Search

Background: Minimally invasive pancreatic resection has been gathering interest over the last decade due to the technical demands and high morbidity associated with these typically open procedures. We report our experience with robotic pancreatectomy within an Australian context. Methods: All patients undergoing robotic distal pancreatectomy (DP) and pancreaticoduodenectomy (PD) at two Australian tertiary academic hospitals between May 2014 and December 2020 were included. Results: Sixty‐two patients underwent robotic pancreatectomy during the study period. Thirty‐four patients with a median age of 68 years (range 42–84) were in the PD group whilst the DP group included 28 patients with a median age of 60 years (range 18–78). Thirteen patients (46.4%) in the DP group had spleen‐preserving procedures. There were 13 conversions (38.2%) in the PD group whilst 0 conversions occurred in the DP group. The Clavien‐Dindo grade ≥III complication rate was 26.4% and 17.9% in the PD and DP groups, respectively. Two deaths (5.9%) occurred within 90‐days in the PD group whilst none were observed in the DP group. The median length of hospital stay was 11.5 days (range 4–56) in the PD group and 6 days (range 2–22) in the DP group. Conclusion: Robotic pancreatectomy outcomes at our institution are comparable with international literature demonstrating it is both safe and feasible to perform. With improved access to this platform, robotic pancreas surgery may prove to be the turning point for patients with regards to post‐operative complications as more experience is obtained. [ABSTRACT FROM AUTHOR]

Background: Malignant tumours within the proximal pancreas traditionally require pancreaticoduodenectomy (PD) for cure. For smaller lesions with borderline malignant potential the risk/benefit of PD becomes difficult to justify. Robotic approaches to these lesions allow for parenchymal preserving resection with reduced complication profile without oncological compromise. Methods: A review of a single surgeons prospectively collated database across two institutions of consecutive robotic enucleations or parenchyma preserving resections of the proximal pancreas was performed between July 2018 and October 2021. Standard demographic data, preoperative variables, intraoperative parameters, post‐operative outcomes, morbidity and mortality were recorded. Results: Thirteen patients (8 female and 5 male) underwent robotic enucleation (EN) (8) and/or uncinectomy (UN) (5) in the proximal pancreas. Mean BMI was 32(kg/m2). Three patients (21%) underwent preoperative prophylactic pancreatic duct stenting. One patient required conversion to open. The median operative time in the EN group was 170 min (108–224 min) and the UN group was 160 min (110–204 min). The majority (8) of lesions were pNETs. Three lesions were IPMNs, with 1 solitary fibrous tumour and a serous cystic neoplasm (SCN) respectively. Median tumour size was 23 mm (11–58 mm) in the EN group, and 27 mm (17–38 mm) in the UN group. Ten of 13 patients had an R0 resection. There was no mortality in our series. Four (31%) patients across both groups developed clinically relevant POPF while none developed new endocrine or exocrine insufficiency. Average outpatient follow‐up has been 6 months (1–18 months). Conclusion: A robotic approach in proximal parenchymal preserving pancreatectomy is expanding, safe and feasible. [ABSTRACT FROM AUTHOR]

Developments in pedagogical knowledge in the teaching of social research methods have largely been generated through teachers reflecting on their practice. This paper presents an alternative approach to generating data through reflective dialogue between researchers, teachers and learners. The approach incorporates elements of video stimulated recall and reflective dialogue within focus group interviewing. The rationale and affordances are discussed in relation to the goals of discussing teachers' pedagogical decision-making and learners' experience of, and response to, various pedagogical practices. The context is a study of capacity-building short courses in advanced social science research methods, specifically courses on: multi-modal analysis, computer-assisted qualitative data analysis software, multi-level modelling, and systematic review. The paper examines the methodological challenges of capturing the everyday realities of methods classrooms for teachers and learners and the affordances of using dialogue on observed teaching sessions to gain further insight into each other's thinking and action. It concludes with lessons learned about methodological and pedagogical processes and an argument about the value of bringing methods and standpoints together in creative dialogue.

This article presents an adaptation of established qualitative research methods for online focus groups by using the "Disqus" website-based commenting platform as a medium for discussion among doctoral and early-career academic learners. Facilities allowing Internet users to comment on the content of web pages are increasingly popular on news websites, social media, and elsewhere. This research deployed this technology as a means of hosting a group discussion in response to preliminary findings from a study into the teaching and learning of social research methods. This article explores the methodological and technical considerations associated with this method and presents an analysis of the data collection process. e-Research paradata generated by the website reveal how learners engaged with the discussion, while a thematic analysis of the comments themselves explores the nature of the qualitative data generated from responses. Website-based commenting appears to have potential as a means of facilitating learners' engagement in educational e-research, especially when faced with constraints of distance, time, or access. However, methodological challenges may also arise when recruiting participants and sustaining discussion using this method.

In light of calls to improve the capacity for social science research within UK higher education, this article explores the possibilities for an emerging pedagogy for research methods. A lack of pedagogical culture in this field has been identified by previous studies. In response, we examine pedagogical literature surrounding approaches for teaching and learning research methods that are evident in recent peer-reviewed literature. Deep reading of this literature (as opposed to systematic review) identifies different but generally complementary ways in which teachers of methods seek to elucidate aspects of the research process, provide hands-on experience and facilitate critical reflection. At a time when the advancement of research capacity is gaining prominence, both in the academy and in reference to the wider knowledge economy, this paper illustrates how teachers of methods are considering pedagogical questions and seeks to further stimulate debates in this area.

This article explores stories of former members of the Khmer Rouge who have converted to Christianity. It sheds light on the intersections of patterns of religious change in Cambodia, which implicates peace-building, redress, and development trajectories in the wake of conflict and atrocities. The case raises important questions about why former members of the Khmer Rouge convert to Christianity and the social, political, and ethical implications of their conversions. We explore these questions to show that, while transitions and attendant redress efforts in Cambodia have been principally explained at the level of the state, we should pay closer attention to the granular experiences of former Khmer Rouge members as they navigate Cambodia's changing post-conflict terrain, and the social and cultural sites through which they have made their experiences of the past meaningful. [ABSTRACT FROM AUTHOR]

Background This report describes the technical aspects and outcomes of a laparoscopic approach in planned two-stage liver resections for patients with bilobar colorectal cancer ( CRC) liver-only metastases. Methods This is a retrospective review of our database examining consecutive patients who underwent an initial first-stage laparoscopic liver resection for CRC metastases, with a planned second-stage resection from 2007 to 2013. Results Seven patients underwent an initial laparoscopic first stage with concurrent right portal vein ligation ( RPVL) in two patients. Median operating time was 100 (60-170) min with a median blood loss of 100 (50-400) mL. Median length of stay was 3 (2-5) days. The remaining five patients required post-operative right portal vein embolization ( RPVE). All patients had significant hypertrophy of the future liver remnant ( FLR) (future liver remnant volume ( FLRV) >25%) and six patients subsequently had a successful open right hepatectomy with one attempted laparoscopically converted to open. Two patients had prolonged bile leaks after the second procedure. Three patients remained disease free, with median follow-up of 34 (13-80) months. One patient had disease progression following RPVE precluding performance of second stage. Conclusion Laparoscopic first-stage resection of tumours in the left liver can be safely combined with RPVL/RPVE to achieve adequate hypertrophy of the FLR, allowing subsequent right hepatectomy. [ABSTRACT FROM AUTHOR]

This article presents an adaptation of established qualitative research methods for online focus groups by using theDisquswebsite-based commenting platform as a medium for discussion among doctoral and early-career academic learners. Facilities allowing Internet users to comment on the content of web pages are increasingly popular on news websites, social media, and elsewhere. This research deployed this technology as a means of hosting a group discussion in response to preliminary findings from a study into the teaching and learning of social research methods. This article explores the methodological and technical considerations associated with this method and presents an analysis of the data collection process. e-Research paradata generated by the website reveal how learners engaged with the discussion, while a thematic analysis of the comments themselves explores the nature of the qualitative data generated from responses. Website-based commenting appears to have potential as a means of facilitating learners' engagement in educational e-research, especially when faced with constraints of distance, time, or access. However, methodological challenges may also arise when recruiting participants and sustaining discussion using this method. [ABSTRACT FROM PUBLISHER]

A novel immunoglobulin superfamily (Igsf) protein gene was discovered by computational analysis of human draft genomic DNA, and multiple cDNA clones were obtained. The protein encoded by this gene contains five Ig domains, one transmembrane domain, and an intracellular domain. It has significant similarity with several known Igsf proteins, including Drosophila RST (irregular chiasm C-roughest) protein and mammalian KIRREL (kin of irregular chiasm C-roughest), NEPH1, and NPHS1 (nephrin) proteins. All these proteins have multiple Ig domains, possess properties of cell adhesion molecules, and play important roles in organ development. RT-PCR and Northern blot results indicate this gene is predominantly expressed in pancreas, and public sequence databases indicate there is also expression in the nervous system. We have named this gene Kirrel2 (kin of irregular chiasm-like 2), to reflect its similarity to irregular chiasm C-roughest and Kirrel. Four splice forms of Kirrel2 were observed, including two that we cloned from pancreas mRNA as well as two GenBank entries, one from the brain and one from a retinoblastoma cell line. A partial cDNA clone of the mouse orthologue was obtained by RT-PCR from mouse brain, and the inferred protein sequence has 85% sequence identity to the human protein. Immunohistochemical staining results indicate that the KIRREL2 protein is conserved from rodents to primates, and it is highly expressed in pancreatic islets. RT-PCR results on mouse pancreatic cell lines indicate that expression in the pancreas is restricted to beta cells. Thus, KIRREL2 protein is a beta-cell-expressed Ig domain protein and may be involved in pancreas development or beta cell function.