Government of Jiangsu Province

School violence and bullying in China is under investigated, though it has become a national concern recently. Using updated national representative survey data collected in 2016 from seven provinces across China, covering students from all pre-college school types (primary, middle, high and vocational schools), this paper analyzes the prevalence of school bullying and the correlation with several school attributes. The incidences of reported bullying, bullying others and witnessing bullying are 26.10%, 9.03% and 28.90%, respectively. Primary school students are more likely to be involved in bullying behaviors. Students from elite schools (leading schools) are also more likely to be involved. Relation with teachers, relation with peers and perceived academic achievement are protective factors. Being a boy is the only significant predictor of school bullying among the family and demographic characteristics used. The results highlight the importance of school climate on preventing school violence and bullying, and a whole-school intervention approach is needed for future intervention.

Climate control is one of the important targets of Sustainable Development Goals (SDGs), which along with other SDGs plays an imperative role in environmental sustainability strategies. Recently, studies on the driving forces of climate change and environmental quality focus on using environmental indicators like CO2 and ecological footprint (EF). Evidently, CO2 emissions have been criticized on the ground that they cannot indicate environmental deterioration to a large extent. EF also focuses only on the consumption of resources and overlooks biocapacity (supply side). The adoption of green energy, which is the fundamental agenda of SDG 7, is the most practical solution toward energy transition and controlling fossil fuel consumption. Also, human-induced environmental challenges require considering factors like education and awareness to cultivate a green society. Against this background, this study employs the load capacity factor (LCF), which considers both supply and demand sides to gauge the environmental quality, and inspects the human capital (HUC), green energy (GEN), and environmental quality nexus using the data from the Association of Southeast Asian Nations (ASEAN) from 1986 to 2018 in the context of the load capacity curve (LCC) hypothesis. Results of the cross-sectionally augmented ARDL, robust to heterogeneity, fractional integration, endogeneity, and cross-sectional dependence (CSD), established that the load capacity curve holds in the context of ASEAN. Thus, achieving a higher income level will support ASEAN to expand LCF and increase environmental quality. HUC is found to expand LCF and promote environmental quality. Similarly, green energy is found to stimulate LCF. However, population density and economic globalization expand environmental deterioration. The paper is concluded by providing detailed policies to enhance environmental quality.

Inflammatory bowel disease (IBD) results from a chronic intestinal inflammation and tissue destruction via an aberrant immune-driven inflammatory response towards an altered gut microbiota. Dietary intervention is becoming an attractive avenue for the therapy of colitis because diet is a key determinant of the mucosal immune response. Quercetin (QCN) is the most common in nature and the major representative of dietary antioxidant flavonoids, which has been demonstrated to influence the progression of colitis. However, the underlying mechanism of QCN on intestinal immunomodulation remains unclear. Here, our study demonstrated dietary QCN could ameliorate experimental colitis in part by modulating the anti-inflammatory effects and bactericidal capacity of macrophages via Heme oxygenase-1 (Hmox1, HO-1) dependent pathway. It suggested that QCN might restore the proper intestinal host-microbe relationship to ameliorate the colitis via rebalancing the pro-inflammatory, anti-inflammatory and bactericidal function of enteric macrophages. Hence, modulating the function of intestinal macrophages with dietary administration of QCN to restore the immunological hemostasis and rebalance the enteric commensal flora is a potential and promising strategy for IBD therapy.

BACKGROUND: Jiangsu was one of the first four pilot provinces to engage in comprehensive health care reform in China, which has been on-going for the past 5 years. This study aims to evaluate the equity, efficiency and productivity of health care resource allocation in Jiangsu Province using the most recent data, analyse the causes of deficiencies, and discuss measures to solve these problems. METHODS: Data were extracted from the Jiangsu Health/Family Planning Statistical Yearbook (2015-2019) and Jiangsu Statistical Yearbook (2015-2019). The Gini coefficient (G), Theil index (T) and health resource density index (HRDI) were chosen to study the fairness of health resource allocation in Jiangsu Province. Data envelopment analysis (DEA) and the Malmquist productivity index (MPI) were used to analyse the efficiency and productivity of this allocation. RESULTS: From 2014 to 2018, the total amount of health resources in Jiangsu Province increased. The G of primary resource allocation by population remained below 0.15, and that by geographical area was between 0.14 and 0.28; additionally, the G of health financial resources was below 0.26, and that by geographical area was above 0.39. T was consistent with the results for G and Lorenz curves. The HRDI shows that the allocated amounts of health care resources were the highest in southern Jiangsu, except for the number of health institutions. The average value of TE was above 0.93, and the DEA results were invalid for only two cities. From 2014 to 2018, the mean TFPC in Jiangsu was less than 1, and the values exceeded 1 for only five cities. CONCLUSION: The equity of basic medical resources was better than that of financial resources, and the equity of geographical allocation was better than that of population allocation. The overall efficiency of health care resource allocation was high; however, the total factor productivity of the whole province has declined due to technological regression. Jiangsu Province needs to further optimize the allocation and increase the utilization efficiency of health care resources.

The willingness to take action against climate change may be shaped by cultural orientations. The present study investigated individualist-collectivist differences in climate change inaction as well as the mediating role of perceived intractability. In Study 1, a survey of 182 undergraduates showed that greater perceived intractability of climate change was significantly related to a lower frequency of climate-friendly actions in the preceding six months. In Study 2, participants who were exposed to information concerning the intractability of climate change (experimental group, n = 98) reported a significantly greater perceived intractability of climate change and lower intention to assume a low-carbon lifestyle than those presented with neutral information (control group, n = 83). Based on Studies 1 and 2, participants with collectivist or individualist orientations were recruited from a pool of Chinese undergraduate students in Study 3. We found that participants with a more individualist orientation (n = 62) are more subject to perceived intractability, and less likely to take climate-friendly action than those with a more collectivist orientation (n = 94), and individualist/collectivist status affects climate change inaction through perceived intractability as mediator. The implications of these findings are discussed in relation to the promotion of public engagement with climate change by mitigating perceived intractability.

Residential air conditioning loads with energy storage characteristics can quickly participate in the demand response, making it an important demand response resource. It can improve resource utilisation and the flexibility of power grid operation through the effective regulation. However, the degree of residential air conditioning to participate in demand response is affected by the outdoor temperature, users’ comfort settings, thermal storage and insulation properties of buildings. Moreover, the difficulty of assessing the demand response potential is further increased by the uncertainty of the influencing factors. To guide the residential air conditioners to participate in the power grid operation, the aggregated air conditioner model is established to describe the relationship among the total power, the external environment, and the indoor temperature. The demand response potential model is established from the amount and the duration of demand response. The effects of outdoor temperature, indoor temperature adjustment and the number of air conditioners participating in the response are quantitatively evaluated. Finally, the accuracy of the aggregated model and demand response potential model are verified by numerical simulation.

BACKGROUND: The standard neoadjuvant treatments in patients with esophageal squamous cell carcinoma (ESCC) still have either poor safety or efficacy. Better therapies are needed in China. METHODS: This was an open-label, single-arm, phase 2 trial. Patients with potentially resectable ESCC (cT1b-3, Nany, M0 or T4a, N0-1, or M0) received preoperative intravenous sintilimab plus triplet chemotherapy (liposomal paclitaxel, cisplatin, and S-1) every 3 weeks for two cycles. The primary endpoints were safety and surgical feasibility; the secondary endpoint was major pathological response (MPR) rate. Genomic biomarkers (genetic mutations, tumor mutational burden (TMB), circulating tumor DNA status and immune microenvironment) in baseline tumor samples were investigated. RESULTS: All 30 patients completed two cycles of neoadjuvant treatment and underwent surgical resection. Grade 3-4 treatment-related adverse events (TRAEs) occurred in 36.7% (11/30) of patients. The most frequent TRAEs were decreased white cell count (76.7%), anemia (76.7%), and decreased neutrophil count (73.3%). All TRAEs were hematological toxicities; none caused ≥30 days surgical delay. The MPR and pathological complete response (pCR) rates were 50.0% (15/30; 95% CI 33.2 to 66.9) and 20.0% (6/30; 95% CI 9.5 to 37.3), respectively. Patients with higher TMB and more clonal mutations were more likely to respond. ERBB2 alterations and ctDNA high-releaser status have a negative correlation with neoadjuvant ICI response. No significant difference was observed between therapeutic response and tumor immune microenvironment. CONCLUSIONS: Neoadjuvant sintilimab plus platinum-based triplet chemotherapy appeared safe and feasible, did not delay surgery and induced a pCR rate of 20.0% in patients with potentially resectable ESCC. TRIAL REGISTRATION NUMBER: NCT03946969.

For decades, scholars of political culture have held that mass political attitudes have a profound impact on the process of democratization. In studying this impact, an increasing number of political scientists have recently theorized that the level of democratization a political system reaches depends on the extent to which its political institutions meet citizen demand for democracy. In testing such theoretical models of democratic demand and supply, however, many political scientists have mistakenly equated democratic demand with citizen preference for democracy over its alternatives. In this study, we first argue that popular demand for democracy is not the same thing as democratic regime preference or support. Instead, demand for democracy arises from dissatisfaction with democracy-in-practice. By analyzing the fourth wave of the World Values Survey, we then demonstrate that the critical orientations of democrats promote democratic development more powerfully than do the two attitudes — democratic regime support and self-expression values — that prior public opinion research has identified as the forces driving democratization.

The genus Fusarium includes numerous important plant and human pathogens, as well as many industrially and commercially important species. During our investigation of fungal diversity in China, a total of 356 fusarioid isolates were obtained and identified from diverse diseased and healthy plants, or different environmental habitats, i.e., air, carbonatite, compost, faeces, soil and water, representing hitherto one of the most intensive sampling and identification efforts of fusarioid taxa in China. Combining morphology, multi-locus phylogeny and ecological preference, these isolates were identified as 72 species of Fusarium and allied genera, i.e., Bisifusarium (1), Fusarium (60), and Neocosmospora (11). A seven-locus dataset, comprising the 5.8S nuclear ribosomal RNA gene with the two flanking internal transcribed spacer (ITS) regions, the intergenic spacer region of the rDNA (IGS), partial translation elongation factor 1-alpha ( tef1 ), partial calmodulin (cam), partial RNA polymerase largest subunit ( rpb1 ), partial RNA polymerase second largest subunit ( rpb2 ) gene regions, and partial β-tubulin ( tub2 ), were sequenced and employed in phylogenetic analyses. A genus-level phylogenetic tree was constructed using combined tef1 , rpb1 , and rpb2 sequences, which confirmed the presence of four fusarioid genera among the isolates studied. Further phylogenetic analyses of two allied genera ( Bisifusarium and Neocosmospora ) and nine species complexes of Fusarium were separately conducted employing different multi-locus datasets, to determine relationships among closely related species. Twelve novel species were identified and described in this paper. The F. babinda species complex is herein renamed as the F. falsibabinda species complex, including descriptions of new species. Sixteen species were reported as new records from China.

Abstract This special issue provides an assessment of the contribution of soils to Nature's Contributions to People (NCP). Here, we combine this assessment and previously published relationships between NCP and delivery on the UN Sustainable Development Goals (SDGs) to infer contributions of soils to the SDGs. We show that in addition to contributing positively to the delivery of all NCP, soils also have a role in underpinning all SDGs. While highlighting the great potential of soils to contribute to sustainable development, it is recognized that poorly managed, degraded or polluted soils may contribute negatively to both NCP and SDGs. The positive contribution, however, cannot be taken for granted, and soils must be managed carefully to keep them healthy and capable of playing this vital role. A priority for soil management must include: (i) for healthy soils in natural ecosystems, protect them from conversion and degradation; (ii) for managed soils, manage in a way to protect and enhance soil biodiversity, health and sustainability and to prevent degradation; and (iii) for degraded soils, restore to full soil health. We have enough knowledge now to move forward with the implementation of best management practices to maintain and improve soil health. This analysis shows that this is not just desirable, it is essential if we are to meet the SDG targets by 2030 and achieve sustainable development more broadly in the decades to come. This article is part of the theme issue ‘The role of soils in delivering Nature's Contributions to People’.

Programmed cell death 4 (PDCD4), as a tumor suppressor gene, is frequently reduced in a variety of tumors, including gastric cancer. Previous findings have indicated that PDCD4 participates in tumorigenesis through the regulation of apoptosis, but the molecular basis of this process has not been fully elucidated, and no studies have shown the upstream regulation of this gene in gastric cancer. In this study, we used bioinformatics analysis to search for miRNAs that could potentially target PDCD4 and identified miR-93 as a candidate. Moreover, we observed the inverse correlation between miR-93 and PDCD4 protein levels, but not mRNA levels, in human gastric cancer tissues. We further experimentally validated PDCD4 as the direct target of miR-93 by evaluating PDCD4 expression in gastric cancer cells after the overexpression or knockdown of miR-93. Additionally, the biological consequences of targeting PDCD4 through miR-93 were examined using cell apoptosis assays in vitro. We demonstrated that the repression of PDCD4 through miR-93 suppressed the apoptosis of gastric cancer cells. Finally, we revealed that miR-93 promoted the development of gastric tumor growth in xenograft mice by negatively regulating PDCD4. Taken together, the findings of the present study indicated the oncogenic role of miR-93 in gastric cancer tumorigenesis through targeting PDCD4, particularly in apoptosis.

Does increasing government transparency in an authoritarian regime, absent electoral forms of accountability, change outcomes? The case of China, which has adopted a number of open governance and public information laws, is examined to see whether increased transparency by local environmental protection bureaus affects key environmental outcomes, specifically reductions in air and water pollution. Several unique environmental performance measurements, developed by the authors, are used to supplement standard government-reported measurements of environmental outcomes, and a widely used environmental transparency index (the PITI). By testing information that is newly supplied to the public, but already available to government, government and public monitoring are distinguished from one another, and the effect of public knowledge of government functions is tested. In the absence of a mechanism for the public to hold local government accountable, public transparency alone has no impact on outcomes other than information provision itself.

Investigating the spatial distribution and adaptation mechanisms of traditional villages is crucial for their development and human well-being. However, relatively few studies have focused on the interaction and comprehensive influence of historical-cultural, natural-geographic and socio-economic factors on traditional villages in Jiangnan region. Employing geographically weighted regression (GWR) and Geodetector methods, we developed an integrated framework. We found that (1) Traditional villages exhibit a “one-core, multiple-periphery” clustering pattern (nearest neighbor index <1), with significant high-high and low-low local spatial clustering characteristics and preferring gentle and relatively Complex terrains to adapt to the need to avoid warfare. (2) Urbanization negatively affects traditional village density patterns, while natural-geographic complexity has a positive impact. Their interaction nonlinearly amplifies this effect, with the urbanization-GDP interplay being particularly significant (q = 0.765). (3) Factors exhibit significant spatial heterogeneity in their impact on traditional village density, with the explanatory power increasing by 20% (GWR/R2 = 0.65). The urbanization rate and slope are the most critical socio-economic and natural-geographic factors, respectively (local regression coefficient: 23.31 and 11.58). Our study transcends administrative boundaries, revealing how historical-cultural, natural-geographical, and socio-economic factors collectively influence the distribution of traditional villages. This not only provides a new theoretical foundation for the conservation and development of traditional villages but also provides a new methodology basis for research on traditional villages.

Background: With the continuous large-scale development of the COVID-19 vaccine, the acceptance of vaccination and its influencing factors at the individual level have become crucial to stemming the pandemic. This study aims to explore the factors that influence the acceptance of the COVID-19 vaccine among international college students. Methods: The target population constituted international students pursuing various degrees in Jiangsu Province through an online cross-sectional study. A cluster random sampling was performed using a self-administered questionnaire. The Health Belief Model and Knowledge, Attitude/Beliefs, and Practice Theory served as the underlying theories to understanding the factors that influence vaccine acceptance. Results: We received 330 responses. About 36.4% intended to accept the vaccine. The acceptance varied across respondents’ place of residence, program of study, continent of origin, knowledge, susceptibility, severity, benefits, and cues to action (p &lt; 0.05). A multivariable logistics regression revealed cues to action (p &lt; 0.001), the perception of COVID-19 vaccination benefits (p = 0.002), and the perception of barriers (p &lt; 0.001) that were associated with vaccine acceptance. Conclusions: The acceptance of the COVID-19 vaccine was low among international students. The correct and comprehensive beliefs of the target groups regarding the benefits and barriers of the vaccination must be raised. Various effective social strategies must be adopted to trigger the intention of COVID-19 vaccination. The study findings will inform the decisions of public health campaigners, aimed at reducing vaccine hesitation when the COVID-19 vaccine is widely available.

To examine the spatial variation of stroke mortality risk during heat wave, we collected 418 stroke mortality cases with permanent addresses for a severe heat wave (July 28-August 15, 2010) and 624 cases for the reference period (July 29-August 16, 2009 and July 27-August 14, 2011) in Nanjing, China. Generalized additive models were used to explore the association between location and stroke mortality risk during the heat wave while controlling individual-level risk factors. Heat wave vulnerability was then applied to explain the possible spatial variations of heat-wave-related mortality risk. The overall risk ratio (95% confidence intervals) of stroke mortality due to the heat wave in Nanjing was 1.34 (1.21 to 1.47). Geolocation was found to be significantly associated with the heat-wave-related stroke mortality risk. Using alternative reference periods generated similar results. A district-level risk assessment revealed similar spatial patterns. The highest stroke mortality risk observed in Luhe district was due to the combination of high heat exposure and high vulnerability. Our findings provide evidence that stroke mortality risk is higher in rural areas during heat waves and that these areas require future interventions to reduce vulnerability.

Background: Avian AIV-H7N9 influenza progresses rapidly and has a high fatality rate. However, it lacks an early effective biomarker to predict disease severity and fatal outcomes successfully. Our study aimed to explore whether the neutrophil-to-lymphocyte ratio (NLR) taken within 24 h after admission can predict disease severity and fatality in AIV-H7N9-infected patients. Methods: We retrospectively studied 237 AIV-H7N9-infected patients from multiple centers from 2013 to 2015. We used univariate analysis and multivariate analysis to compare clinical variables between the survival and fatal groups to evaluate the prognostic value. Results: The NLR taken within 24 h after admission in the fatal group was significantly higher than that in the survival group ( P <0.01). Our study found that NLR was independently associated with fatality. The area under the curve (AUC) of the NLR was 0.70, and moreover, when the NLR =19.94, the specificity was 100%, and the sensitivity was 28.4%. The fatality in the NLR ≥19.94 group was significantly increased relative to the patients with an NLR <19.94 ( P <0.05). Conclusion: The NLR is potentially a predictive prognostic biomarker in patients infected with the AIV-H7N9 influenza virus. Keywords: NLR (neutrophil-to-lymphocyte ratio), influenza A, AIV-H7N9, biomarker

Purpose Immune checkpoint inhibitors plus antiangiogenic tyrosine kinase inhibitors may offer a first-line treatment for advanced hepatocellular carcinoma (HCC). In this phase 2 trial [registered with clinicaltrials.gov (NCT04052152)], we investigated the safety and efficacy of first-line anti-PD-1 antibody sintilimab plus antiangiogenic TKI anlotinib for advanced HCC. Methods and Materials Pathologically-proven advanced HCC patients received sintilimab (200 mg) on day 1 and anlotinib (12 mg) once daily on days 1 to 14 every 3 weeks, with a safety run-in for the first six participants to assess dose-limiting toxicities (DLTs). The primary endpoints were safety and objective response rate (ORR) per RECIST v1.1. Results Twenty advanced HCC patients were enrolled. No DLTs occurred in the safety run-in. All patients had treatment-related adverse events (TRAEs). Grade 3 TRAEs occurred in 8 (40.0%) patients, the most common being decreased platelet count (10.0%) and increased γ-glutamyl transferase (10.0%). No grade 4/5 TRAEs occurred. Five (25%) patients developed immune-related AEs. The ORR was 35.0% (95%CI 15.4%-59.2%) per RECIST v1.1 and 55.0% (95%CI 31.5%-76.9%) per modified RECIST. At data cutoff (March 31, 2021), the median progression-free survival was 12.2 months (95%CI, 3.8 to not reached). The median PFS was significantly longer in patients with lower LDH levels (not reached [NR], 95% CI, 8.7 to NR vs. higher LDH levels 5.2 months, 95% CI 3.4 to NR; P =0.020) and a CONUT score ≤2 (NR, 95% CI 5.1 to NR vs. CONUT score &amp;gt;2 6.2 months, 95% CI 1.8 to NR; P =0.020). Furthermore, patients showing tumor response had a significantly higher median proportion of CD16 + CD56 + NK cells than patients who had stable or progressive disease (21.6% vs. 14.6%; P=0.026). Conclusion Sintilimab plus anlotinib showed promising clinical activities with manageable toxicity as first-line treatment of advanced HCC.

Purpose The purpose of this research is to seek better relational strategies between formal and informal stakeholder relationships to improve megaproject performance. Design/methodology/approach The conceptual model was developed with twenty hypotheses based on the literature review. Then a questionnaire survey was conducted, and the collected data were analyzed by Partial Least squares Structural Equation Modeling (PLS-SEM) for validating the proposed model. Finally, the findings were discussed by a comparative study to explain the different effects of the formal and informal relationship on megaproject performance, and the managerial implications are presented for the stakeholders to implement the relationship management in the megaprojects. Findings The research finding reveals that formal relationship plays a dominating role in cost, quality, and labor protection; meanwhile, it is still more reliable in improving coordination, safety and environmental protection. Both formal and informal relationship is equally important towards collaboration and scheduling while the informal relationship is more effective in communication and project transparency. Originality/value The study extends the knowledge of relationship management in the domain of the megaproject performance. It provides a comprehensive and systematic understanding of the impact of formal and informal stakeholder relationships on ten aspects of the megaproject performance by the proposed conceptual model and PLS-SEM results. The research findings contribute to the theory of relationship management on how the different influences between formal and informal stakeholder relationships lead to better megaproject performance from inter-organizational level to project and societal level.

Purpose This paper aims to explore the impact of business environment on high-quality economic development (HQED) and clarify the role of technological innovation and government intervention in this relationship. Design/methodology/approach Based on China’s provincial panel data from 2010 to 2019, this paper adopts the system generalized method of moments to empirically analyze the influential mechanism and heterogeneity of the business environment on HQED. Furthermore, the authors construct a dynamic panel threshold model to test the threshold effect of government intervention. Findings The results indicate that optimizing the business environment can significantly promote HQED, technological innovation plays a partial mediating role in the impact of business environment on HQED, mainly by enhancing the intensity of innovation input and increasing innovation output to facilitate HQED. Government intervention can regulate the impact of business environment on HQED, and there is a double threshold effect, and it possesses an inverted U-shaped feature of first promoting and then inhibiting. Originality/value This paper examines the influence path of business environment on HQED from the perspective of technological innovation and government intervention, filling the gap in the study of provincial business environment. Moreover, the conclusions furnish a theoretical basis for optimizing the business environment and facilitating the HQED in China.

Establishing effective climate control and reducing the ecological footprint (EF) are necessary for pursuing Sustainable Development Goals (SDGs), in particular Goal 13. In this context, it is required to enhance the understanding of various factors that can either decrease or enhance the EF. In the literature to date, limited studies on external conflicts (EX) have reported diverse results, and also the impacts of government stability (GS) on EF are less explored. This study explores the roles of external conflicts, economic growth, and government stability on EF in the context of SDG-13. The study also contributes to the literature by examining the environmental effects of government stability and external conflicts for the first time in Pakistan. This research uses time-series methodologies on data from Pakistan from 1984 to 2018 for exploring the long-run relations and causal dynamics. The results unfolded that external conflicts stimulate and Granger cause EF and therefore expand environmental deterioration. Thus, limiting conflicts is in the favor of Pakistan to achieve SDG-13. Surprisingly, government stability also poses harmful impacts on environmental quality by enhancing the EF, indicating that stable governments focus on improving economic conditions rather than environmental quality. Moreover, the study proves the validity of the environmental Kuznets curve. Policy suggestions are made to move forward in achieving SDG-13 and to evaluate the effectiveness of government environmental policies.