bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic thyroiditis in lateral ectopic thyroid mimicking cervical metastasis of thyroid cancer
Authors: Pederzoli Simone , Salviato Tiziana , Mattioli Francesco , Di Massa Gianluca , Brigante Giulia 
Published: July 2021

Summary
We present the case of a 45-year-old Caucasian woman who attended the Endocrinology Unit for a left cervical mass discovered during follow-up for autoimmune chronic thyroiditis. The ultrasound-guided fine-needle aspiration biopsy of the lesion was consistent with a metastasis of follicular thyroid carcinoma. The sonographic neck evaluation revealed no thyroid nodules but three markedly hypoechoic and highly vascularized areas, with irregular margins and hyperechoic spots. In the clinical suspicion of primary thyroid neoplasm, ultrasound-guided fine-needle aspiration biopsy of two of the three areas was performed, but both cytological reports were non-diagnostic, revealing only colloid and blood. Subsequently, the patient underwent surgical removal of the cervical mass, with the intra-operatory consultation with frozen section examination suggesting follicular-like neoplasia. For this reason, thyroidectomy with both central and lateral neck dissection was performed. Surprisingly, the final histologic examination revealed chronic thyroiditis in the thyroid specimen and no evidence of metastasis in the left neck mass. Consequently, the pathological revision of the frozen section assessment led to the final diagnosis of chronic thyroiditis on the lateral ectopic thyroid. This case represents an uncommon example of lateral ectopic thyroid tissue with coexisting normally located thyroid tissue both affected by chronic thyroiditis.

Learning points

Ectopic thyroid must be considered in the diagnostic work-up of lateral neck mass.

Even if rare, ectopic thyroid tissue can be found lateral to the carotid sheath and with coexisting normally located thyroid tissue.

As the orthotopic tissue, lateral ectopic thyroid tissue can be affected by chronic thyroiditis, which may complicate the diagnosis both on ultrasound and cytology.
Refrações medievais em Agustina Bessa Luís: Leonor Teles e Lady Macbeth
Authors: Machado Ana 
Published: July 2021

O estudo da receção da Idade Média nos séculos ulteriores, sobretudo na sua vertente criativa revela imagens do medieval e interrogações sobre o tempo presente. Partindo dos hipotextos medievais, Agustina Bessa-Luís reconfigura a imagem de Leonor Teles através da lente de Lady Macbeth. Na abordagem do conto “D. Leonor Teles”, inserido em Fama e Segredo na História de Portugal (2006), estudam-se as perceções do passado e interroga-se o sentido, as razões e as modalidades dessa presença medieval no imaginário contemporâneo, sendo certo que, como lembra Gómez Redondo (2006, p. 324), “toda pesquisa del pasado se practica para iluminar con ella el presente; no se ponen en pie estos ‘mundos posibles’ por simple ejercicio de arqueología literaria”. Numa perspetiva comparativa e sob o prisma do medievalismo, conclui-se que a autora concilia a atemporalidade com a referencialidade medieval para representar Leonor Teles num “sublime negativo” (Bloom, 1997) em que supera Lady Macbeth.
Ambiguidade nas figurações femininas em Ana Teresa Pereira e Cristina Fernández Cubas
Authors: Simões Maria João 
Published: July 2021

A ambiguidade e a estranheza presidem à construção das figuras fantásticas de Ana Teresa Pereira e de Cristina Fernández Cubas. As autoras desenham figuras femininas que se confrontam com contextos de poder e jogos de sedução ambivalentes. Através da utilização do “tempo expandido” ou de “tempos convergentes” (segundo D. Roas), ou da utilização de “espaços rizomáticos” (segundo P. García), as personagens enfrentam ocorrências irreais e impossíveis. Pretende-se analisar, em Inverness e El Columpio, como se dá a ver esse apagamento do real nas personagens e também como se constroem as figuras fantásticas, segundo o modelo dual de D. Mellier: fantástico explícito versus fantástico da indeterminação. Proceder-se-á à análise dos efeitos de fantástico atingidos na figuração das personagens femininas, investigar-se-á como os jogos do tempo e do espaço concorrem para a construção dessas figuras e mostrar-se-á como esta figuração questiona a condição feminina, compondo-se em metáfora da construção de subjetividades femininas.
La recepción del Mamita Yunai de Carlos Luis Fallas en Italia y Francia: entre la proximidad lingüística y la divergencia cultural
Authors: García Albero Javier 
Published: July 2021

El siguiente texto intenta ser una aportación a la historia de la traducción. Más concretamente, se analizan aspectos sobre la recepción de Mamita Yunai de Carlos Luis Fallas en Italia y Francia. Con la observación, en un primer estadio, de las condiciones de recepción de la obra en estos países se da una idea sobre el ámbito cultural en que se movieron las traducciones. En una segunda parte, se describen las traducciones (sobre todo, en sus factores culturales) para observar si el patrimonio cultural costarricense se ha mantenido en las versiones francesa e italiana.The following text is intended as a contribution to the history of translation. Specifically, we will analyze the reception of Mamita Yunai by Carlos Luis Fallas in Italy and France. In the first part, the observation of the conditions of reception of the novel in each of the countries provides an idea about the cultural environment where the translated versions were published. In the second part we will analyze the translations (their cultural elements, in particular) in order to observe whether the Costa Rican cultural heritage has been kept alive in the Italian and French versions.
Variation in Intravenous Acetaminophen Use in Pediatric Hospitals: Priorities for Standardization
Authors: Toomey Vanessa , Randolph Adrienne , Bourgeois Florence , Graham Dionne 
Published: July 2021

OBJECTIVESThe primary objective was to evaluate hospital variation in intravenous (IV) acetaminophen use across pediatric patient populations. The secondary objective was to identify populations with high use of IV acetaminophen and wide variation in practice to identify priority areas for cost reduction and practice standardization.METHODSWe performed a retrospective study of children ≤18 years old hospitalized in 2019 in 48 US pediatric hospitals in the Pediatric Health Information System. Primary measures included IV acetaminophen use (percentage of encounters) and total days of therapy (DOT). A multivariable analysis identified clinical and demographic factors associated with IV acetaminophen use. High-priority groups for practice standardization were the All Patient Refined Diagnosis Related Groups in the top quartile of DOT, with wide variation of use across hospitals (interquartile range &gt;50%).RESULTSAmong 866 346 encounters, 14.4% received 1 dose of IV acetaminophen with 287 935 DOT, costing $29.8 million. In multivariable analysis age, payer, surgical procedure, ICU admission, total parenteral nutrition, and case mix index remained significantly associated with IV acetaminophen use. After multivariable adjustment, variation in hospital use ranged from &lt;0.1% to 31% of all encounters. Twenty diagnosis groups accounted for 47% of total DOT (135 910 days) and 48% of cost ($14.2 million). Appendectomy, tonsil and adenoidectomy, and craniotomy were identified as top candidates for standardization efforts.CONCLUSIONSWe observed large variation in IV acetaminophen use across pediatric hospitals and within diagnosis groups. These diagnoses represent candidates for practice standardization.
Interpreter Use for Limited English Proficiency Patients/Families: A QI Study
Authors: Rajbhandari Prabi , Keith Mary F. , Braidy Roula , Gunkelman Samantha M. , Smith Elizabeth 
Published: July 2021

BACKGROUNDCommunication is fundamental to high-quality health care. Despite federal requirements to provide interpreters and growing evidence favoring the benefits of interpreter use, providers’ use of interpreters remains suboptimal. In acute care settings, where decisions need to be made rapidly on the basis of changing clinical circumstances, this has proven to be challenging.METHODSWe designed a quality improvement project using the model for improvement methodology for patients admitted to the pediatric hospital medicine service. A multidisciplinary team developed interventions focused on provider education and leveraging health information technology (IT). We used health IT to improve the identification of families with limited English proficiency, improve access to various modalities of interpreting, standardize workflow to request face-to-face (F2F) interpreters, and create a designated place in the electronic health record for interpreter use documentation. The use of all forms (telephone, video, and F2F) of interpreter service, documentation of interpreter uses, and F2F interpreter overload were tracked monthly for 3 years.RESULTSThe baseline use of interpreter services for the pediatric hospital medicine inpatient service was 64%. After starting the project, the use of interpreter service increased to 97% and has sustained for more than a year since the project’s completion. The use of F2F interpreters also increased from a baseline of 20% to 54% post intervention.CONCLUSIONSWe successfully achieved and sustained our goals of improving interpreter use through supportive leadership and a multidisciplinary approach using quality improvement methodology. Future efforts should be focused on defining and standardizing metrics for families with limited English proficiency across institutions and using health IT to improve care.
Trends in Technology Assistance Among Patients With Childhood Onset Chronic Conditions
Authors: Boggs Elizabeth F. , Foster Carolyn , Shah Parag , Goodman Denise M. , Hall Matthew , Garfield Craig F. 
Published: July 2021

OBJECTIVE
To describe the prevalence, types, and trends over time of medical technology assistance (TA) in patients at the age of transition to adult care with childhood onset chronic conditions (COCCs) cared for at children’s hospitals.

PATIENTS AND METHODS
In this retrospective repeated annual cross-sectional cohort study of the Pediatric Health Information Systems inpatient data, patients with at least 1 hospitalization from January 1, 2008, to December 31, 2018 with a selected COCC were included. The COCCs investigated were brain and spinal cord malformation, cerebral palsy, heart and great vessel malformation, cystic fibrosis, sickle cell anemia, and chronic renal failure. TA was defined as requiring an indwelling medical device to maintain health status. Trends over time in TA were analyzed with the Cochran–Armitage test and generalized linear models.

RESULTS
During the study, 381 289 unique patients accounted for 940 816 hospitalizations. Transition-aged patients (19–21 years old) represented 2.4% of all included hospitalizations over the 11-year period, whereas patients ages 21 and above represented 2.7%. The annual proportion of patients with TA increased significantly from 31.3% in 2008 to 36.9% in 2018, a 17.9% increase (P &lt; .001).

CONCLUSIONS
In this cohort of patients with select COCCs hospitalized at children’s hospitals, a substantial and growing number of patients at the age of transition to adult care required TA. Identifying adult providers with resources to manage COCCs and maintain medical devices placed in childhood is challenging. These trends warrant special attention to support the timely and successful transition of medically complex patients from pediatric to adult care.
Mycoplasma Pneumoniae Testing and Treatment Among Children With Community-Acquired Pneumonia
Authors: Desai Sanyukta , Hall Matthew , Lipsett Susan C. , Shah Samir S. , Brogan Thomas V. , Hersh Adam L , Williams Derek J. , Grijalva Carlos G. , Gerber Jeffrey S. , Blaschke Anne J. , Neuman Mark I. , Ambroggio Lilliam 
Published: July 2021

OBJECTIVES
To describe testing and treatment practices for Mycoplasma pneumoniae (Mp) among children hospitalized with community-acquired pneumonia (CAP).

METHODS
We conducted a retrospective cohort study using the Pediatric Health Information Systems database. We included children 3 months to 18 years old hospitalized with CAP between 2012 and 2018 and excluded children who were transferred from another hospital and those with complex chronic conditions. We examined the proportion of patients receiving Mp testing and macrolide therapy at the hospital level and trends in Mp testing and macrolide prescription over time. At the patient level, we examined differences in demographics, illness severity (eg, blood gas, chest tube placement), and outcomes (eg, ICU admission, length of stay, readmission) among patients with and without Mp testing.

RESULTS
Among 103 977 children hospitalized with CAP, 17.3% underwent Mp testing and 31.1% received macrolides. We found no correlation between Mp testing and macrolide treatment at the hospital level (R2 = 0.05; P = .11). Patients tested for Mp were more likely to have blood gas analysis (15.8% vs 12.8%; P &lt; .1), chest tube placement (1.4% vs 0.8%; P &lt; .1), and ICU admission (3.1% vs 1.4%; P &lt; .1). Mp testing increased (from 15.8% to 18.6%; P &lt; .001), and macrolide prescription decreased (from 40.9% to 20.6%; P &lt; .001) between 2012 and 2018.

CONCLUSIONS
Nearly one-third of hospitalized children with CAP received macrolide antibiotics, although macrolide prescription decreased over time. Clinicians were more likely to perform Mp testing in children with severe illness, and Mp testing and macrolide treatment were not correlated at the hospital level.
Childhood Gun Access, Adult Suicidality, and Crime
Authors: Copeland William E. , Tong Guangyu , Gifford Elizabeth J. , Easter Michele M. , Shanahan Lilly , Swartz Marvin S. , Swanson Jeffrey W. 
Published: July 2021

OBJECTIVES:To test the associations of childhood domestic gun access with adult criminality and suicidality.METHODS:Analyses were based on a 20+ year prospective, community-representative study of 1420 children, who were assessed up to 8 times during childhood (ages 9–16; 6674 observations) about access to guns in their home. Participants were then followed-up 4 additional times in adulthood (ages 19, 21, 25, and 30; 4556 observations of 1336 participants) about criminality and suicidality.RESULTS:During childhood, the 3-month prevalence of having a gun in the home was 55.1% (95% confidence interval [CI]: 52.1%–58.7%). Of the children in homes with guns, 63.3% (95% CI: 59.7%–66.9%) had access to a gun, and 25.0% (95% CI: 21.2%–28.8%) owned a gun themselves. Having gun access as a child was associated with higher levels of adult criminality (odds ratios = 1.1–3.5) and suicidality (odds ratios = 2.9–4.4), even after adjusting for childhood correlates of gun access. Risk of adult criminality and suicidality among those with childhood gun access was greatest in male individuals, those living in urban areas, and children with a history of behavior problems. Even in these groups, however, most children did not display adult criminality or suicidality.CONCLUSIONS:Childhood gun access is prospectively associated with later adult criminality and suicidality in specific groups of children.
A statistics-based review of microgrid protection with a concentration on adaptive protection
Authors: Damanjani Amin , Abardeh Mohamad Hosseini , Azarfar Azita , Hojjat Mehrdad 
Published: July 2021

AbstractMicrogrid (MG) is a system of production and distribution of electrical energy that can operate both in grid-connected and islanded modes. This capability leads to significant variations in the fault current level. Moreover, dynamic changes corresponding to the line outage contingencies or outages of the distributed generations (DGs) that are implemented for local generation in the MGs lead to the changes in the fault current level. These changes in the fault current level make some miscoordination between the overcurrent relays (OCRs) in the conventional protection schemes. To overcome this drawback, there is a need for an adaptive protection scheme that can adapt to both operational and dynamic changes and takes effective protection decisions accordingly. This paper first presents a statistic-based review of MG and its protection including total publications, type of publications, the ten most researchers, and the ten most sources. Finally, comprehensive remarks of the 30 most cited papers related to adaptive protection of MG are presented. This paper will help the researchers of the MG protection to learn the most desirable techniques and the concentration of studies in adaptive protection of MGs for future works.
Architectural tunability of mechanical metamaterials in the nanometer range
Authors: Kurpiers Chantal Miriam , Hengsbach Stefan , Schwaiger Ruth 
Published: July 2021

AbstractMechanical metamaterials can exhibit extraordinary mechanical properties due to a specific architecture rather than the base material. When the structural dimensions reach the sub-micrometer range, such micro- and nanolattices may also benefit from size-affected mechanical properties. However, well-defined geometric adjustments on this length scale are limited by the resolution limits of the underlying manufacturing technology. Here, we used a 3D direct laser writing (3D-DLW) process with integrated laser power variation to fabricate polymeric microlattices, which were then pyrolized to obtain glassy carbon structures. The laser power was varied by a quadratic function along the beams from one node to another over the length of a unit cell, thus enabling geometric adjustments in the range of a few nanometers. Rounded and notch-like joints were realized by increased and reduced laser power at the nodes, respectively. Furthermore, the beam cross section was varied along the beam length, thereby creating convex or concave beam shapes. A laser power variation opens up new design possibilities for micro- and nanolattices in the sub-micrometer range by overcoming process related limitations.
Safety margin from characteristic values in settlement calculations of embankments on clay
Authors: López Ramírez Alejandra , Löfman Monica Susanne , Korkiala-Tanttu Leena 
Published: July 2021

Settlement calculations in serviceability limit state (SLS) design of embankments require the estimation of characteristic values of soil properties to account for different sources of uncertainty. The upcoming revised version of EN 1997-1:2004 (Eurocode 7) presents a statistically based equation to determine characteristic values of soil properties with the aim of providing a more consistent safety margin. The aim of this study is to quantify the safety margin in settlement calculations using this equation and performing probabilistic analyses. Four different cases of embankments on soft soil with different soil conditions were considered, including significant non-linear stress–strain behaviour. This allowed evaluation of the consistency of the safety margin from statistically derived characteristic values for different soil conditions. Probabilistic analyses were performed using Monte Carlo simulations to determine the statistics of total settlements. The safety margin was then defined based on the distance between the settlement from characteristic values and the mean settlement value of the simulations. The quantified safety margin was not consistent among the cases, which may be related to varying levels of non-linear compressibility and degree of consolidation. Moreover, for some cases, the safety margin might be too conservative for SLS design of embankments.
Automatic phase pickers: Their present use and future prospects
Authors: Allen Rex 
Published: July 2021

abstractAutomatic phase-picking algorithms are designed to detect a seismic signal on a single trace and to time the arrival of the signal precisely. Because of the requirement for precise timing, a phase-picking algorithm is inherently less sensitive than one designed only to detect the presence of a signal, but still can approach the performance of a skilled analyst. A typical algorithm filters the input data and then generates a function characterizing the seismic time series. This function may be as simple as the absolute value of the series, or it may be quite complex. Event detection is accomplished by comparing the function or its short-term average (STA) with a threshold value (THR), which is commonly some multiple of a long-term average (LTA) of a characteristic function. If the STA exceeds THR, a trigger is declared. If the event passes simple criteria, it is reported. Sensitivity, expected timing error, false-trigger rate, and false-report rate are interrelated measures of performance controlled by choice of the characteristic function and several operating parameters. At present, computational power limits most systems to one-pass, time-domain algorithms. Rapidly advancing semi-conductor technology, however, will make possible much more powerful multi-pass approaches incorporating frequency-domain detection and pseudo-offline timing.
The 23 November 1980 southern Italy earthquake
Authors: Del Pezzo Edoardo , Iannaccone Giovanni , Martini Marcello , Scarpa Roberto 
Published: July 2021

abstractThe seismic activity associated with the catastrophic southern Italy earthquake was monitored by 11 seismic stations operating before this event, within an epicentral distance of 200 km, and by 32 additional short-period seismometers installed soon after the main shock. The hypocenter of this event was located at 40°46′N and 15°18′E, at 16 km depth. The fault-plane solution reveals normal faulting, with tensile axis dipping 18° and oriented orthogonal to the axis of the Apennines chain. This mechanism is in good agreement with the stress pattern inferred from some previous earthquakes and the local seismotectonics.The hypocenter locations of more than 600 aftershocks, with local magnitudes greater than 2.4, show a pronounced alignment extending for about 70 km, oriented north 120° and scattered laterally less than 15 km. These events are mostly concentrated between 8 and 16 km depth. A cluster of aftershocks occurred close to the hypocenter of the main shock covering a region elongated 25 km which corresponds also to the highly damaged area. No significant spreading of the aftershock area with time is observed, but one of the events with higher magnitude (ML = 4.8, 14 February 1981) is displaced 20 km NW from the tip of the aftershock region. The time evolution of the number of aftershocks fits well Omori's hyperbolic law with a decay coeffcient of 1.07 ± 0.06.The possibility of a future delayed multiple sequence of large events, as already observed in the past along the central and southern Apennines, is discussed. In particular, a relatively high seismic potential seems to exist along the northern boundary of the 1980 rupture segment.