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This article places the study of rural environmental activism in the wider context of the Chinese government's promotion of Ecological Civilization (shengtai wenming 生态文明). Ecological Civilization is, we argue, a top-down imaginary of China's future that opens up space for environmental agency while setting authoritative standards for how to frame protests in a logic of science and social stability. The article compares how residents in a small cluster of villages in Zhejiang province dealt with different sources of air pollution over a span of ten years: how, when and why they chose to negotiate with local officials and industrial managers to prevent or reduce air pollution, and what the outcome was. We found that in addition to a consciousness of the right to protest, villagers had come to regard the ability to evoke science in negotiations with officials and industrial managers as crucial for success. We suggest that the forms of environmental activism we observed were in effect “containable protests” that befit the state-initiated national imaginary of an ecologically civilized world. 这篇文章把乡村环保行动置于中国政府推进的”生态文明”建设的大背景下进行研究。我们认为, “生态文明” 建设是一种自上而下的对未来中国发展的 “国家想象”, 它把环保抗争有效地纳入到科学发展和社会稳定的制度框架里, 更重要的是, 为环境保护行动打开了一个新的空间。文章从抗争方式、时间选择和原因诉求等方面, 通过对浙江省多个村落的村民进行调查, 比较研究他们十年来面对不同的空气污染源, 与地方官员、工厂老板协商阻止和缓解空气污染的环保抗争及其行动结果。我们发现, 除了 “依权抗争” 之外, 在与官方和老板协商过程中, 村民运用科学知识的能力成为他们成功的重要手段。我们建议, 环保行动中的 “包容抗争” 方式可能更利于实现由国家发起的生态文明建设 “国家想象” 的愿景。

This introduction provides an overview and analysis of key scientific data regarding air pollution in China. It constitutes a reference for understanding how policymakers, media and population in China make sense of and deal with air pollution, as discussed in the other articles of the section. We summarize the major characteristics and trends regarding air pollution in China, including its main sources and composition, levels of population exposure across the country, attributable mortality, and mitigation efforts. We also compare current levels of air pollution in China with other parts of the world and in a historical perspective. While the situation remains dire in many regions, particularly the Northeast, we conclude that there are signs of relief, or at least a halt to the increase in ambient air pollution levels. At the same time, critical issues regarding unequal levels of exposure remain, and health damaging levels of air pollution in cities will undoubtedly remain high for a long time to come. The rural population residing in areas close to industry and polluted cities and still depending on solid household fuels will likely be the worst off when it comes to air pollution exposure.

Background Knowledge on the prevalence of sex chromosome abnormalities (SCAs) is limited, and delayed diagnosis or non-diagnosis of SCAs are a continuous concern. We aimed to investigate change over time in incidence, prevalence and age at diagnosis among Turner syndrome (TS), Klinefelter syndrome (KS), Triple X syndrome (Triple X) and Double Y syndrome (Double Y). Methods This study is a nationwide cohort study in a public health care system. The Danish Cytogenetic Central Registry (DCCR) holds information on all karyotypes performed in Denmark since 1961. We identified all individuals in the DCCR with a relevant SCA during 1961–2014; TS: n  = 1156; KS: n  = 1235; Triple X: n  = 197; and Double Y: n  = 287. From Statistics Denmark, which holds an extensive collection of data on the Danish population, complete data concerning dates of death and migrations in and out of Denmark were retrieved for all individuals. Results The prevalence among newborns was as follows: TS: 59 per 100,000 females; KS: 57 per 100,000 males; Triple X: 11 per 100,000 females; and Double Y: 18 per 100,000 males. Compared with the expected number among newborns, all TS, 38% of KS, 13% of Triple X, and 18% of Double Y did eventually receive a diagnosis. The incidence of TS with other karyotypes than 45,X ( P  < 0.0001), KS ( P  = 0.02), and Double Y ( P  = 0.03) increased during the study period whereas the incidence of 45,X TS decreased ( P  = 0.0006). The incidence of Triple X was stable ( P  = 0.22). Conclusions The prevalence of TS is higher than previously identified, and the karyotypic composition of the TS population is changing. Non-diagnosis is extensive among KS, Triple X and Double Y, whereas all TS seem to become diagnosed. The diagnostic activity has increased among TS with other karyotypes than 45,X as well as among KS and Double Y.

Due to increased longevity, women can expect to live more than one-third of their lives in a post-menopausal state, which is characterised by low circulating levels of oestrogen and progesterone. The aim of this review is to provide insights into current knowledge of the effect of female hormones (or lack of female hormones) on skeletal muscle protein turnover at rest and in response to exercise. This review is primarily based on data from human trials. Many elderly post-menopausal women experience physical disabilities and loss of independence related to sarcopenia, which reduces life quality and is associated with substantial financial costs. Resistance training and dietary optimisation can counteract or at least decelerate the degenerative ageing process, but lack of oestrogen in post-menopausal women may reduce their sensitivity to these anabolic stimuli and accelerate muscle loss. Tendons and ligaments are also affected by sex hormones, but the effect seems to differ between endogenous and exogenous female hormones. Furthermore, the effect seems to depend on the age, and as a result influence the biomechanical properties of the ligaments and tendons differentially. Based on the present knowledge oestrogen seems to play a significant role with regard to skeletal muscle protein turnover. Therefore, oestrogen/hormonal replacement therapy may counteract the degenerative changes in skeletal muscle. Nevertheless, there is a need for greater insight into the direct and indirect mechanistic effects of female hormones before any evidence-based recommendations regarding type, dose, duration and timing of hormone replacement therapy can be provided.

Clinical placements and supervision is an integral part of nursing education internationally. There are significant differences between students’ expectations of clinical learning and their fulfillment. Few studies have focused on supervisors’ perspectives on clinical placements. The objective of this study was to explore nursing supervisors’ perspectives on students’ preparedness for clinical placements.

Lay Summary We demonstrate that ustekinumab does not adversely affect semen quality or sex hormones in male patients. Ustekinumab is not detectable in semen and poses no risk to partners. Our observations support a recommendation to continue ustekinumab therapy in patients wishing to conceive.

Falls among older adults is one of the major public health challenges facing the rapidly changing demography. The valid assessment of reaction time (RT) and other well-documented risk factors for falls are mainly restricted to specialized clinics due to the equipment needed. The Nintendo Wii Balance Board has the potential to be a multi-modal test and intervention instrument for these risk factors, however, reference data are lacking. To provide RT reference data and to characterize the age-related changes in RT measured by the Nintendo Wii Balance Board. Healthy participants were recruited at various locations and their RT in hands and feet were tested by six assessors using the Nintendo Wii Balance Board. Reference data were analysed and presented in age-groups, while the age-related change in RT was tested and characterized with linear regression models. 354 participants between 20 and 99 years of age were tested. For both hands and feet, mean RT and its variation increased with age. There was a statistically significant non-linear increase in RT with age. The averaged difference between male and female was significant, with males being faster than females for both hands and feet. The averaged difference between dominant and non-dominant side was non-significant. This study reported reference data with percentiles for a new promising method for reliably testing RT. The RT data were consistent with previously known effects of age and gender on RT.

Objective: This study aimed to investigate associations between work postures, lifting at work, shift work, work hours, and job strain and the risk of sick leave during pregnancy from 10-29 completed pregnancy weeks in a large cohort of Danish pregnant women. Methods: Data from 51 874 pregnancies in the Danish National Birth Cohort collected between 1996-2002 were linked to the Danish Register for Evaluation of Marginalization. Exposure information was based on telephone interviews. Hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated by Cox regression analysis, using time of first episode of sick leave as the primary outcome. Results: We found statistically significant associations between all the predictors and risk of sick leave; for non-sitting work postures (HR_(range) 1.55-2.79), cumulative lifting HR_(trend) 1.29, 95% CI 1.26-1.31, shift work (HR_(evening) 1.90, 95% CI 1.73-2.09, HR_(night) 1.52, 95% CI 1.15-2.01), monthly night shifts HR_(trend) 1.12, 95% CI 1.11-1.14, increasing weekly work hours HR_(trend) 0.93, 95% CI 0.91-0.95 and high job strain HR 1.52, 95% CI 1.42-1.63. Some exposures influenced HR in either a positive or negative time-dependent way. Conclusion: Our results support previous findings and suggest that initiatives to prevent sick leave during pregnancy could be based on work conditions. Preventive measures may have important implications for pregnant women and workplaces.

CoolSeal is a new vessel sealing system for dissection and hemostasis during surgery. No clinical studies have investigated safety, advantages or disadvantages regarding the use of this device. The aim of the present study was to investigate the safety of CoolSeal and compare it with conventional ligation technique or LigaSure during the total thyroidectomy. We hypothesized that the use of CoolSeal would reduce the operating time and bleeding without complications increase. Study design represents a retrospective cohort study with a tertiary reference center setting. We analyzed total thyroidectomy data from January 2021 to June 2023. We recorded patients’ characteristics, surgical information, and postoperative outcome. We performed 221 total thyroidectomies in the study period. Analysis was restricted to 171 patients operated by only two surgeons. Hemostasis was secured by conventional ligation in 117 patients (68%), LigaSure in 34 patients (20%) and CoolSeal in 20 patients (12%). Median thyroid weight and bleeding were 67 g and 50 ml, respectively. Procedures using LigaSure or Cool-Seal were on larger glands (median 205 g) without increased bleeding (50 ml). Operating time was shortest with CoolSeal (96 min, p=0.003) compared with LigaSure (117 min) or conventional ligation (115 min). Bleeding was reduced with CoolSeal compared with LigaSure (45 vs. 100 ml, p=0.003). With CoolSeal, median hospitalization was one postoperative day, no patients required re-operation. There was no palsy of recurrent laryngeal nerves and no permanent hypoparathyroidism. In our first clinical experience, CoolSeal was safe and efficient for total thyroidectomy. With a small sample size, we saw a clinical benefit with reduced operating time without post-operative complications increase.

In Denmark, American mink (Neovison vison) have been bred for their fur since the mid-1920s. Mink escaping from farms may supply the feral population. Often, it is of biological and management interest to separate the population of feral mink (i.e. mink caught in the wild) in two groups: 1) mink born on farms i.e., escapees, and 2) mink born in the wild. In this study, two methods were used for separating feral mink into the two groups: a) Comparison of body length of farmed mink and feral mink, and b) Presence of a biomarker (tetracycline: an oral antibiotic used on mink farms). A total of 367 wild caught mink (from the mainland of Denmark and the island of Bornholm), and 147 mink from farms, collected during the period 2014-2018, were used for the analysis of body length. For the testing of tetracycline (TC) as a biomarker, 78 mink from farms where there was knowledge about TC treatment (with or without) were examined for fluorescent markings in the canine teeth. Results from both univariate analyses and Gaussian mixture model analysis demonstrated clear divisions between the mean body length (mean ± S.E., range) of farmed males (52.1 cm ± 0.4, 48-68) and farmed females (mean 44.0 ± 0.2, 40-50), and between farmed mink and wild caught mink. Mixture analysis identified two groups within each sex of the wild caught mink, one assigned to farmed mink (born in captivity) and another group of smaller mink suspected of being born in the wild. On Bornholm, the mean (±SD, range) length of males born in the wild was 43.7cm (± 0.3, 36-57) and for females 37.5cm (± 0.3, 32-45). The mean length (±SD, range) of males born in the wild in the mainland of Denmark was 42.5cm (± 2.3, 36-46) and for females 36.1cm (± 1.0, 34-37). Among the feral mink from mainland Denmark, 28.4% of males and 21.6% of females were identified as escapees, while 0% of the males and 1% of the females were identified as escapees among the wild caught mink on Bornholm. Eight percent of mink from farms using tetracycline were false negatives, while no false positives were found among mink from farms not using TC. TC fluorescence was found in five of 217 mink caught in the wild equivalent to 22% escapees in mainland Denmark. No TC markings were found in mink caught in the wild on Bornholm. In conclusion, both methods a) the body length of mink, and b) fluorescent biomarkers in canine teeth are considered as useful tools to identifing mink that have escaped from farms.