To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To report a case of cutaneous tumour seeding following core biopsy of a thyroid malignancy.
Methods
This paper presents a case report of cutaneous tumour seeding following core biopsy and a review of the literature concerning the role, and risks, of fine needle aspiration and core biopsy in the diagnostic evaluation of neck lumps.
Results
A 75-year-old woman presented with a left-sided level IV neck lump adjacent to the left lobe of the thyroid. Fine needle aspiration revealed that the neck lump contained follicular epithelial cell groups; however, nuclear grooves and pseudo-inclusions could not exclude a diagnosis of papillary thyroid carcinoma. Subsequent core biopsy confirmed features of a thyroid neoplasm, although abundant necrosis and limited lesional cells within the specimen made histological diagnosis difficult. The patient underwent total thyroidectomy and left-sided selective neck dissection for symptom control. A superficial nodule overlying the core biopsy site was noted at operation and excised; it was found to contain cells of poorly differentiated papillary carcinoma identical to the subsequently confirmed thyroid primary.
Conclusion
This case highlights a rare but important risk associated with sampling neck lumps. Nevertheless, ultrasound-guided sampling is an essential investigative step with great diagnostic accuracy and patient acceptability.
Many Emergency Medical Services (EMS) agencies modified their protocols during the height of the COVID-19 pandemic, particularly those involving procedures that lead to an increased risk of airborne exposure, such as intubation. In 2020, local Advanced Life Support (ALS) providers’ first-line airway management device was the supraglottic airway (SGA), and tracheal intubations (TIs) were rarely performed.
Objective:
This study’s aim was to investigate the potential clinical effect of this pandemic-related protocol change on first-pass TI success rates and on overall initial advanced airway placement success.
Methods:
This study was a retrospective prehospital chart review for all ALS encounters from a single urban EMS agency that resulted in the out-of-hospital placement of at least one advanced airway per encounter from January 1, 2019 through June 30, 2021 (n = 452). Descriptive statistics and chi square tests were used to evaluate data. Statistical significance was defined at P < .05.
Results:
Significantly fewer TIs were attempted in 2020 (n = 16) compared to 2019 (n = 80; P < .001), and first-pass TI success rates significantly decreased in 2021 (n = 22; 61.1%) compared to 2019 (n = 63; 78.8%; P = .047). Also, SGA placement constituted 91.2% of all initial airway management attempts in 2020 (n = 165), more than both 2019 (n = 114; 58.8%; P < .001) and 2021 (n = 87; 70.7%; P < .001). Overall first-attempt advanced airway placement success, encompassing both supraglottic and TI, increased from 2019 (n = 169; 87.1%) to 2020 (n = 170; 93.9%; P = .025). Conversely, overall first attempt advanced airway placement success decreased from 2020 to 2021 (n = 104; 84.6%; P = .0072).
Conclusions:
Lack of exposure to TI during the COVID-19 pandemic likely contributed to this local agency’s decreased first-pass TI success in 2021. Moving forward, agencies should utilize simulation labs and other continuing education efforts to help maintain prehospital providers’ proficiency in performing this critical procedure, particularly when protocol changes temporarily hinder or prohibit field-based psychomotor skill development.
In a famous essay, Michel Foucault introduced the term “author-function” into scholarly discourse, and later scholars of authorship in antiquity have applied the term in different ways to different concepts. Some scholars center the notion of authorship around authority, while others look to the notion of authorizing a work as a finished literary work. This article seeks to retrieve a suggestion in Foucault’s essay that the author-function can fruitfully be understood under the notion of Foucault’s French term appropriation, that is, making something belong to a person, for purposes of punishment or praise. This article applies all three notions of the author-function in scholarly use to the complex testimonium on the authorship of the Gospel of Mark by Papias in Eusebius, Church History 3.39.15, and concludes that Foucault’s own construal of his term explains best the intricacies of this ancient statement of gospel authorship.
This article explores the formation of the University of California amidst widespread populist agitation against university leaders in the 1870s. These complaints were rooted in corruption by the Board of Regents as well as their failure to honor the requirement of the 1862 Morrill Act to offer practical training in “agriculture and the mechanic arts.” It argues that Yosemite served as a vehicle through which representatives of the University of California countered charges of elitism and fostered a reputation for trustworthy stewardship of public land. These efforts were visible to the public through literary texts, newspapers, public lectures, nature writings, and other forms of popular literature. By positioning Yosemite as a site of middlebrow intellectual exchange and an alternative to the demonstration farms established at other land grant institutions, professors such as Joseph LeConte helped quell populist critiques and strengthen affective ties to the university. The resulting shift in popular sentiment helped secure public trust in the university for the remainder of the Gilded Age and Progressive Era.
This article introduces the Voice Leaf, an outsider among Baschet’s numerous sound sculptures because of the use of the performative voice. Conceived in 1965 by French pioneers Bernard and François Baschet, the sculpture for voice consists of a stainless steel sheet folded as a leaf using origami technique. This article explores how voice and sculpture interplay acoustically by evaluating the voice’s agency and the sculpture’s aural dynamic gain. In this mutualist relationship, multiple senses are mobilised: aural, visual and haptic. The voice harboured in the sculptural leaf gains materiality and a resonance altered by the sculpture’s intrinsic properties. The article draws from conversations at the Structures Sonores Baschet Association open day with chairperson Pierre Cuffini and former workshop and acoustics research director Frédéric Fradet, as well as an interview with multidisciplinary artist and long-term collaborator of Bernard Baschet, Sophie Chénet.
Ludwig Wittgenstein’s later philosophy has been hugely influential but can be difficult to understand. He has a radical approach to philosophy. Most philosophers think that questions such as ‘How can I know there is an external world?’ or ‘How is my private inner world of thought and experience related to my body?’ raise genuine puzzles requiring solutions. Wittgenstein, on the other hand, takes such questions to result from linguistic confusion and a scientistic approach to philosophy. Such questions require, not answers, but conceptual elucidation. This article introduces Wittgenstein’s later philosophy.
This article provides a critical examination of the Moscow Mechanism, a rapid-response tool within the Organization for Security and Co-operation in Europe. Originally established in 1991 and rarely invoked during its first three decades of existence, the Mechanism has experienced a reinvigoration since Russia’s full-scale invasion of Ukraine in 2022, having been triggered six times, four of which were in response to alleged violations of international humanitarian law and international human rights law during the conflict. Drawing on the authors’ experience as experts in these four missions, the article offers a historical overview, explains the Mechanism’s procedural dynamics and assesses its unique features. Through a comprehensive analysis of its repeated use in respect of Ukraine, the article highlights both the strengths and limitations of the Moscow Mechanism, ultimately arguing that recent developments have revealed its full potential as an instrument for advancing international justice and accountability.
Understanding the development and use of musical instruments in prehistory is often hampered by poor preservation of perishable materials and the relative rarity of durable examples. Here, the authors present a pair of third-millennium BC copper cymbals, excavated at Dahwa, Oman. Although they are the only well-contextualised examples from Arabia, the Dahwa cymbals are paralleled by contemporaneous examples from the Indus Valley and images in Mesopotamian iconography. Not only do the cymbals add to the body of evidence interpreted in terms of Indus migrants in Early Bronze Age Oman, they also suggest shared musical and potentially ritual practices around the Arabian Gulf at that time.