Intraductal Papillary Mucinous Neoplasms of the Pancreas: Clinical Surveillance and Malignant Progression, Multifocality and Implications of a Field-Defect

Intraductal papillary mucinous neoplasms (IPMNs) are a heterogeneous group of mucin producing cystic tumors that involve the main pancreatic duct and/or branch ducts and may be associated with invasive carcinoma. Predicting the risk of malignant transformation of an IPMN lesion can be challenging. The Sendai criteria, based in large part on radiographic imaging features, help guide surgical intervention based on the stratification of cysts into high and low risk lesions for malignancy. Invasive carcinoma may develop in the index IPMN lesion or in a separate site within the pancreas, supporting the concept of a field defect in IPMN tumorigenesis. This stresses the importance of evaluation of the entire pancreas upon diagnosis of IPMN and continued surveillance of the residual pancreas following resection. Herein, the authors summarize the data presented at the 2012 ASCO Gastrointestinal Cancers Symposium regarding prevalence and site of invasive carcinoma detected in patients undergoing surveillance for IPMN (Abstract #152)

An Update on Surgical Staging of Patients with Pancreatic Cancer

 Accurate staging of pancreatic adenocarcinoma is a crucial step in determining the appropriate therapeutic approach to pancreatic cancer and to maximizing life expectancy. Despite the availability of high-quality abdominal imaging, the use of multi-modality imaging and of diagnostic laparoscopy, a portion of surgically explored patients fail to undergo resection secondary to metastatic disease. This review is an update from the 2012 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium of new developments in the staging of localized pancreatic adenocarcinoma. (Abstracts #168, #177, and #212).

Unsettling planning theory

Recent political developments in many parts of the world seem likely to exacerbate rather than ameliorate the planetary-scale challenges of social polarization, inequality and environmental change societies face. In this unconventional multi-authored essay, we therefore seek to explore some of the ways in which planning theory might respond to the deeply unsettling times we live in. Taking the multiple, suggestive possibilities of the theme of unsettlement as a starting point, we aim to create space for reflection and debate about the state of the discipline and practice of planning theory, questioning what it means to produce knowledge capable of acting on the world today. Drawing on exchanges at a workshop attended by a group of emerging scholars in Portland, Oregon in late 2016, the essay begins with an introduction section exploring the contemporary resonances of ‘unsettling’ in, of and for planning theory. This is followed by four, individually authored responses which each connect the idea of unsettlement to key challenges and possible future directions. We end by calling for a reflective practice of theorizing that accepts unsettlement but seeks to act knowingly and compassionately on the uneven terrain that it creates

A curricular model to train doctoral students in interdisciplinary research at the food-energy-water nexus

Food, energy and water (FEW) systems are inextricably linked, and thus, solutions to FEW nexus challenges, including water and food insecurity, require an interconnected science and policy approach framed in systems thinking. To drive these solutions, we developed an interdisciplinary, experiential graduate education program focused on innovations at the FEW nexus. As part of our program, PhD students complete a two-course sequence: (1) an experiential introduction to innovations at the FEW nexus and (2) a data practicum. The two courses are linked through an interdisciplinary FEW systems research project that begins during the first course and is completed at the end of the second course. Project deliverables include research manuscripts, grant proposals, policy memos, and outreach materials. Topics addressed in these projects include building electrification to reduce reliance on fossil fuels for heating, agrivoltaic farming to combat FEW vulnerabilities in the southwestern United States, assessment of food choices to influence sustainable dining practices, and understanding the complexities of FEW nexus research and training at the university level. Evaluation data were generated from our first three student cohorts (n = 33 students) using a mixed method, multi-informant evaluation approach, including the administration of an adapted version of a validated pre-post-survey to collect baseline and end-of-semester data. The survey assessed student confidence in the following example areas: communication, collaboration, and interdisciplinary research skills. Overall, students reported confidence growth in utilizing interdisciplinary research methods (e.g., synthesize the approaches and tools from multiple disciplines to evaluate and address a research problem), collaborating with range of professionals and communicating their research results to diverse audience. The growth in confidence in the surveyed areas aligned with the learning objectives for the two-course sequence, and the interdisciplinary project experience was continually improved based on student feedback. This two-course sequence represents one successful approach for educators to rethink the traditional siloed approach of training doctoral students working at the FEW nexus

Table_2_A curricular model to train doctoral students in interdisciplinary research at the food-energy-water nexus.DOCX

Food, energy and water (FEW) systems are inextricably linked, and thus, solutions to FEW nexus challenges, including water and food insecurity, require an interconnected science and policy approach framed in systems thinking. To drive these solutions, we developed an interdisciplinary, experiential graduate education program focused on innovations at the FEW nexus. As part of our program, PhD students complete a two-course sequence: (1) an experiential introduction to innovations at the FEW nexus and (2) a data practicum. The two courses are linked through an interdisciplinary FEW systems research project that begins during the first course and is completed at the end of the second course. Project deliverables include research manuscripts, grant proposals, policy memos, and outreach materials. Topics addressed in these projects include building electrification to reduce reliance on fossil fuels for heating, agrivoltaic farming to combat FEW vulnerabilities in the southwestern United States, assessment of food choices to influence sustainable dining practices, and understanding the complexities of FEW nexus research and training at the university level. Evaluation data were generated from our first three student cohorts (n = 33 students) using a mixed method, multi-informant evaluation approach, including the administration of an adapted version of a validated pre-post-survey to collect baseline and end-of-semester data. The survey assessed student confidence in the following example areas: communication, collaboration, and interdisciplinary research skills. Overall, students reported confidence growth in utilizing interdisciplinary research methods (e.g., synthesize the approaches and tools from multiple disciplines to evaluate and address a research problem), collaborating with range of professionals and communicating their research results to diverse audience. The growth in confidence in the surveyed areas aligned with the learning objectives for the two-course sequence, and the interdisciplinary project experience was continually improved based on student feedback. This two-course sequence represents one successful approach for educators to rethink the traditional siloed approach of training doctoral students working at the FEW nexus.</p

Table_3_A curricular model to train doctoral students in interdisciplinary research at the food-energy-water nexus.DOCX

Food, energy and water (FEW) systems are inextricably linked, and thus, solutions to FEW nexus challenges, including water and food insecurity, require an interconnected science and policy approach framed in systems thinking. To drive these solutions, we developed an interdisciplinary, experiential graduate education program focused on innovations at the FEW nexus. As part of our program, PhD students complete a two-course sequence: (1) an experiential introduction to innovations at the FEW nexus and (2) a data practicum. The two courses are linked through an interdisciplinary FEW systems research project that begins during the first course and is completed at the end of the second course. Project deliverables include research manuscripts, grant proposals, policy memos, and outreach materials. Topics addressed in these projects include building electrification to reduce reliance on fossil fuels for heating, agrivoltaic farming to combat FEW vulnerabilities in the southwestern United States, assessment of food choices to influence sustainable dining practices, and understanding the complexities of FEW nexus research and training at the university level. Evaluation data were generated from our first three student cohorts (n = 33 students) using a mixed method, multi-informant evaluation approach, including the administration of an adapted version of a validated pre-post-survey to collect baseline and end-of-semester data. The survey assessed student confidence in the following example areas: communication, collaboration, and interdisciplinary research skills. Overall, students reported confidence growth in utilizing interdisciplinary research methods (e.g., synthesize the approaches and tools from multiple disciplines to evaluate and address a research problem), collaborating with range of professionals and communicating their research results to diverse audience. The growth in confidence in the surveyed areas aligned with the learning objectives for the two-course sequence, and the interdisciplinary project experience was continually improved based on student feedback. This two-course sequence represents one successful approach for educators to rethink the traditional siloed approach of training doctoral students working at the FEW nexus.</p

Table_1_A curricular model to train doctoral students in interdisciplinary research at the food-energy-water nexus.DOCX

Food, energy and water (FEW) systems are inextricably linked, and thus, solutions to FEW nexus challenges, including water and food insecurity, require an interconnected science and policy approach framed in systems thinking. To drive these solutions, we developed an interdisciplinary, experiential graduate education program focused on innovations at the FEW nexus. As part of our program, PhD students complete a two-course sequence: (1) an experiential introduction to innovations at the FEW nexus and (2) a data practicum. The two courses are linked through an interdisciplinary FEW systems research project that begins during the first course and is completed at the end of the second course. Project deliverables include research manuscripts, grant proposals, policy memos, and outreach materials. Topics addressed in these projects include building electrification to reduce reliance on fossil fuels for heating, agrivoltaic farming to combat FEW vulnerabilities in the southwestern United States, assessment of food choices to influence sustainable dining practices, and understanding the complexities of FEW nexus research and training at the university level. Evaluation data were generated from our first three student cohorts (n = 33 students) using a mixed method, multi-informant evaluation approach, including the administration of an adapted version of a validated pre-post-survey to collect baseline and end-of-semester data. The survey assessed student confidence in the following example areas: communication, collaboration, and interdisciplinary research skills. Overall, students reported confidence growth in utilizing interdisciplinary research methods (e.g., synthesize the approaches and tools from multiple disciplines to evaluate and address a research problem), collaborating with range of professionals and communicating their research results to diverse audience. The growth in confidence in the surveyed areas aligned with the learning objectives for the two-course sequence, and the interdisciplinary project experience was continually improved based on student feedback. This two-course sequence represents one successful approach for educators to rethink the traditional siloed approach of training doctoral students working at the FEW nexus.</p