bluuebunny/crossref_metadata_2025_split huggingface dataset:
Grammatical Parallelism in Aphasia: A Lesion-Symptom Mapping Study
Authors: Matchin William , den Ouden Dirk-Bart , Basilakos Alexandra , Stark Brielle Caserta , Fridriksson Julius , Hickok Gregory 
Published: August 2023

Abstract
Sentence structure, or syntax, is potentially a uniquely creative aspect of the human mind. Neuropsychological experiments in the 1970s suggested parallel syntactic production and comprehension deficits in agrammatic Broca’s aphasia, thought to result from damage to syntactic mechanisms in Broca’s area in the left frontal lobe. This hypothesis was sometimes termed overarching agrammatism, converging with developments in linguistic theory concerning central syntactic mechanisms supporting language production and comprehension. However, the evidence supporting an association among receptive syntactic deficits, expressive agrammatism, and damage to frontal cortex is equivocal. In addition, the relationship among a distinct grammatical production deficit in aphasia, paragrammatism, and receptive syntax has not been assessed. We used lesion-symptom mapping in three partially overlapping groups of left-hemisphere stroke patients to investigate these issues: grammatical production deficits in a primary group of 53 subjects and syntactic comprehension in larger sample sizes (N = 130, 218) that overlapped with the primary group. Paragrammatic production deficits were significantly associated with multiple analyses of syntactic comprehension, particularly when incorporating lesion volume as a covariate, but agrammatic production deficits were not. The lesion correlates of impaired performance of syntactic comprehension were significantly associated with damage to temporal lobe regions, which were also implicated in paragrammatism, but not with the inferior and middle frontal regions implicated in expressive agrammatism. Our results provide strong evidence against the overarching agrammatism hypothesis. By contrast, our results suggest the possibility of an alternative grammatical parallelism hypothesis rooted in paragrammatism and a central syntactic system in the posterior temporal lobe.
Reexamining Race and Capitalism in the Marxist Tradition – Editorial Introduction
Authors: Knox Robert , Kumar Ashok 
Published: August 2023

Abstract
The question of capitalism’s relationship to issues of race, racism and processes of racialisation has become increasingly prominent in contemporary debates. This special issue of Historical Materialism on ‘Race and Capital’ seeks to intervene in these debates. In this Introduction, we situate the special issue within this wider political, historical and theoretical context. We begin by reconstructing some of the key tensions and fault lines within contemporary discussions of race and racism, particularly in relation to the Marxist tradition. Against those who claim a primarily oppositional relationship between the Marxist tradition and anti-racist thinking, we chart a historical account of key moments in which Marxist movements and thinkers have attempted to articulate distinctively historical-materialist accounts of race and racism. We then situate the key themes of the special issue – and the various articles that compose the issue – against this background.
Coherent Bimodal Events in Ensemble Forecasts of 2-m Temperature
Authors: Bertossa Cameron , Hitchcock Peter , DeGaetano Arthur , Plougonven Riwal 
Published: August 2023

Abstract
A previous study has shown that a large portion of subseasonal-to-seasonal European Centre for Medium-Range Weather Forecasts (ECMWF) ensemble forecasts for 2-m temperature exhibit properties of univariate bimodality, in some locations occurring in over 30% of forecasts. This study introduces a novel methodology to identify “bimodal events,” meteorological events that trigger the development of spatially and temporally correlated bimodality in forecasts. Understanding such events not only provides insight into the dynamics of the meteorological phenomena causing bimodal events, but also indicates when Gaussian interpretations of forecasts are detrimental. The methodology that is developed allows one to systematically characterize the spatial and temporal scales of the derived bimodal events, and thus uncover the flow states that lead to them. Three distinct regions that exhibit high occurrence rates of bimodality are studied: one in South America, one in the Southern Ocean, and one in the North Atlantic. It is found that bimodal events in each region appear to be triggered by synoptic processes interacting with geographically specific processes: in South America, bimodality is often related to Andes blocking events; in the Southern Ocean, bimodality is often related to an atmospheric Rossby wave interacting with sea ice; and in the North Atlantic, bimodality is often connected to the displacement of a persistent subtropical high. This common pattern of large-scale circulation anomalies interacting with local boundary conditions suggests that any deeper dynamical understanding of these events should incorporate such interactions.

Significance Statement
Repeatedly running weather forecasts with slightly different initial conditions provides some information on the confidence of a forecast. Occasionally, these sets of forecasts spread into two distinct groups or modes, making the “typical” interpretation of confidence inappropriate. What leads to such a behavior has yet to be fully understood. This study contributes to our understanding of this process by presenting a methodology that identifies coherent bimodal events in forecasts of near-surface air temperature. Applying this methodology to a database of such forecasts reveals several key dynamical features that can lead to bimodal events. Exploring and understanding these features is crucial for saving forecasters’ resources, creating more skillful forecasts for the public, and improving our understanding of the weather.
Evidence-based models of rural palliative care: A systematic review
Authors: Marshall Claire , Virdun Claudia , Phillips Jane L 
Published: August 2023

Background: Forty-five percent of the world’s population lives in rural areas, yet their access to palliative care is quite limited. Identifying the care elements rural populations with palliative care needs require is critical to improving care outcomes. Aim: To identify the key care elements that optimise palliative care for people in rural communities. Design and data sources: A systematic review of articles studying the impact of novel rural model of care interventions was undertaken in May 2022. This study is reported using the PRISMA Statement and was registered with Prospero (CRD42020154273). Three databases were searched, and the data analysed according to Popay’s narrative synthesis, and elements classified using the WHO Innovative Care for Chronic Conditions (ICCC) Framework. Results: Of the 9508 identified papers, 15 met the inclusion criteria, reporting on 14 studies involving 1820 rural patients. Care received spanned 12/18 of the WHO ICCC Framework elements, with wide variability in how these elements were operationalised. The five elements that signal improved outcomes were: (1) Promote continuity and coordination; (2) Prepared, informed and motivated health care teams; (3) Prepared, informed and motivated patients and families; (4) Organise and equip health care teams and (5) Promote consistent financing. Conclusions: A well-coordinated multidisciplinary team approach, led by clinicians with specialist palliative care expertise, integrated across local health care settings, using information systems and care planning, is critical to optimising rural palliative care patient outcomes. Rural patients and their families require timely input from specialist palliative care clinicians and information to address their needs. Prospero registration ID: CRD42020154273 https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=154273
Perceptions about positive mental health among university students from Southern India: An occupational perspective
Authors: Divecha Hasti , Acharya Vinita 
Published: August 2023

Introduction: Positive mental health (PMH) is essential for a healthy and fulfilling life. Lack of it may lead to increased negative thoughts and the use of unhealthy coping mechanisms. This study aimed to explore university students’ perceptions of PMH from an occupational perspective. Method: Six online focus groups with participants recruited through purposive sampling were conducted among university students in southern India. A semi-structured interview guide facilitated the data collection. Thematic analysis was done for the transcribed data. Results: Two themes emerged from the data: “No health without mental health” and “action plan for mental health.” The findings reflected participants’ understanding of mental health and its relation to socio-emotional wellbeing, positive state of mind, and productivity. They described the use of various personal strategies including certain occupations for mental health promotion. Conclusion: The findings suggest that students were mindful of the significance of the presence or absence of PMH. They valued the role of daily habits and routines in maintaining PMH. Future intervention programs for PMH can be developed by integrating an occupational perspective.
Late-Life High Blood Pressure and Enlarged Perivascular Spaces in the Putaminal Regions of Community-Dwelling Japanese Older Persons
Authors: Tachibana Ayumi , Iga Jun-ichi , Tatewaki Yasuko , Thyreau Benjamin , Chen Hongkun , Ozaki Tomoki , Yoshida Taku , Yoshino Yuta , Shimizu Hideaki , Mori Takaaki , Furuta Yoshihiko , Shibata Mao , Ohara Tomoyuki , Hata Jun , Taki Yasuyuki , Nakaji Shigeyuki , Maeda Tetsuya , Ono Kenjiro , Mimura Masaru , Nakashima Kenji , Takebayashi Minoru , Ninomiya Toshiharu , Ueno Shu-ichi ,   for the JPSC-AD study group
Published: August 2023

Background Enlarged perivascular spaces (EPVS) of the brain may be involved in dementia, such as Alzheimer’s disease and cerebral small vessel disease (CSVD). Hypertension has been reported to be a risk factor for dementia and CSVD, but the association between blood pressure (BP) and perivascular spaces is still unclear. The aim of this study was to determine the association between BP and EPVS volumes and to examine the interactions of relevant factors. Methods A total of 9296 community-dwelling subjects aged ≥65 years participated in a brain magnetic resonance imaging and health status screening examination. Perivascular volume was measured using a software package based on deep learning that was developed in-house. The associations between BP and EPVS volumes were examined by analysis of covariance and multiple regression analysis. Results Mean EPVS volumes increased significantly with rising systolic and diastolic BP levels ( P for trend = .003, P for trend<.001, respectively). In addition, mean EPVS volumes increased significantly for every 1-mmHg-increment in systolic and diastolic BPs (both P values <.001). These significant associations were still observed in the sensitivity analysis after excluding subjects with dementia. Conclusions The present data suggest that higher systolic and diastolic BP levels are associated with greater EPVS volumes in cognitively normal older people.
Digital ethical reflection in long-term care: Leaders’ expectations
Authors: Jakobsen Lena , Olsen Rose Mari , Brinchmann Berit Støre , Devik Siri Andreassen 
Published: August 2023

Background Healthcare leader support and facilitation for ethics work are of great importance for healthcare professionals’ handling of ethical issues, moral distress, and quality care provision. A digital tool for ethical reflection in long-term care was developed in response to the demand for appropriate tools. Research aim This study aimed to explore healthcare leaders’ expectations of using a digital tool for ethical reflection among their home nursing care staff. Research design A qualitative research design with vignettes and focus group interviews was used. The data were analyzed using reflexive thematic analysis. Participants and Research Context The sample comprised ten healthcare leaders from municipal long-term care in Norway. Ethical Considerations Participation was voluntary and based on informed consent. The Norwegian Agency for Shared Services in Education and Research approved this study. Findings The analysis resulted in the development of three themes representing leaders’ expectations of the tool: (i) giving staff a voice, (ii) revealing ethics in practice, and (iii) keeping the pot boiling. Discussion Leaders must be informed about the ethical issues experienced to engage in supportive measures for their staff. Digital channels can increase the democratization, safety, and efficiency of communication between employees and leaders and increase awareness of ethical aspects in daily care work. The leaders had positive expectations of employees’ activities and benefits from using the tool for ethical reflection. However, they admitted that realizing the tool’s potential to ensure continuity in ethics work requires considerable organizational and leader involvement. Conclusions This study shows that healthcare leaders are open to digital solutions for managing ethics work in home nursing care. Both opportunities and important prerequisites for successfully implementing the digital tool were identified.
Ethical issues in long-term care settings: Care workers’ lived experiences
Authors: Arjama Anna-Liisa , Suhonen Riitta , Kangasniemi Mari 
Published: August 2023

Background Professional care workers face ethical issues in long-term care settings (LTCS) for older adults. They need to be independent and responsible, despite limited resources, a shortage of skilled professionals, global and societal changes, and the negative reputation of LTCS work. Research aim Our aim was to describe the care workers’ lived experiences of ethical issues. The findings can be used to gain new perspectives and to guide decision-making to improve the quality of care, occupational well-being and nursing education. Research design Focus group interviews were analyzed using a hermeneutic-phenomenological method. The analysis comprised three steps: naïve reading, structural analysis, and comprehensive understanding. Participants and research context We randomly sampled LTCS service providers in Finland and 53 care workers with different educational backgrounds from seven organizations participated in focus group interviews in 2021. Ethical considerations This was a sensitive study, which was connected to the participants’ individual views of the world, professional ethics and social and health care legislation. The participants' provided informed consent and their anonymity was guaranteed. Findings Care workers spoke about their lived experiences of ethical issues in an emotional way, using practical examples. They talked about how they were experts at caring and advocating for residents, balanced the responsibilities of their different roles, and defended their work to the wider society. The care workers said that ethical aspects of their work were too difficult to solve on their own. There were elements of their working environment and practices that caused unnecessary strain and they needed the commitment of managers, organizations, and society to solve ethical issues in LTCS. Conclusions Ethical issues were related to the well-being of both residents and care workers and reflected both internal and external pressures. Some issues could not be resolved by individuals and needed input from managers, organizations, and society.
Alleviating suffering of individuals with multimorbidity and complex needs: A descriptive qualitative study
Authors: Younas Ahtisham , Inayat Shahzad 
Published: August 2023

Background Individuals living with multimorbidity and/or mental health issues, low education, socioeconomic status, and polypharmacy are often called complex patients. The complexity of their health and social care needs can make them prone to disease burden and suffering. Therefore, they frequently access health care services to seek guidance for managing their illness and suffering. Aims The aim of this research was to describe the approaches used by nurses to alleviate the suffering of individuals with multimorbidity and complex needs in acute care settings. Research Design A qualitative descriptive approach. Participants and Research Context Semi-structured interviews were conducted with 19 nurses working in general, medical-surgical, specialized, and intensive care settings across five hospitals in Pakistan. Reflexive thematic analysis was used for analysis. Ethical Considerations Ethical approval was obtained from the Ethical Committee of Al-Nafees Medical College Islamabad, Pakistan. Findings Four themes were generated: Deeper Exploration of Patients’ Health-Illness Situation and Complexity, Prioritizing Patient Psychosocial and Emotional Needs, Instilling Hope and Encouragement in Patients, and Creating a Comforting Environment to Foster Sharing of felt needs. Discussion Nurses emphasized the need of deeper inquiry into patients illness situation and complexity to discern the impact of determinants on their well-being and develop care plans that are tailored to address psychosocial, emotional, and physical suffering of this patient population. Conclusions Alleviation of patient suffering is integral to compassionate nursing care. Nurses use a multifaceted approach entailing sensitive understanding, recognizing sociocultural and structural determinants impact on patient situation, and individual and interdisciplinary altruistic actions to alleviate patient suffering.
Corporate Cash Holdings and Share Buyback: Evidence from Emerging Markets
Authors: Saxena Vedika , Sahoo Seshadev 
Published: August 2023

This study evaluates corporate cash holdings (CCHs) as a determinant of share buyback for three emerging economies, India, Malaysia, and South Korea, from 2002 to 2020. We find CCH as a significant determinant of share buyback for our sample nations. Our results suggest that share buyback is a flexible way for firms to distribute excess cash across our sample nations. Our study also documents the impact of different country-level investor protection frameworks on buybacks. A favorable relationship between a strong investor protection environment (good governance) and buyback explains the effective role of buyback in resolving agency conflicts compared to dividends. JEL Codes: C5, F3, G3
From the chemical imbalance to the power imbalance: A psychiatry trainee’s perspectives on service-user supervision
Authors: Bhagavan Chiranth , Gordon Sarah , Sundram Frederick 
Published: August 2023

Objective This paper describes perspectives and insights of a trainee’s experience of service-user supervision. This includes the background to this novel approach, outlining its process and content, key themes arising, applications in practice, limitations of the approach, and future considerations. Conclusions Service-user supervision promotes education and experiences at this important stage of professional development and can promote clinical, cultural, and systemic changes required to support the paradigm shift towards recovery-oriented and human rights-based practice.
Are Palliative Care Volunteers Special People? A Comparative Observational Study Exploring Their Sociodemographic Profile and Psychological Resources
Authors: Varay Caroline , Lareyre Olivier , Baeza-Velasco Carolina 
Published: August 2023

Background Faced with rising needs for patient support, palliative care is shifting towards a more community-based approach. Yet the profile of volunteers in this field is poorly known. Aim To explore psychosocial characteristics of palliative care volunteers, by comparing them to two groups, volunteers from the health and social sector without contact with palliative patients, and people from the general population without volunteer activity. Design Observational comparative study. Data were analyzed using descriptive statistics and logistic regression analysis. Participants The 3 groups of participants were recruited in France between September 2020 and June 2021. They completed an online survey assessing sociodemographic characteristics and psychological resources (self-efficacy, hope, optimism, resilience, mindfulness, self-compassion, empathy, forgivingness, and gratitude). Results Data from 559 participants were analyzed. Palliative care volunteers had overall significantly higher levels of psychological resources than control groups. Multivariate analysis revealed, among sociodemographic and psychological characteristics that showed differences between groups at the univariate level, the most efficient predictors of group status. The best criteria to distinguish palliative care volunteers from health and social sector volunteers were older age, having received training, and lower levels of self-compassion. To distinguish palliative care volunteers from people with no volunteer activity, older age and non-active professional status were the best criteria. Conclusions Palliative care volunteers displayed more psychological resources than controls. However, older age and being trained for volunteering, emerged as stronger factors for distinguishing palliative care volunteers from controls. Pursuing research about these volunteers should facilitate recruitment, training, and retention.
Survival Outcomes of Metastatic Non-small Cell Lung Cancer Patients With Limited Access to Immunotherapy and Targeted Therapy in a Cancer Center of a Low- and Middle-Income Country
Authors: Ballén Diego-Felipe , Carvajal-Fierro Carlos Andrés , Beltrán Rafael , Alarcón Martha-Liliana , Vallejo-Yepes Camilo , Brugés-Maya Ricardo 
Published: August 2023

Objective To describe the survival outcomes of metastatic non-small cell lung cancer patients with limited access to immunotherapy and targeted therapy in a cancer reference center in Colombia. Methods A retrospective analysis of metastatic non-small cell lung cancer patients treated between 2013 and 2018 was performed, majority diagnosed with adenocarcinoma. It was carried out in a public cancer reference center that provides care to patients of low and middle socioeconomic status. Overall survival and progression-free survival were evaluated by Kaplan–Meier analysis and log-rank test. A Cox regression model was performed for univariate and multivariate analysis. Results 209 patients were included with majority of adenocarcinoma (79.5%). First-line treatment was cytotoxic chemotherapy (50.2%), EGFR-targeted therapy (14.8%), chemoimmunotherapy (1.9%), and ALK-targeted therapy (1.4%). 31.6% received best supportive care. Median time of follow-up was 13 months, median overall survival was 11.2 months (95% CI, 7.9–14.4), 13 months for adenocarcinoma (95% CI, 8.1–17.9), and 2.5 months for squamous cell carcinoma (95% CI, 0.6–4.4) ( P < .001). Median progression-free survival was 9.3 months (95% CI, 7.9–10.7) without differences according to the type of first-line therapy. Median time-to-treatment was 55 days and only 54% of patients with a tested actionable mutation in EGFR received an EGFR-targeted therapy as the first-line treatment. Multivariate analysis showed that squamous cell carcinoma histology and receiving best supportive care were independent factors for worse overall survival ((HR:1.8, 95% CI, 1.076–3.082, P=.026) and (HR:14.6, 95% CI, 8.921–24.049, P < .001), respectively). Meanwhile, squamous cell carcinoma histology was an independent factor for worse progression-free survival (HR:3.4, 95% CI, 1.540-7.464, P=.002). Conclusions Despite advances in precision medicine, during the study period, cytotoxic chemotherapy was the most used treatment in our patients. Furthermore, about a third of them received best supportive care. The use of targeted therapies has been restricted by access to molecular diagnosis and remained low until 2018. Access to immunotherapy should be prioritized.