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We conducted a surveillance among acute respiratory tract infection (ARTI) cases to define the epidemiology, clinical characteristics and genetic variations of enterovirus D68 (EV-D68) in Beijing, China from 2015 to 2017. Nasopharyngeal swabs and sputum were collected from 30 sentinel hospitals in Beijing and subjected to EV and EV-D68 detection by real-time PCR. The VP1 gene region and complete genome sequences of EV-D68 positive cases were analyzed. Of 21816 ARTI cases, 619 (2.84%) were EV positive and 42 cases were EV-D68 positive. The detection rates of EV-D68 were 0 (0/6644) in 2015, 0.53% (40/7522) in 2016 and 0.03% (2/7650) in 2017, respectively. Two peaks of EV-D68 infections occurred in late summer and early-winter. Ten cases (23.81%) with upper respiratory tract infection and 32 cases (76.19%) presented with pneumonia, including 3 cases with severe pneumonia. The phylogenetic analysis suggested 15 subclade D3 strains and 27 subclade B3 strains of EV-D68 were circulated in China from 2016 to 2017. A total of 52 amino acid polymorphisms were identified between subclades D1 and D3. These data suggest an upsurge of EV-D68 occurred in Beijing in 2016, the new subclade D3 emerged in 2016 and co-circulated with subclade B3 between 2016 and 2017.

A B S T R A C T Previous studies have indicated that the regression slope between the interhemispheric difference (IHD) of CO 2 mixing ratios and fossil fuel (FF) CO 2 emissions was rather constant at about 0.5 ppm/Pg C yr(1 during 1957Á2003. In this study, we found that the average regression slopes between the IHD of CO 2 mixing ratios and IHD of FF emissions for 16 sites in the Northern Hemisphere (NH) decreased from 0.6990.12 ppm/Pg C yr (1 during 1982Á1991 to 0.3790.06 ppm/Pg C yr (1 during 1996Á2008 (IHD of CO 2 defined as the differences between each site and the South Pole, SPO). The largest difference was found in summer and autumn. The change in the spatial distribution of FF emissions driven by fast increasing Asian emissions may explain the slope change at three sites located north of 608N but not at the other sites. A 30-yr SF 6 simulation with time-varying meteorology and constant emissions suggests no significant difference in the decadal average and seasonal variation of interhemispheric exchange time (t ex ) between the two periods. Based on the hemispheric net carbon fluxes derived from a two-box model, we attributed 75% of the regression slope decrease at NH sites south of 608N to the acceleration of net carbon sink increase in the NH and 25% to the weakening of net carbon sink increase in the SH during 1996Á2008. The growth rate of net carbon sink in the NH has increased by a factor of about three from 0.02890.

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Large day-to-day variability in O(3) and CO was observed at Chongming, a remote rural site east of Shanghai, in August 2010. High ozone periods (HOPs) that typically lasted for 3-5 days with daily maximum ozone exceeding 102 ppb were intermittent with low ozone periods (LOPs) with daily maximum ozone less than 20 ppb. The correlation analysis of ozone with meteorological factors suggests that the large variations of surface ozone are driven by meteorological conditions correlated with the changes in the location and intensity of the west Pacific subtropical high (WPSH) associated with the East Asian summer monsoon (EASM). When the center of WPSH with weaker intensity is to the southeast of Chongming site, the mixing ratios and variability of surface ozone are higher. When the center of WPSH with stronger intensity is to the northeast of Chongming site, the mixing ratios and variability of surface ozone are lower. Sensitivity simulations using the GEOS-Chem chemical transport model indicate that meteorological condition associated with WPSH is the primary factor controlling surface ozone at Chongming in August, while local anthropogenic emissions make significant contributions to surface ozone concentrations only during HOP.

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BackgroundThe financial relationship between physicians and industries has become a hotly debated issue globally. The Physician Payments Sunshine Act of the US Affordable Care Act (2010) promoted transparency of the transactions between industries and physicians by making remuneration data publicly accessible in the Open Payments Program database. Meanwhile, according to the World Health Organization, the majority of all noncommunicable disease deaths were caused by cardiovascular disease.ObjectiveThis study aimed to investigate the distribution of non-research and non-ownership payments made to thoracic surgeons, to explore the regularity of financial relationships between industries and thoracic surgeons.MethodsAnnual statistical data were obtained from the Open Payments Program general payment dataset from 2014-2016. We characterized the distribution of annual payments with single payment transactions greater than US $10,000, quantified the major expense categories (eg, Compensation, Consulting Fees, Travel and Lodging), and identified the 30 highest-paying industries. Moreover, we drew out the financial relations between industries to thoracic surgeons using chord diagram visualization.ResultsThe three highest categories with single payments greater than US $10,000 were Royalty or License, Compensation, and Consulting Fees. Payments related to Royalty or License transferred from only 5.38% of industries to 0.75% of surgeons with the highest median (US $13,753, $11,992, and $10,614 respectively) in 3-year period. In contrast, payments related to Food and Beverage transferred from 93.50% of industries to 98.48% of surgeons with the lowest median (US $28, $27, and $27). The top 30 highest-paying industries made up approximately 90% of the total payments (US $21,036,972, $23,304,996, and $28,116,336). Furthermore, just under 9% of surgeons received approximately 80% of the total payments in each of the 3 years. Specifically, the 100 highest cumulative payments, accounting for 52.69% of the total, transferred from 27 (6.05%) pharmaceutical industries to 86 (1.89%) thoracic surgeons from 2014-2016; 7 surgeons received payments greater than US $1,000,000; 12 surgeons received payments greater than US $400,000. The majority (90%) of these surgeons received tremendous value from only one industry.ConclusionsThere exists a great discrepancy in the distribution of payments by categories. Royalty or License Fees, Compensation, and Consulting Fees are the primary transferring channels of single large payments. The massive transfer from industries to surgeons has a strong “apical dominance” and excludability. Further research should focus on discovering the fundamental driving factors for the strong concentration of certain medical devices and how these payments will affect the industry itself.

Tropospheric ozone observations over China from 2005 to 2010 at three pressure levels (484, 681 and 825 hPa) from the Tropospheric Emission Spectrometer on board the NASA Aura satellite have been analyzed. Fourier Transform analysis revealed the trends and seasonality of regionally-averaged, monthly-mean ozone concentrations over western, northern and southern China. Significant increases in ozone levels are found over all three regions at 464 hPa and the rate of increase is fastest over northern China, reaching 0.89±0.059 nL/(L a). At 681 hPa, ozone shows increases over northern and western China, at a rate of 0.57± 0.065 nL/(L a) and 0.41±0.041 nL/(L a) respectively, but is constant over southern China. At 825 hPa, ozone increases at a rate of 0.36±0.074 nL/(L a) over northern China, while decreasing over southern China at a rate of 0.21±0.061 nL/(L a). Over the three regions, ozone levels are generally higher in summer and lower in winter. Over southern China at all three pressure levels and northern China at the 825 hPa level, ozone shows double peaks occurring in spring and autumn as a result of the combined effects of atmospheric chemistry and global transport. This work provides a useful observational dataset and tools for future analysis of changes in tropospheric ozone over China. TES, ozone, China, interannual variation, seasonal variation Citation:Shen L L, Wang Y X. Changes in tropospheric ozone levels over the Three Representative Regions of China observed from space by the Tropospheric