Retrosternal Percutaneous Tracheostomy: An Approach for Predictably Impossible Classic Tracheostomy

Percutaneous tracheostomy is a routine procedure in intensive care units. In cases of very low position of the larynx, cervical spine deformation, morbid obesity, or neck tumor, performance of the classic tracheostomy is inapplicable. Retrosternal approach to tracheostomy in such 20 patients is herein reported. After preoperative neck computerized tomography to define the neck anatomy, a small suprasternal incision followed by a short retrosternal tissue dissection to expose the trachea was done; the trachea was then catheterized at the level of the 2nd ring in the usual tracheostomy manner. The immediate and late (≥6 months) outcomes were similar to that of the standard tracheostomy. Thus, percutaneous retrosternal tracheostomy is safe in patients with abnormal positioning of the trachea or neck constitution. It is a bedside applicable technique, that, however, requires caution to avoid hazardous vascular complications

A wide lens on learning in a networked society: What can we learn by synthesizing multiple research perspectives?

Learning in a networked society is presented in this symposium with the basic assumption that “schooling” and “society” cannot be considered as separate entities and should bring together the theoretical and practical tools of scientists in both the social and educational sciences. Despite the powerful potential for cross-fostering of ideas between these fields, one key question arising inquires whether educational scientists—who focus on the interventionist, design-based study of learning—and social scientists, who concentrate on analytic study of spontaneous social interaction and knowledge construction, can engage in a productive collaboration. This symposium seeks to address this question by adopting an interdisciplinary lens, through which these perspectives have been integrated, or at least juxtaposed, to develop new insights regarding what it means to learn in an information-based networked society. Six interdisciplinary research projects that represent lessons learned from synergistic projects among researchers from these fields are presented in this symposium