be easily transferred onto 2D semiconductors to form van der Waals (vdW) contacts. In this method, polymethyl methacrylate (PMMA) serves both as an electron resist for electrode patterning and as a sacrificial layer. Contacted with our transferred electrodes, MoS₂ exhibits tunable Schottky barrier heights and a transition from n-type dominated to ambipolar conduction with increasing metal work functions, while InSe shows pronounced ambipolarity. Additionally, using α-In2Se3 as an example, we demonstrate that our transferred electrodes enhance resistance switching in ferroelectric memristors. Finally, the universality of our method is evidenced by the successful transfer of various metals with different adhesion forces and complex patterns.

Dry Transfer of van der Waals Junctions of Two-Dimensional Materials onto Patterned Substrates Using Plasticized Poly(vinyl chloride)/Kamaboko-Shaped Polydimethylsiloxane.

Two-dimensional (2D) materials can be transferred onto substrates with various surface structures, opening up multiple functions and applications for 2D materials in the form of suspended membranes. In this paper, we present a method for transferring exfoliated 2D crystal flakes from SiO2 substrates onto patterned substrates using a poly(vinyl chloride) (PVC) layer mounted on a polydimethylsiloxane (PDMS) stamp structure. 2D crystal flakes can be transferred onto various patterned structures such as grooves, round holes, and periodic hole or groove patterns. Our method can also be used to fabricate suspended van der Waals (vdW) heterostructures by assembling 2D crystal flakes on the PVC/PDMS stamp and then transferring them onto patterned substrates. The adhesiveness and curvature of the PVC/PDMS stamp were tuned, and a high successful transfer rate was realized due to the use of kamaboko-shaped (semicylindrical) PDMS and the addition of an appropriate amount of a high-viscosity plasticizer to the PVC layer. Taking advantage of this method, we demonstrate the facile fabrication, simply by transferring a vdW heterostructure onto an Au-coated groove substrate, of a suspended vdW field-effect transistor device with the carrier density tuned using ionic gating. This method enables the transfer of 2D crystal flakes and vdW heterostructures onto various patterned substrates, and hence it should help to advance suspended 2D materials research.

Cottontail Rabbit Papillomavirus (CRPV) Related Animal Models for Head and Neck Cancer Research: A Comprehensive Review of the Literature

Having suitable animal models is crucial to mimic human disease states and for the successful transfer of experimental data into clinical practice. In the field of papillomavirus research, the domestic rabbit (Oryctolagus cuniculus) has served as an indispensable model organism for almost 100 years. The identification and characterization of the first papillomaviruses in rabbits, their carcinogenic potential and their immunogenicity have contributed significantly to the state of knowledge on the genetics and life cycle of papillomaviruses in general, as well as the development of antiviral strategies such as vaccination procedures. Due to the high species specificity of papillomaviruses, only rabbit papillomaviruses (RPVs) can be used for animal studies on papilloma-based tumor diseases in the rabbit. The major focus of this article is on cottontail rabbit papillomavirus (CRPV)-related rabbit squamous cell carcinoma (RSCC). A brief history outlines the discovery and generation of experimentally used RSCC tumors. A comprehensive overview of the current CRPV-associated VX2 carcinoma-based tumor models with a major focus on human head and neck squamous cell carcinoma (HNSCC) tumor models is provided, and their strengths in terms of transferability to human HNSCC are discussed.

Trans-spectral transfer of spatio-temporal optical Ferris wheel with nonlinear wave mixing

The trans-spectral manipulation of spatio-temporal structured light, characterized by dynamic inhomogeneous trajectories and a unique nature in the space–time domain, opens myriad possibilities for high-dimensional optical communication in the ultraviolet band. Here, we experimentally demonstrate the high-performance transfer of the spatio-temporal optical Ferris wheel beam from near-infrared to blue–violet wavelengths. Owing to the energy conservation and momentum conservation mechanism, the 420 nm output signal beam accurately retains the spatio-temporal characteristics of the 776 nm input probe optical Ferris wheel beam, facilitated by the 780 nm Gaussian pump beam. The identical multi-petal intensity profiles confirm the successful transfer of spatial characteristics from the input probe to the output signal beams. The fully synchronized rotation velocities and directions of the probe and signal beams demonstrate the precise transfer of temporal characteristics, achieving approximately 98% conversion accuracy. This work enables efficient information transfer across different wavelength bands and offers a promising approach for achieving high-dimensional quantum communication.

Mitigating not-invented-here syndrome in consultant knowledge transfer by developing appropriate implementation guidelines

Purpose This study aims to propose a framework for the development of implementation guidelines (IGs) that can help consultants mitigate not-invented-here (NIH) syndrome during a consultant intervention as a specific type of knowledge transfer. Design/methodology/approach The authors adopted a design science research approach for proposing an NIH-mitigating IG development framework. Inspired by findings and rich primary data from two consultant interventions, the authors, through theory building, ground five core principles in the general theory of NIH attitude functions. Finally, the authors revisit two consultant interventions to identify and describe mechanisms that led to the enactment of the principles. Findings The proposed framework provides five principles for developing NIH-mitigating IGs. The present research proposes that successful knowledge transfer and the mitigation of NIH syndrome as a prerequisite for this success are conditioned by adequately developed IGs. Originality/value The originality and value of the present research lie in the proposed NIH-mitigating IG development framework containing a set of principles for IG development as a proactive rather than reactive approach to NIH mitigation. To the best of the authors’ knowledge, this is the first research to address the problematics of mitigating NIH syndrome in consultant knowledge transfer by focusing on developing appropriate IGs. By developing and implementing IGs based on the proposed framework, a more successful transfer of knowledge from consultants to clients should take place, thus, increasing the value that clients receive from consultancy.

Transferability of vaccination interventions from a community perspective: One size does not fit all

Abstract Background Removing health system barriers to childhood vaccination is an urgent matter in the migrant community in Greece, the Turkish and Moroccan communities in the Netherlands, the Ukrainian minority in Poland, and the marginalized Roma community in Slovakia. The objective of this study was to select and adapt potentially transferable evidence-based interventions for HPV and MMR vaccine uptake in partnership with the underserved communities. Methods Using a participatory approach, we assessed transferability of six pre-selected interventions with the Population, Intervention, Environment and Transfer (PIET-T) models: All countries investigated two interventions with trained community members to support vaccination as health promoters. Greece and the Netherlands included a school-based vaccination program. The Netherlands added two interventions addressing providers’ HPV vaccine communication, and Slovakia a multilevel intervention. Results We identified barriers and facilitators for successful intervention transfer in each of the target contexts. The transferability analysis showed that an intervention with health promoters is potentially transferable with adaptations in all countries. Principles of trust in the educator, tailored and trustworthy information, help in navigating the health system for vaccination and easy access at no cost are transferable key elements in all contexts. Adaptations refer to the intervention elements that need to be tailored to specific contextual needs. School-based vaccination was nowhere transferable. Health provider training needs to be culturally sensitive and adapted to the Dutch system. The multilevel intervention in Slovakia is not fully transferable. Conclusions Participatory transferability analysis was essential for decision-making and intervention adaptation. All countries independently selected a health promoter intervention as having potential to remove the identified health system barriers in the respective context.

Exploring methodologies and frameworks for best practice transfer at the primary care level

Abstract Background In Feb 2023, the EU’s Joint Action on the transfer of best praCtices In pRimary CarE (CIRCE-JA) was launched with the objective of effectively transferring and implementing six best practices (BPs) among Member States (MS). Transferability from one primary care (PC) setting to another can be challenging given organizational, legal, cultural, social, economic, and environmental factors, requiring robust a methodological framework to guide the transfer process. A scoping review was conducted to identify conceptual models and methodological frameworks for context-relevant and evidence-informed BP transfer in PC settings. Methods The study aimed to identify models or frameworks to guide BP transfer in PC settings, whilst maximizing transferability. The JBI methodology was used, and an extensive search was conducted in PubMed (time limit: Jan ‘13-May ‘23). All publications of original research, systematic reviews, and text and opinion papers in English were eligible for inclusion. Key exclusion criteria were set, i.e., intervention type, level of care and reporting quality. The search was supplemented by gray literature review. Results From a total of 369 publications, 9 met eligibility criteria, reporting on 10 conceptual and methodological models/framework largely varying. These included transfer models applicable to all BPs as well as elements specific to some BPs, i.e., addressing integration, patient-centered care, care coordination, and health promotion. Strengths and weaknesses were identified for all. Conclusions Transferability of health interventions is complex, requiring systematic consideration of setting and intervention characteristics to inform and support local adaptation, implementation, and decision-making. Key elements identified can support the CIRCE-JA BP transfer and are largely relevant for further BP transfer across PC settings in EU MS, incl. for local adaptation, stakeholder engagement and effective implementation monitoring. Key messages • Innovative BPs are successfully deployed in many EU MS. To best support transformation for strong EU primary care and resilient health systems, it is important to ensure evidence-informed BP transfer. • This review reports on the selection of appropriate frameworks and models, and key elements thereof, to allow successful transfer of CIRCE-JA BPs and other BP transfer across PC settings in Europe.

Needs Assessment for Primary Care for Best Practice Implementation: The CIRCE Joint Action

Abstract Introduction CIRCE is a Joint Action (JA) supporting the transfer of six best practices (BPs) to new primary care settings in Europe. High-quality needs assessment can set the foundation for strong planning and implementation of the CIRCE-JA best practices in these new primary care settings. Methods A needs assessment tool was developed based on the TO-REACH knowledge transfer framework and learnings from a scoping review of international knowledge transfer frameworks. The needs assessment provides structured tool for local sites to self-assess the alignment of the BP with local priorities, readiness of the local site to successfully implement the BP, the availability of necessary leadership, resources and partnerships, and an examination of barriers to local BP implementation and mitigation strategies. Results Twenty-six CIRCE-JA teams completed the needs assessments. Local teams identified the CIRCE-JA BPs were value-adding and aligned with local priorities. Cross-cutting barriers were identified which were common among the six CIRCE-JA best practices across five thematic areas: (1) provider level, (2) intervention level, (3) health system/policy level, (4) partnership and physical resources and (5) information technology. The needs assessment supported primary care sites with a structured approach to planning for transfer of BPs to their local setting that is based on established international best practices and knowledge transfer frameworks including early identification of barriers and mitigating strategies. Conclusions The needs assessment has supported teams with conducting a self-assessment and informing initial planning for adoption of the BP in their local primary care practice. Given the importance of the local needs assessment to high quality implementation of BP the CIRCE-JA experience with local needs assessment may provide learnings for future BP transfer initiatives. Key messages • Local needs assessment supports the transfer of best practices to primary care settings, which is a critical component of service transformation during the post-COVID-19 period. • For successful transfer of best practices in primary care, it is vital to give to examine such as provider capacity, available human resources, health policy, and information technology.

Evaluation of antibiotics resistance and transmission risk of Escherichia coli in rice-frog coculture system

In order to assess the antibiotic resistance of Escherichia coli and its transmission risk in a rice-frog coculture system in Zhejiang Province, this study collected E. coli from isolated soil, field water, and frog feces from the rice-frog coculture systems in four different areas of Zhejiang Province. The collected isolates were identified by 16S rRNA sequencing, while their antibiotic-resistant phenotypes were determined by Kirby-Bauer (K-B) method. PCR was used to identify the antibiotic-resistant genotypes and integrons, while conjugative transfer experiments were used to assess resistance transmission characteristics. The results showed a high prevalence of antibiotic resistance in the 82 strains of E. coli tested, primarily against tetracycline, sulfisoxazole, amoxicillin, and erythromycin. Most of these strains exhibited multidrug resistance, with the Fuyang area demonstrating the highest resistance rate compared to the other three areas. Further PCR analysis identified the sul1 gene as the most frequently detected resistance gene (63.41%), followed by blaTEM, tetA, and tetB. Among the 16 antibiotic resistance genes (ARGs) detected, the Fuyang isolates consistencly exhibited higher detection rate of 9 ARGs in comparison to the other regions. Additionally, the integrase gene intI1 displayed the highest detection rate, with 14 strains (34.15%) of integrase-positive bacteria carrying gene cassettes. Four different gene cassette compositions were observed, with dfrA1-aadA1 and dfrA17-aadA5 being the most common combinations. Conjugative transfer experiments demonstrated successful transfer of gene cassettes in 4 out of 14 donor bacteria, with conjugation transfer frequencies ranging from 4.32×10-5 to 7.13×10-4. These findings revealed the severity of resistance in the Fuyang area among the four regions. Integrons play a significant role in mediating the resistance to multiple antibiotics in E. coli, facilitating the potential spread of resistance gene cassettes between different bacteria. Overall, this study provides valuable insights into the resistance status and transmission characteristics of E. coli in the rice-frog coculture system in Zhejiang Province, providing a theoretical basis for ensuring the food safety of rice crops.

More is not always merrier: does leader-team perceptual distance on context influence leadership training transfer?

ABSTRACT Although the organizational context has been identified as an important factor contributing to the success or failure of leadership training initiatives, exploration of the interaction between differing contextual perceptions in relation to the transfer of leadership training is lacking. Building on Oc’s framework on context and leadership, we examine how the degree of perceptual alignment of leader and teams on two contextual factors, formalization and employee orientation, were related to followers’ ratings of transformational leadership after a leadership training in the forest industry (n = 37 leaders). Polynomial regression with response surface analysis revealed that agreement between leaders and their teams on formalization and employee orientation predicted improvements in transformational leadership but only up to a certain point. At high levels of formalization agreement negatively impacted leaders’ development of transformational leadership, and at high levels of employee orientation the positive impact of agreement flattened out. Leaders who rated formalization and employee orientation higher than their teams increased their transformational leadership to a lesser extent as rated by their followers. Our findings extend the framework developed by Oc and offer a new perspective on the complex interplay between leader, follower, and contextual factors that all matter for successful leadership training transfer.

Biomimetic Cooling: Functionalizing Biodegradable Chitosan Films with Saharan Silver Ant Microstructures.

The increasing occurrence of hot summer days causes stress to both humans and animals, particularly in urban areas where temperatures can remain high, even at night. Living nature offers potential solutions that require minimal energy and material costs. For instance, the Saharan silver ant (Cataglyphis bombycina) can endure the desert heat by means of passive radiative cooling induced by its triangular hairs. The objective of this study is to transfer the passive radiative cooling properties of the micro- and nanostructured chitin hairs of the silver ant body to technically usable, biodegradable and bio-based materials. The potential large-scale transfer of radiative cooling properties, for example, onto building exteriors such as house facades, could decrease the need for conventional cooling and, therefore, lower the energy demand. Chitosan, a chemically altered form of chitin, has a range of medical uses but can also be processed into a paper-like film. The procedure consists of dissolving chitosan in diluted acetic acid and uniformly distributing it on a flat surface. A functional structure can then be imprinted onto this film while it is drying. This study reports the successful transfer of the microstructure-based structural colors of a compact disc (CD) onto the film. Similarly, a polyvinyl siloxane imprint of the silver ant body shall make it possible to transfer cooling functionality to technically relevant surfaces. FTIR spectroscopy measurements of the reflectance of flat and structured chitosan films allow for a qualitative assessment of the infrared emissivity. A minor decrease in reflectance in a relevant wavelength range gives an indication that it is feasible to increase the emissivity and, therefore, decrease the surface temperature purely through surface-induced functionalities.

Applicability of the adjusted morbidity groups algorithm for healthcare programming: results of a pilot study in Italy

BackgroundPopulation-based Health Risk Assessment (HRA) tools are strategic for the implementation of integrated care. Various HRA algorithms have been developed in the last decades worldwide. Their full adoption being limited by technical, functional, and economical factors. This study aims to apply the Adjusted Morbidity Groups (AMG) algorithm in the context of an Italian Region, and evaluate its performance to support decision-making processes in healthcare programming.MethodsThe pilot study used five Healthcare Administrative Databases (HADs) covering the period 2015–2021. An iterative semi-automated procedure was developed to extract, filter, check and merge the data. A technical manual was developed to describe the process, designed to be standardized, reproducible and transferable. AMG algorithm was applied and descriptive analysis performed. A dashboard structure was developed to exploit the results of the tool.ResultsAMG produced information on the health status of Marche citizens, highlighting the presence of chronic conditions from age 45 years. Persons with high and very high level of complexity showed elevated mortality rates and an increased use of healthcare resources. A visualization dashboard was intended to provide to relevant stakeholders accessible, updated and ready-to-use aggregated information on the health status of citizens and additional insight on the use of the healthcare services and resources by specific groups of citizens.ConclusionThe flexibility of the AMG, together with its ability to support policymakers and clinical sector, could favour its implementation in different scenarios across Europe. A clear strategy for the adoption of HRA tools and related key elements and lessons learnt for a successful transferability at the EU level were defined. HRA strategies should be considered a pillar of healthcare policies and programming to achieve person-centred care and promote the sustainability of the EU healthcare systems.

From hiding to sharing: a knowledge hiding perspective on knowledge management in MNEs

Purpose Knowledge is a vital strategic resource for multinational enterprises (MNEs). As MNEs expand internationally, knowledge transfer through expatriates is a crucial part of the value proposition of outward foreign direct investment. However, this is undermined if knowledge is hidden rather than shared. Given the scarcity of research on knowledge hiding in MNEs, this paper aims to investigate this phenomenon among expatriates and develops a new framework to analyze knowledge hiding. Design/methodology/approach Survey data from 201 Chinese MNE expatriates is collected and analyzed using Partial Least Squares – Structural Equation Modeling to test the relationships between knowledge hiding, organizational practices, cultural intelligence and job embeddedness. Relevant organizational practices based on the ability-motivation-opportunity enhancing framework were identified, based on 24 semi-structured qualitative interviews which guided the quantitative analysis. Findings The direct effects of organizational practices on all types of knowledge hiding are limited. However, organizational practices’ influence on knowledge hiding is mediated by the cultural intelligence of expatriates, and this relationship is moderated by job embeddedness. Originality/value The research advances current thinking about knowledge management and outlines both theoretical and practical implications at organizational and societal levels. It explores the mechanisms for remedying knowledge hiding through organizational practices, including the interactive effects of cultural intelligence and job embeddedness among expatriates. Organizational knowledge management strategies in MNEs need to recognize cultural differences and improve job embeddedness to form the basis of successful knowledge transfer.

A meta-analysis and systematic review of the use of transition tools for patients transitioning from paediatric to adult rheumatology services

Abstract Objectives Transition from paediatric to adult care can be challenging, but transition tools are designed to increase successful rates of transfer. We aimed to conduct a meta-analysis and systematic review into the use of transition tools on transfer of care from paediatric to adult services for rheumatology patients. Methods An extensive literature search was conducted using Medline, PubMed and Embase. 12 papers were included in a systematic review and 8 papers in the meta-analysis looking at use of transition tools on successful follow up in adult clinics. Results The meta-analysis showed 86.6% (95% CI: 53.3–80.6%) of patients who used a transition tool attended an adult outpatient clinic within 1 year of their last paediatric appointment, compared with 67.7% (95% CI: 56.7–99.7%) of patients who successfully transferred without a transition tool. Conclusions The systematic review demonstrated several unique transition tools with local success but no dominant method. This paper demonstrated a general positive influence of transition tools on successful transfer, but more research is needed to strengthen the association.

Teaching for transfer of learning in health professions education: AMEE Guide No. 176

Transfer of learning occurs when past learning is applied to new situations, and also at a varying time from the initial time of learning. Importantly, research in both academic and clinical areas of health professions education has highlighted that transfer of learning often does not successfully occur. Successful transfer is multi-dimensional and occurs when the learner has the required motivation, mental model, metacognitive processes relevant to the task, and the opportunity to transfer their learning to different situations. An essential aspect of successful transfer is the educator. This Guide provides an overview of an integrated model of transfer that can inform a variety of practical teaching strategies in both academic and clinical areas of health professions education.

DiaBetter Together: Clinical trial protocol for a strengths-based Peer Mentor intervention for young adults with type 1 diabetes transitioning to adult care

BackgroundType 1 diabetes (T1D) management is challenging for young adults, who are expected to transfer from the pediatric to adult T1D healthcare system while also managing typical developmental demands (e.g., social, financial, work/school, residential). Many young adults have extended gaps in care before following up in adult care, increasing risk for poor health outcomes. There are few evidence-based programs to support young adults with T1D to promote a timelier transition during this period. This paper reports on the design of DiaBetter Together, a randomized controlled trial to evaluate a 12-month Peer Mentor-delivered intervention compared to usual care among young adults with T1D during the transfer from pediatric to adult care. MethodsOne-hundred young adults (age 17–25) with T1D and 29 Peer Mentors enrolled in this randomized clinical trial. Peer Mentors are experienced, older young adults with T1D, trained by the study team to share transition experiences and strategies to successfully navigate the adult healthcare system, help young adults prepare for the first adult care visit, and use strengths-based support strategies to teach and model skills for managing T1D-related challenges. ResultsThe primary outcome of the trial is HbA1c, and secondary outcomes include time to adult care, engagement in diabetes self-management behaviors, and psychosocial well-being. ConclusionThe goal of this research is to evaluate a developmentally appropriate, supportive intervention that can improve T1D self-management and successful transfer of care during the difficult young adult years and promote optimal T1D health outcomes.

Proficiency in bariatric surgery may shorten the learning curve for minimally-invasive D2 gastrectomy.

Evidence from Asian studies suggests that minimally-invasive gastrectomy achieves equivalent oncological but improved perioperative outcomes compared to open surgery. Oncological gastric resections are less frequent in European countries. Index procedures may play a role for the learning curve of minimally-invasive gastrectomy. The aim of our study was to evaluate if skills acquired in bariatric surgery allow a safe and oncologically adequate implementation of minimally-invasive gastrectomy in a cohort of european patients. In this single-center retrospective study, all patients who received primary bariatric surgery between January 2015 and December 2018 and minimally-invasive surgery for gastric cancer treated from June 2019 to January 2023 were evaluated. Primary endpoints were operation time, lymph node yield and lymph node fractions. Secondary endpoints included postoperative complications and oncological outcomes. Learning curves for two surgeons with 350 bariatric procedures and 44 minimally-invasive gastrectomies were analyzed. For bariatric surgery, the mean operation time decreased from initially 82 ± 27 to 45 ± 21min and 118 ± 28 to 81 ± 36min for sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), while the complication rate remained within the international benchmark. For laparoscopic gastrectomy (n = 30), operation times decreased but then remained stable over time. Operation times for the robotic platform were longer (302 ± 60 vs. 390 ± 48min; p < 0.001) with the learning curve remaining incomplete after 14 procedures. R0 status was achieved in 95.5% of patients; the mean number of lymph nodes retrieved was 37 ± 14 with no differences between the groups. Complete mesogastric excision was more frequently achieved during the later laparoscopic cases whereas it occurred earlier for the robotic group (p = 0.004). Perioperative morbidity was comparable to the European benchmark. Textbook outcome was achieved in 54.4% of the cases. In summary, we could demonstrate a successful skill transfer from bariatric surgery to minimally-invasive laparoscopic oncological gastric surgery enabling safe and oncologically adequate minimally-invasive D2 gastrectomy in a central European patient collective.

The pivotal role of neurosurgeons in transitional care: A comprehensive tertiary healthcare institution's experience.

Transitional care (TC) is increasingly crucial, particularly in neurosurgery, where optimal follow-through of patients' care is paramount. Challenges of transition are exacerbated by the complexity of neurosurgical conditions, with pediatric and adult neurosurgery often managed separately by different attending neurosurgeons or in different institutions. While numerous models for transitioning have been proposed, several barriers persist, impeding successful transfer from pediatric to adult settings. Our review focuses on important roles neurosurgeons can play in facilitating successful transition, exploring some existing TC models, with emphasis on the benefits of maintaining a single provider. Clinic visits data between 2019 to 2023 of patients between the ages of 16 to 26 was compiled retrospectively. Successful transition was defined as continued follow-up moving from pediatric to adulthood with lost to follow-up being that of unsuccessful transition. Age, diagnosis and whether patients were successfully transitioned or lost to follow-up were documented. 1829 neurosurgical patients between the ages of 16 to 26 were identified over 5 years. A snapshot review identified 78 adolescent patients deemed to require follow-up into adulthood. 13 patients had epilepsy, 32 central nervous system (CNS) tumors, 17 congenital conditions, 14 neurovascular, and 2 patients had idiopathic intracranial hypertension. All 78 were noted to have successfully transited into their adulthood (age 21 and beyond). Having the same providers; having pediatric and adult neurosurgery within the same institution, was the single most important factor in facilitating successful transition. Neurosurgeons in institutions, particularly those with experience and competencies in both pediatric and adult care, can serve as crucial anchors during the transitional period. At our institution, the implementation of this continuity of care model has demonstrated remarkable success. Institutions with both pediatric and adult services would be uniquely positioned to develop and implement effective transitional care.