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Hospital-acquired pneumonia (HAP) represents one of the most common nosocomial infections in intensive care units (ICUs), accounting for 25% of all hospital-acquired infections. While oral care is recommended as a preventive measure, the relationship between standardized oral care practices and HAP incidence remains incompletely characterized.
Objective:
To evaluate the association between oral care practice compliance and HAP incidence in ICU patients, and to identify specific aspects of oral care delivery that influence outcomes.
Methods:
We conducted a prospective mixed-methods observational cohort study from May 2021 across seven ICUs in a tertiary hospital in China. The study utilized a two-phase approach: (1) systematic assessment of oral care implementation through structured observation of nursing staff (n = 58), and (2) prospective evaluation of HAP outcomes in patients (n = 142). Primary outcomes included oral care compliance metrics and HAP incidence. HAP was defined according to standardized clinical criteria and confirmed by two independent physicians.
Results:
Among 142 unique patients, 63 (44.37%) received oral care orders. The oral care completion rate was 61.93%, and the qualification rate was 54.13%. In our analysis, HAP (including both ventilator-associated pneumonia [VAP] and non-ventilator hospital-acquired pneumonia [NVHAP]) occurred in 15/63 (23.81%) patients receiving oral care and 22/79 (27.85%) patients without oral care. Multivariate analysis revealed that incomplete oral care (adjusted OR 2.47, [95% CI, 1.15–4.45], P = 0.009), non-qualified care techniques (adjusted OR 3.17, [95% CI, 1.45–6.35], P = 0.002), and inadequate item qualification (adjusted OR 3.33, [95% CI, 1.47–6.55], P = 0.001) were independently associated with increased HAP risk, after adjusting for confounders. Stratified analysis showed similar associations in both VAP and NVHAP subgroups.
Conclusion:
Our investigation demonstrated that suboptimal oral care practices were associated with increased HAP risk in ICU patients. Implementation of evidence-based standardized protocols and improved adherence strategies may help reduce HAP incidence.
Mediation analysis is one of the most popularly used methods in social sciences and related areas. To estimate the indirect effect, the least-squares regression is routinely applied, which is also the most efficient when the errors are normally distributed. In practice, however, real data sets are often non-normally distributed, either heavy-tailed or skewed, so that the least-squares estimators may behave very badly. To overcome this problem, we propose a robust M-estimation for the indirect effect via a general loss function, with a main focus on the Huber loss which is more slowly varying at large values than the squared loss. We further propose a data-driven procedure to select the optimal tuning constant by minimizing the asymptotic variance of the Huber estimator, which is more robust than the least-squares estimator facing outliers and non-normal data, and more efficient than the least-absolute-deviation estimator. Simulation studies compare the finite sample performance of the Huber loss with the existing competitors in terms of the mean square error, the type I error rate, and the statistical power. Finally, the usefulness of the proposed method is also illustrated using two real data examples.
This study aimed to demonstrate the utilization value of 1PN embryos. The 1PN zygotes collected from December 2021 to September 2022 were included in this study. The embryo development, the pronuclear characteristics, and the genetic constitutions were investigated. The overall blastocyst formation and good-quality blastocyst rates in 1PN zygotes were 22.94 and 16.24%, significantly lower than those of 2PN zygotes (63.25 and 50.23%, respectively, P = 0.000). The pronuclear characteristics were found to be correlated with the developmental potential. When comparing 1PN zygotes that developed into blastocysts to those that arrested, the former exhibited a significantly larger area (749.49 ± 142.77 vs. 634.00 ± 119.05, P = 0.000), a longer diameter of pronuclear (29.81 ± 3.08 vs. 27.30 ± 3.00, P = 0.000), and a greater number of nucleolar precursor body (NPB) (11.56 ± 3.84 vs. 7.19 ± 2.73, P = 0.000). Among the tested embryos, the diploidy euploidy rate was significantly higher in blastocysts in comparison with the arrested embryos (66.67 vs. 11.76%, P = 0.000), which was also significantly higher in IVF-1PN blastocysts than in ICSI-1PN blastocysts (75.44 vs. 25.00%, P = 0.001). However, the pronuclear characteristics were not found to be linked to the chromosomal ploidy once they formed blastocysts.
In summary, while the developmental potential of 1PN zygotes is reduced, our study shows that, in addition to the reported pronuclear area and diameter, the number of NPB is also associated with their developmental potential. The 1PN blastocysts exhibit a high diploidy euploidy rate, are recommend to be clinically used post genetic testing, especially for patients who do not have other 2PN embryos available.
The aim of this study was to investigate the antioxidant effect of alpha-lipoic acid (α-LA) in dairy cows and its metabolic mechanism. Thirty Holstein cows weighing 550 ± 25 kg, 200 ± 15 days of lactation and calving 2–3 times were randomly divided into three groups, ten cows in each group. Different doses of α-LA were added based on body weight: 0 (CTL), 30 (LA-L) and 60 (LA-H) mg/kg per head per day; 7 days adaptation period, 30 days formal period. Milk production was recorded daily during the test period. Milk and blood samples were collected on the last day. ELISA kits and automatic biochemical analyser were used to detect the indicators in blood; serum metabolites were detected and analysed by non-target metabolomics. The results of the study showed that the addition of α-LA significantly increased milk yield; blood concentrations for HDL, triglyceride, cortisol and triiodothyronine were significantly elevated; and levels of glutathione reductase and nitric oxide synthase were significantly reduced in LA-L group as compared to CTL group. The concentrations of IL-1β, IL-2, TNF-α, IgG and IgA were significantly higher after supplementation with α-LA. Metabolomics analysis revealed 13 and 15 differential metabolites each in positive or negative modes. Methylmalonic acid levels were significantly higher following α-LA supplementation compared to CTL group, as were D-lactose, D-maltose and oleanolic acid levels in LA-L group. In summary, α-LA can enhance milk production, improve antioxidant capacity and immunity, and is more beneficial for animal production and economic benefits at 30 mg/kg.
The Accidental Republic is a concern for all industrialised countries, and China is no exception. To solve this problem, Workers’ Compensation Insurance (WCI) is a perfect option. The redemption of The Accidental Republic can be understood through the development of WCI. However, little attention has been paid to the development of Chinese WCI. Starting from labour insurance regulations promulgated in 1951, this research explores over 70 years of reform and development of Chinese WCI, explicitly dividing reforms into three phases – establishment and implementation, exploration and practice, and adaptation and formation – that aligned with stages of China’s economic development. Further, the insurance fund performance in the last decade is evaluated by Data envelopment analysis and Malmquist (DEA-Malmquist), through the static and dynamic results, yielding generally average results. Subsequently, five major problems of WCI are identified and discussed and five suggestions offered drawing on international comparison and the national situation. Lastly, the accidental and inevitable aspects of China’s WCI system during the redemption of The Accidental Republic are summarised.
In the present study, we performed direct numerical simulations for a hypersonic turbulent boundary layer over the windward side of a lifting body, the HyTRV model, at Mach number $6$ and attack angle 2$^{\circ }$ to investigate the global and local turbulent features, and evaluate its difference from canonical turbulent boundary layers. By scrutinizing the instantaneous and averaged flow fields, we found that the transverse curvature on the windward side of the HyTRV model induces the transverse opposing pressure gradients that push the flow on both sides towards the windward symmetry plane, yielding significant effects of the azimuthal inhomogeneity and large-scale cross-stream circulations, moderate and azimuthal independent influences of adverse pressure gradient, and negligible impact of the mean flow three-dimensionality. Further inspecting the local turbulent statistics, we identified that the mean and fluctuating velocity become increasingly similar to the highly decelerated turbulent boundary layers over flat plates in that the mean velocity deficit is enhanced, and the outer layer Reynolds stresses are amplified as it approaches the windward symmetry plane, and prove to be self-similar under the scaling of Wei & Knopp (J. Fluid Mech., vol. 958, 2023, A9) for adverse-pressure-gradient turbulent boundary layers. Conditionally averaged Reynolds stresses based on strong sweeping and ejection events demonstrated that the Kelvin–Helmholtz instability of the strong embedded shear layer induced by the large-scale cross-stream circulations is responsible for the turbulence amplification in the outer layer. The strong Reynolds analogy that relates the mean velocity and temperature was refined to incorporate the non-canonical effects, showing considerable improvements in the accuracy of such a formula. On the other hand, the temperature fluctuations are still transported passively, as indicated by their resemblance to the velocity. The conclusions obtained in the present study provide potentially profitable information for turbulent modelling modification for the accurate predictions of skin friction and wall heat transfer.
We report on a high-efficiency, high-power tandem Ho:YAG single-crystal fiber (SCF) laser in-band pumped by a Tm-doped fiber laser at 1907 nm. In addition to the uniform heat distribution resulting from the large surface-to-volume ratio of this fiber-like thin-crystal rod, the long gain region provided by the tandem layout of two SCFs enables high lasing efficiency and power handling capability. More than 100 W output power is achieved at 2.1 μm, corresponding to a slope efficiency of 70.5% and an optical-to-optical efficiency of 67.6%. To the best of our knowledge, this is the highest output power and efficiency ever reported from SCF lasers in the 2-μm spectral range.
The response of airfoils to unsteady disturbances is a classic problem in the aerodynamics field. Many theoretical models have been proposed in the past to predict the unsteady aerodynamic forces of airfoils. However, these theories focused on individual airfoil motions or incoming flow disturbances, while the theoretical models for multiple disturbances still need to be developed. In this study, a theoretical model to predict the aerodynamic force of an oscillating airfoil encountering vertical gust is derived from a linear combination of Theodorsen's and Sears’ theories. Experimental investigations involving a two-dimensional pitching airfoil encountering a sinusoidal vertical gust are carried out to examine the proposed theory. It is found that the theory effectively captures the trends in the unsteady lift of airfoils subjected to dual disturbances. However, it tends to overestimate the lift amplitude. Notably, when a quasi-steady correction is applied to the theory, the prediction accuracy is greatly improved. The theory correction agrees well with experiment at small pitching frequencies, while deviations exist at higher pitching frequencies. The temporal evolution of the flow velocity reveals that the velocity disturbance induced by the coupled disturbance around the airfoil conforms to the linear superposition of the velocities induced by each individual disturbance, consistent with the prediction of the vortex sheet model. As the pitching frequency increases, significant nonlinear effects appear near the trailing edge of the airfoil, which may be one key factor for the disparities between the theoretical predictions and the experimental lift at higher pitching frequencies.
Gust response has consistently been a concern in engineering. Critical theories have been proposed in the past to predict the unsteady lift response of an airfoil experiencing vertical gusts by Atassi, and longitudinal gusts by Greenberg. However, their applicability for an airfoil with non-zero angles of attack still needs clarification. Thus, force measurements are conducted to examine these theories’ validity and quasi-steady corrections are applied to compensate potential disparities between the idealised and real flow conditions. Velocity measurements are performed to scrutinise the effect of gusts on the flow around the airfoil, and subsequently to reveal the underlying mechanism governing the airfoil's response to gust-induced perturbations. In the study, two pitching vanes are arranged upstream to generate periodic vertical and longitudinal gusts, whereas a downstream airfoil with angles of attack of 0–12° is subjected to two gust types. It is found that Greenberg's theory demonstrates superior predictive capability in pre-stall regimes, with the potential for its effectiveness to be expanded to post-stall regimes through theoretical refinements. In contrast, Atassi's theory exhibits significant deviations from experimental outcomes across the measured angles of attack. Nevertheless, a modified version of the theory aligns better with experimental results at small angles of attack, whereas substantial discrepancies persist as the angle of attack increases. In the pre-stall regime, the aerodynamic response of the airfoil to vertical gusts displays a linear correlation with the flow angle near the leading edge. In the post-stall regime, the vertical gust induces dynamic stall of the airfoil. The flow angle has an essential effect on the lift coefficient but it alone is inadequate to dictate the trend of the lift coefficient. The vorticity statistics show that negative vortex circulation strongly correlates with the lift coefficient. Thus, further correction of the theory or a new vortex model can be expected to predict the lift variation.
Sepiolite-based composites have great potential for application as flame-retardant and thermal-insulation material but their application and development are limited by poor mechanical properties. The objective of the present study was to combine polyvinyl alcohol (PVA) and 3-aminopropyltriethoxysilane (KH-550) with sepiolite (Sep) to improve its aerogel strength. A universal testing machine, thermogravimetry, and microcalorimetry were used to investigate the mechanical properties, thermal-stability, and flame-retardant properties, respectively, of aerogels. The results indicated that KH-550 can enhance effectively the mechanical properties and flame retardancy of aerogels. The compressive modulus of PVA/Sep vs KH-550/PVA/Sep aerogel was 209.28 vs. 474.43 kPa, the LOI index changed from 26.4 to 30.4%. The porosity of the aerogels was > 96% and the density was < 0.05 g/cm3. The thermal conductivity remained at between 0.0340 and 0.0390 W/(m·K), and the aerogel could recover to > 85% after a 50% compressive deformation. These data indicated that Sep-based aerogel would act as a flame retardant and a thermal insulating material with excellent mechanical properties.
Hydrophobicity, swellability, and dispersion are important properties for organo-montmorillonites (OMnt) and have yet to be fully characterized for all OMnt configurations. The purpose of the present work was to examine the preparation of OMnt from the reaction of Ca2+-montmorillonite (Ca2+-Mnt) with a high concentration of surfactant and to reveal the relevant properties of hydrophobicity and dispersion of the resultant OMnt. A series of OMnt samples were prepared using a small amount of water and cetyltrimethylammonium bromide (CTAB) with a concentration more than the CTAB critical micelle concentration (CMC). The relationship between OMnt microstructure and the hydrophobicity and swellability properties was investigated in detail. The resulting OMnt samples were characterized using powder X-ray diffraction patterns (XRD), Fourier-transform infrared (FTIR) spectroscopy, thermogravimetric and differential thermogravimetry (TG-DTG), water contact angle tests, swelling indices, and transmission electron microscopy (TEM). The addition of CTAB and water in the OMnt preparation affected the OMnt microstructure and properties. An increase in CTAB concentration led to a more ordered arrangement of cetyltrimethylammonium (CTA+) cations in the interlayer space of the OMnt and a large amount of CTA+ cations on the outer surfaces of the OMnt. The swelling indices and the water contact angles of OMnt samples depended on the distribution of the CTAB surfactant on OMnt and the orientation of the surfactant hydrophilic groups on the inner and on the outer surfaces of OMnt. A maximum swelling index of 39 mL/g in xylene was achieved with an average water contact angle of 62.0° ± 2.0° when the amount of CTAB added was 2 times the cation exchange capacity (CEC) of Mnt and the lowest water to dry Mnt mass ratio was 3 during the preparation of OMnt samples. The platelets of OMnt aggregated together in xylene by electrostatic attraction and by hydrophobic interactions.
The Tuluanshan Formation of the eastern Coastal Range of Taiwan overlies an andesitic core complex presumed to be the source of hydrothermal fluids responsible for the Si- and Mg-rich mineralization of sepiolite and palygorskite (attapulgite) which are found in veins within fissures and in fracture zones of the volcanic rocks of the region. This study was undertaken in order to understand these relationships better by characterizing sepiolite and palygorskite in this Formation and by examining their occurrence and distribution in the Tungho (TH) and Chunjih (CJ) areas. Samples were analyzed using X-ray diffraction (XRD), thermal analysis, Fourier-transform infrared (FTIR) spectroscopy, and petrographic, scanning (SEM), and transmission (TEM) electron microscopic methods. Sepiolite and palygorskite are blocky and earthy-type materials that display fibrous characteristics when viewed using TEM and SEM and occurred alone or with chalcedony in veins. The fibers of blocky sepiolite are commonly intercalated with smectite but the earthy type of sepiolite and palygorskite observed in this study displayed precipitation from fluid enriched in Si, Al, Mg, and minor Fe and depleted in other ions at an earlier stage of offset of the andesitic veins. Continuation of reverse faulting and high shearing stress caused the precipitation of a significant quantity of interlaminated sepiolite. Sepiolite and palygorskite were formed at an earlier stage of fluid interaction relative to smectite in the Tuluanshan Formation.
A local COVID-19 outbreak with two community clusters occurred in a large industrial city, Shaoxing, China, in December 2021 after serial interventions were imposed. We aimed to understand the reason by analysing the characteristics of the outbreak and evaluating the effects of phase-adjusted interventions. Publicly available data from 7 December 2021 to 25 January 2022 were collected to analyse the epidemiological characteristics of this outbreak. The incubation period was estimated using Hamiltonian Monte Carlo method. A well-fitted extended susceptible-exposed-infectious-recovered model was used to simulate the impact of different interventions under various combination of scenarios. There were 387 SARS-CoV-2-infected cases identified, and 8.3% of them were initially diagnosed as asymptomatic cases. The estimated incubation period was 5.4 (95% CI 5.2–5.7) days for all patients. Strengthened measures of comprehensive quarantine based on tracing led to less infections and a shorter duration of epidemic. With a same period of incubation, comprehensive quarantine was more effective in containing the transmission than other interventions. Our findings reveal an important role of tracing and comprehensive quarantine in blocking community spread when a cluster occurred. Regions with tense resources can adopt home quarantine as a relatively affordable and low-impact intervention measure compared with centralized quarantine.
The fast pace of modern life and work competition has led to an increase in the incidence rate of depression year by year. In recent years, Mongolian medicine has achieved good results in the treatment of depression. Research on the production of Mongolian medicine group based on Qiwei Guangzao pill to explore its therapeutic effect on moderate depression.
Subjects and Methods
The study selected 70 patients with moderate depression and randomly divided them into an experimental group and a control group. The experimental group received Mongolian medicine based on Qiwei Guangzao pills in the morning, middle, and evening, supplemented by droperidol and melitracen tablets; The control group only received oral administration of flupentixol and melitracin tablets. The treatment course was 4 weeks, and the patient’s status was evaluated by Hamilton Depression Scale (HAMD) score. SPSS25.0 software was used for statistical analysis of the data obtained.
Results
Compared to the control group, the rehabilitation rate of patients in the experimental group was 14.3%, and the proportion of patients with significant treatment effects was 45.8%. The total effective rate was about 91.4%, indicating that the improvement of HAMD scores in the experimental group was higher than that in the control group.
Conclusions
The experimental results show that the Mongolian medicine group based on Qiwei Guangzao pill has a significant therapeutic effect on moderate depression, and can effectively improve patients’ sleep status and gastrointestinal symptoms.
Acknowledgement
The National Natural Science Foundation of China, Correlational study on Lianqiao-4 and intestinal flora in the treatment of liver injury by the theory of “ essence and dross decomposition” (Grant No. 82060910); The National Natural Science Foundation for Young Scientists of China, Study on genomics and proteomics mechanism of Lianqiao-4 against liver injury based on the theory of “ essence and dross decomposition “ in Mongolian Medicine (Grant No. 81760765); The central government supported cross-disciplinary projects with special funds for local construction (No. JCHXKXM001).
Group Cognitive Behavioral Therapy (GCBT) is the primary psychological treatment for social anxiety disorder. The core concept of Cognitive Behavioral Therapy is manifested in two aspects: cognitive correction and behavioral feedback. Social Anxiety Disorder (SAD) is a chronic mental disorder with a high incidence of negative automatic thinking and negative fear.
Subjects and Methods
This study conducted a controlled experiment between 50 SAD patients and 50 healthy people. Before treatment, 50 SAD patients were surveyed by psychological questionnaires, including social anxiety scale, social support scale, and parenting style questionnaire, to evaluate the thinking style, personality characteristics, and external psychosocial support of SAD patients. After GCBT treatment, SAD patients were again surveyed with a scale and questionnaire within one week to evaluate the degree of symptom improvement and cognitive change. In this study, SPSS23.0 analysis software was used for analysis.
Results
There were significant differences in thinking style, personality characteristics, social support, and parenting style between SAD patients and the control group (P<0.05). Social anxiety (P=0.03), negative thinking (P=0.03), and fear of negation (P=0.04) were significantly lower in GCBT patients after treatment than before treatment.
Conclusions
GCBT treatment can change the symptoms of SAD patients in a long-term and stable manner, which is related to the changes in patients’ cognitive habits. GCBT treatment can improve the negative cognition of SAD patients to reduce their symptoms, and increasing subjective social support and reducing paternity rejection can improve the long-term prognosis of patients with social anxiety.
Acknowledgement
The National Social Science Foundation (22XGL021); Guizhou grassroots social governance innovation high-end think tank; the grass-roots governance innovation team for Rural Revitalization of Guizhou Federation of Social Sciences.
The lift generation mechanism of leading-edge vortex (LEV) in the case of a pitching and plunging plate is studied using an experimental approach and the improved discrete vortex method in this research. A formation condition of the secondary structure is introduced into the traditional discrete vortex method to compensate for the shortcomings in the simulation of the viscous effect between LEV and plate. The simulation of the secondary structure helps the improved method perform better in flow-field reconstruction and lift prediction. Accordingly, the lift generation mechanism of the LEV and influence of the secondary structure are studied. The lift contribution of the vortex structure is isolated and linearly decomposed into two parts according to sources of flow field: the quasi-potential flow part and the vortex-induced flow part. The vortex lift is defined as the lift contribution of the vortex structure in vortex-induced flow, which gives a new insight into the production of lift of the LEV. The lift generation mechanism through the discrete vortex method is verified and extended in viscous flow through experimental measurement. In addition, a vortex lift indicator based on the reverse flow of the LEV is proposed to examine the change of vortex lift in experimental measurement. The flow mechanism for the decline of vortex lift for different maximum effective angles of attack is revealed based on the vortex lift indicator. Furthermore, for the LEV-dominating flow, the indicator can also be applied in estimating the maximum value and corresponding critical time of overall lift in experiments.
Despite observed ethnic differences in eating patterns and obesity, evidence in China is limited. This study examined ethnic differences in eating patterns and their associations with weight outcomes among multi-ethnic adults in West China. A cross-sectional survey collected self-reported data on demographics, eating behaviours, weight and height in 2021. Principal component analysis and multivariate regression were conducted to identify eating patterns and examine their associations with weight outcomes. In total, 4407 subjects aged ≥ 18 years were recruited across seven provinces in West China. Four eating patterns were identified: ‘meat-lover’ – characterised by frequent consumption of meat and dairy products, ‘indulgent’ – by frequent intakes of added salt, sugar, alcohol and pickled food, ‘diversified-eating’ – by frequently consuming food with diversified cooking methods and eating out and ‘nutri-health-concerned’ – by good food hygiene behaviours and reading food labels. Ethnic differences in eating patterns were observed. Compared with Han, Hui were less likely to exhibit meat-lover or diversified-eating patterns; Tibetans were less likely to have meat-lover or nutri-health-concerned patterns; Mongolians were more likely to have indulgent pattern. BMI was positively associated with meat-lover pattern in both genders (exp(β): 1·029; 95 % CI: 1·001, 1·058 for men; 1·018; 1·000, 1·036 for women) and negatively associated with nutri-health-concerned pattern in women (0·983; 0·966, 1·000). Mongolians were two times more likely to be overweight/obese than Han (OR: 3·126; 1·688, 5·790). Considerable ethnic differences existed in eating patterns in West China. Mongolians were more likely to be overweight/obese, which was associated with their indulgent eating patterns. Ethnic-specific healthy eating intervention programs are needed.
About a fourth of Chinese adolescents developed clinically significant depressive symptoms following a disaster. However, little is known about whether and how post-trauma negative life events and a sense of security are associated with depressive symptoms in this population. This study examined the psychological experiences of Chinese young people who had experienced the 2013 Ya’an earthquake in Sichuan, China.
Methods:
This cross-sectional study was conducted in 2019. A total of 693 Chinese middle school students completed a questionnaire that measured their level of depressive symptoms, trauma exposure, stressful life events, and sense of security.
Results:
Results of hierarchical multiple-regression analyses showed that the level of life stress from stressful life events was positively associated with the level of depressive symptoms (β = 0.416, P < 0.001) and the level of the sense of security was negatively associated with the level of depressive symptoms (β = −0.352, P < 0.001) when analysis controlled for age, gender, and trauma exposure.
Conclusions:
These findings highlight the importance of considering the influence of life stressors and the sense of security in devising measures and strategies for the prevention of the manifestation of depression among young people, particularly those who were exposed to disasters.
While conservation practices promote soil health and reduce the negative environmental effects from agricultural production, their adoption rates are generally low. To facilitate farmer adoption, we carried out a survey to identify potential challenges faced by farmers regarding conservation tillage and cover crop adoption in the western margin of the US Corn Belt. We found farmers' top two concerns regarding conservation tillage were delayed planting, caused by slow soil warming in spring, and increased dependence on herbicide and fungicides. Narrow planting window and lack of time/labor were perceived by farmers as the two primary challenges for cover crop adoption. Some sense of place factors, including the commonly included dimensions of attachment, identity and dependence, played a role in farmers' perceived challenges. For example, respondents more economically dependent on farming perceived greater challenges. We found that farmers' challenge perceptions regarding reduced yield and lack of time/labor significantly decreased as years of usage increased, implying that time and experience could dilute some challenges faced by farmers. Our findings indicate that social network use, technical guidance and economic subsidies are likely to address the concerns of farmers and facilitate their adoption of conservation practices.