Study of Risk Factors for Total Attack Rate and Transmission Dynamics of Norovirus Outbreaks, Jiangsu Province, China, From 2012 to 2018

Objective: To describe the epidemiological characteristics of norovirus outbreaks in Jiangsu Province, utilize the total attack rate (TAR) and transmissibility (Runc) as the measurement indicators of the outbreak, and a statistical difference in risk factors associated with TAR and transmissibility was compared. Ultimately, this study aimed to provide scientific suggestions to develop the most appropriate prevention and control measures.Method: We collected epidemiological data from investigation reports of all norovirus outbreaks in Jiangsu Province from 2012 to 2018 and performed epidemiological descriptions, sequenced the genes of the positive specimens collected that were eligible for sequencing, created a database and calculated the TAR, constructed SEIAR and SEIARW transmission dynamic models to calculate Runc, and performed statistical analyses of risk factors associated with the TAR and Runc.Results: We collected a total of 206 reported outbreaks, of which 145 could be used to calculate transmissibility. The mean TAR in was 2.6% and the mean Runc was 12.2. The epidemiological characteristics of norovirus outbreaks showed an overall increasing trend in the number of norovirus outbreaks from 2012 to 2018; more outbreaks in southern Jiangsu than northern Jiangsu; more outbreaks in urban areas than in rural areas; outbreaks occurred mostly in autumn and winter. Most of the sites where outbreaks occurred were schools, especially primary schools. Interpersonal transmission accounted for the majority. Analysis of the genotypes of noroviruses revealed that the major genotypes of the viruses changed every 3 years, with the GII.2 [P16] type of norovirus dominating from 2016 to 2018. Statistical analysis of TAR associated with risk factors found statistical differences in all risk factors, including time (year, month, season), location (geographic location, type of settlement, type of premises), population (total number of susceptible people at the outbreak site), transmission route, and genotype (P < 0.05). Statistical analysis of transmissibility associated with risk factors revealed that only transmissibility was statistically different between sites.Conclusions: The number of norovirus outbreaks in Jiangsu Province continues to increase during the follow-up period. Our findings highlight the impact of different factors on norovirus outbreaks and identify the key points of prevention and control in Jiangsu Province.

Job satisfaction of graduates of rural oriented medical students training project in Jiangsu Province, China: a cross-sectional study

Background The Chinese government has worked out the “Rural Oriented Medical Students Training Project” to address physician maldistribution, which attempted to train physicians for rural areas. The present study attempted to evaluate the job satisfaction of the graduates of this project in Jiangsu Province, China. Methods Online questionnaires were sent to the graduates of the “Rural Oriented Medical Students Training Project” (group A) and their colleagues, who were rural physicians recruited from different sources (group B). The study was approved by the Ethics Committee of Xuzhou Medical University, and the approval number was 2,018,057. Information on demographic characteristics, work conditions, and self-reported satisfaction was collected to compare the satisfaction differences between the two recruited rural physicians using the Chi-square test and Mann–Whitney U test. Additionally, factors correlated to the satisfaction of group A were assessed using multivariate linear regression. Statistical analysis was performed using SPSS 23.0 (SPSS Inc., Chicago, IL, USA). P < 0.05 was considered statistically significant. Results Group A exhibited moderate satisfaction (2.81 ± 0.687). The satisfaction score from the highest to the lowest was for occupational ecology, life satisfaction, stress, competency, and internal environment. Positive factors related to the satisfaction of group A were area, monthly income, working hours per week, professional title, and post. Conclusion The satisfaction of the graduates of the “Rural Oriented Medical Students Training Project” was moderate. Factors related to satisfaction included economic incentives, workload, and professional confidence. Possible solutions for increasing satisfaction should consist of economic support and possible ways to improve the professional identification of these graduates.

Labour Costs on the Vegetables: A Research on the location effect on salaries in Jiangsu Province, China

ABSTRACT: In this study, the labour requirement and labour cost of common vegetable cultivation were investigated to help agricultural enterprises and family farms establishing reasonable “working hour” management systems in Jiangsu Province. The labour requirement of each step of three type of producers, agriculture enterprises, family farms, and private vegetable growers, in three regions in Jiangsu Province, named north, middle and south Jiangsu, was investigated by on-site observation or questionnaire survey during 2018 and 2019. The labour cost of each step and each vegetable was counted according to the labour requirement and the salary level. The results indicated that “residue cleaning”, “soil preparation and bedding”, “plant regulation”, “auxin treatment of tomato flowers” and “hand pollination” accounted for higher proportions of labour cost amongst the entire vegetable culture process. No significant differences in the labour requirements of the investigated vegetables were reported amongst three regions in Jiangsu Province. However, the order of labour cost is south Jiangsu > north Jiangsu > middle Jiangsu, due to the salary difference amongst three regions. Watermelon, broccoli and chive are more suitable for growing by agricultural enterprises since they have relatively low unit labour and high prices. We established a method to calculate and analyze labour requirement and cost of vegetable production in Jiangsu Province, which also may be instructive for other regions. In addition, our results provided useful data for various vegetable producers to improve their labour management.

Evaluating the Effectiveness of Regional Ecological Civilization Policy: Evidence from Jiangsu Province, China

Evaluating the effectiveness of ecological civilization policies is the basis from which policymakers can optimize policies. From the perspective of the overall effectiveness of regional policies, and taking Jiangsu Province as an example, this study constructed a quantitative evaluation model of eco-civilization policy text and an eco-civilization evaluation index system. Using these tools, this paper evaluates the effectiveness of 53 ecological civilization policies issued by Jiangsu Province during 2004–2019 to promote the construction of ecological civilization in the four fields of resource utilization, environmental protection, economic development, and social life. There are three key findings. (1) During the period of 2004–2019, the effectiveness of the textual content of ecological civilization policies in Jiangsu Province generally showed a fluctuating upward trend. (2) The construction effectiveness indexes of the four fields of eco-civilization all showed a growth trend, but the construction effect varied greatly. The index of economic development had grown rapidly, while environmental protection had grown slowly. (3) Ecological civilization policies in Jiangsu Province were effective in promoting the construction of ecological civilization. However, the effects of different policy dimensions on ecological civilization development in the four fields were significantly different. Finally, based on these results, powerful recommendations are provided for the optimization of eco-civilization policies in Jiangsu Province. Moreover, Jiangsu is the first province in China to launch a provincial-level ecological civilization construction plan. Its policy optimization to promote ecological civilization construction can also provide an example and realistic basis for reference for the construction of eco-civilization in other provinces in China.

Analysis of Clinical Characteristics and Virus Strains Variation of Patients Infected With SARS-CoV-2 in Jiangsu Province—A Retrospective Study

Background: At present, the global sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2) situation is still grim, and the risk of local outbreaks caused by imported viruses is high. Therefore, it is necessary to monitor the genomic variation and genetic evolution characteristics of SARS-CoV-2. The main purpose of this study was to detect the entry of different SARS-CoV-2 variants into Jiangsu Province, China.Methods: First, oropharyngeal swabs were collected from 165 patients (55 locally confirmed cases and 110 imported cases with confirmed and asymptomatic infection) diagnosed with SARS-CoV-2 infection in Jiangsu Province, China between January 2020 and June 2021. Then, whole genome sequencing was used to explore the phylogeny and find potential mutations in genes of the SARS-CoV-2. Last, association analysis among clinical characteristics and SARS-CoV-2 Variant of Concern, pedigree surveillance analysis of SARS-COV-2, and single nucleotide polymorphisms (SNPs) detection in SARS-COV-2 samples was performed.Results: More men were infected with the SARS-CoV-2 when compared with women. The onset of the SARS-CoV-2 showed a trend of younger age. Moreover, the number of asymptomatic infected patients was large, similar to the number of common patients. Patients infected with Alpha (50%) and Beta (90%) variants were predominantly asymptomatic, while patients infected with Delta (17%) variant presented severe clinical features. A total of 935 SNPs were detected in 165 SARS-COV-2 samples. Among which, missense mutation (58%) was the dominant mutation type. About 56% of SNPs changes occurred in the open reading frame 1ab (ORF1ab) gene. Approximately, 20% of SNP changes occurred in spike glycoprotein (S) gene, such as p.Asp501Tyr, p.Pro681His, and p.Pro681Arg. In total, nine SNPs loci in S gene were significantly correlated with the severity of patients. It is worth mentioning that amino acid substitution of p.Asp614Gly was significantly positively correlated with the clinical severity of patients. The amino acid replacements of p.Ser316Thr and p.Lu484Lys were significantly negatively correlated with the course of disease.Conclusion: Sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may further undergo a variety of mutations in different hosts, countries, and weather conditions. Detecting the entry of different virus variants of SARS-CoV-2 into Jiangsu Province, China may help to monitor the spread of infection and the diversity of eventual recombination or genomic mutations.

Research on the Driving Factors for the Development of Inclusive Finance in Rural Commercial Banks: Market Competition or Government Intervention?

Based on the survey data of 43 rural commercial banks in Jiangsu Province, China, from 2015 to 2018, 14 indicators among 3 dimensions—coverage, business implementation and service quality—were selected to establish the inclusive finance index of rural commercial banks. The impact of market competition and government intervention on the development of the inclusive finance of rural commercial banks and the mechanism were empirically tested. The heterogeneous performance of market competition and government intervention in different market conditions were also thoroughly discussed. The results show that both market competition and government intervention can help reduce the pricing level and broaden the service coverage of rural commercial banks, which can promote the development of inclusive finance. But the role of market competition has a stronger impact than that of government intervention. The heterogeneity test shows that market competition plays a more significant role in the regions with higher levels of market competition and financial development, and in the southern and central Jiangsu Province, where the economy is relatively more developed. However, in the regions with lower levels of market competition and financial development, as well as in the northern Jiangsu Province, with a relatively backward economy, government intervention significantly improves the degree of inclusive finance of rural commercial banks. Finally, we advocate that the roles of market and government should be applied according to local conditions, and the development of the inclusive finance in rural commercial banks needs to be continuously promoted.