Seismicity in northern Arizona is concentrated in a northwest-southeast trending belt that stretches from the Utah border south to the edge of the Colorado Plateau. Located within this NASB （Northern Arizona Seismic ...Seismicity in northern Arizona is concentrated in a northwest-southeast trending belt that stretches from the Utah border south to the edge of the Colorado Plateau. Located within this NASB （Northern Arizona Seismic Belt） is the San Francisco volcanic field, classified by the United States Geological Survey as potentially active. The last volcanic event in the field was located at Sunset Crater and occurred less than 1,000 years ago. Eruption intervals in the volcanic field are of the same order of length of time. Seismic monitoring of the volcanic field area has improved greatly since 1985 with the establishment of new network seismic stations. This has allowed for a lowered threshold of detection of seismic events and improved location capabilities. As an example of the result of this improved ability to locate smaller tremors, two swarms have been identified in the field, the 2009 Halloween swarm near Sunset Crater volcano and the 2011 swarm near Flagstaff, the largest urban community in northern Arizona.展开更多
Vice,faith,xenophobia,and success目睹过罪恶,聆听过福音,经历过排挤,见证过成功;百余年风云变幻,旧金山的唐人街从不缺少传奇San Francisco’s Chinatown may well be the largest outside of Asia,its success fueled in part by a ...Vice,faith,xenophobia,and success目睹过罪恶,聆听过福音,经历过排挤,见证过成功;百余年风云变幻,旧金山的唐人街从不缺少传奇San Francisco’s Chinatown may well be the largest outside of Asia,its success fueled in part by a particularly active community of Chinese diaspora.Since the first Chinese arrived there in 1848,its story has been展开更多
BACKGROUND Liver transplantation(LT)for hepatocellular carcinoma(HCC)has been widely researched and is well established worldwide.The cornerstone of this treatment lies in the various criteria formulated by expert con...BACKGROUND Liver transplantation(LT)for hepatocellular carcinoma(HCC)has been widely researched and is well established worldwide.The cornerstone of this treatment lies in the various criteria formulated by expert consensus and experience.The variations among the criteria are staggering,and the short-and long-term outcomes are controversial.AIM To study the differences in the current practices of LT for HCC at different centers in India and discuss their clinical implications in the future.METHODS We conducted a survey of major centers in India that performed LT in December 2022.A total of 23 responses were received.The centers were classified as high-and low-volume,and the current trend of care for patients undergoing LT for HCC was noted.RESULTS Of the 23 centers,35%were high volume center(>500 Liver transplants)while 52%were high-volume centers that performed more than 50 transplants/year.Approximately 39%of centers had performed>50 LT for HCC while the percent distribution for HCC in LT patients was 5%–15%in approximately 73%of the patients.Barring a few,most centers were divided equally between University of California,San Francisco(UCSF)and center-specific criteria when choosing patients with HCC for LT,and most(65%)did not have separate transplant criteria for deceased donor LT and living donor LT(LDLT).Most centers(56%)preferred surgical resection over LT for a Child A cirrhosis patient with a resectable 4 cm HCC lesion.Positron-emission tomography-computed tomography(CT)was the modality of choice for metastatic workup in the majority of centers(74%).Downstaging was the preferred option for over 90%of the centers and included transarterial chemoembolization,transarterial radioembolization,stereotactic body radiotherapy and atezolizumab/bevacizumab with varied indications.The alphafetoprotein(AFP)cut-off was used by 74%of centers to decide on transplantation as well as to downstage tumors,even if they met the criteria.The criteria for successful downstaging varied,but most centers conformed to the UCSF or their center-specific criteria for LT,along with the AFP cutoff values.The wait time for LT from downstaging was at least 4–6 wk in all centers.Contrast-enhanced CT was the preferred imaging modality for post-LT surveillance in 52%of the centers.Approximately 65%of the centers preferred to start everolimus between 1 and 3 months post-LT.CONCLUSION The current predicted 5-year survival rate of HCC patients in India is less than 15%.The aim of transplantation is to achieve at least a 60%5-year disease free survival rate,which will provide relief to the prediction of an HCC surge over the next 20 years.The current worldwide criteria(Milan/UCSF)may have a higher 5-year survival(>70%);however,the majority of patients still do not fit these criteria and are dependent on other suboptimal modes of treatment,with much lower survival rates.To make predictions for 2040,we must prepare to arm ourselves with less stringent selection criteria to widen the pool of patients who may undergo transplantation and have a chance of a better outcome.With more advanced technology and better donor outcomes,LDLT will provide a cutting edge in the fight against liver cancer over the next two decades.展开更多
Chinese education in America is a cultural product of Chinese immigrants to the United States.In 1848,the California Gold Rush attracted many Chinese to the United States,and gradually formed Chinese communities in th...Chinese education in America is a cultural product of Chinese immigrants to the United States.In 1848,the California Gold Rush attracted many Chinese to the United States,and gradually formed Chinese communities in the local area,and then spontaneously produced Chinese education.At that time,San Francisco Chinatown was the largest Chinatown in the United States,and its Chinese education showed representative characteristics.By studying the origin and development of Chinese education in San Francisco,this paper analyzes the characteristics of Chinese education in the United States,in order to provide experience and reference for contemporary Chinese education in the United States.展开更多
文摘Seismicity in northern Arizona is concentrated in a northwest-southeast trending belt that stretches from the Utah border south to the edge of the Colorado Plateau. Located within this NASB （Northern Arizona Seismic Belt） is the San Francisco volcanic field, classified by the United States Geological Survey as potentially active. The last volcanic event in the field was located at Sunset Crater and occurred less than 1,000 years ago. Eruption intervals in the volcanic field are of the same order of length of time. Seismic monitoring of the volcanic field area has improved greatly since 1985 with the establishment of new network seismic stations. This has allowed for a lowered threshold of detection of seismic events and improved location capabilities. As an example of the result of this improved ability to locate smaller tremors, two swarms have been identified in the field, the 2009 Halloween swarm near Sunset Crater volcano and the 2011 swarm near Flagstaff, the largest urban community in northern Arizona.
文摘Vice,faith,xenophobia,and success目睹过罪恶,聆听过福音,经历过排挤,见证过成功;百余年风云变幻,旧金山的唐人街从不缺少传奇San Francisco’s Chinatown may well be the largest outside of Asia,its success fueled in part by a particularly active community of Chinese diaspora.Since the first Chinese arrived there in 1848,its story has been
文摘BACKGROUND Liver transplantation(LT)for hepatocellular carcinoma(HCC)has been widely researched and is well established worldwide.The cornerstone of this treatment lies in the various criteria formulated by expert consensus and experience.The variations among the criteria are staggering,and the short-and long-term outcomes are controversial.AIM To study the differences in the current practices of LT for HCC at different centers in India and discuss their clinical implications in the future.METHODS We conducted a survey of major centers in India that performed LT in December 2022.A total of 23 responses were received.The centers were classified as high-and low-volume,and the current trend of care for patients undergoing LT for HCC was noted.RESULTS Of the 23 centers,35%were high volume center(>500 Liver transplants)while 52%were high-volume centers that performed more than 50 transplants/year.Approximately 39%of centers had performed>50 LT for HCC while the percent distribution for HCC in LT patients was 5%–15%in approximately 73%of the patients.Barring a few,most centers were divided equally between University of California,San Francisco(UCSF)and center-specific criteria when choosing patients with HCC for LT,and most(65%)did not have separate transplant criteria for deceased donor LT and living donor LT(LDLT).Most centers(56%)preferred surgical resection over LT for a Child A cirrhosis patient with a resectable 4 cm HCC lesion.Positron-emission tomography-computed tomography(CT)was the modality of choice for metastatic workup in the majority of centers(74%).Downstaging was the preferred option for over 90%of the centers and included transarterial chemoembolization,transarterial radioembolization,stereotactic body radiotherapy and atezolizumab/bevacizumab with varied indications.The alphafetoprotein(AFP)cut-off was used by 74%of centers to decide on transplantation as well as to downstage tumors,even if they met the criteria.The criteria for successful downstaging varied,but most centers conformed to the UCSF or their center-specific criteria for LT,along with the AFP cutoff values.The wait time for LT from downstaging was at least 4–6 wk in all centers.Contrast-enhanced CT was the preferred imaging modality for post-LT surveillance in 52%of the centers.Approximately 65%of the centers preferred to start everolimus between 1 and 3 months post-LT.CONCLUSION The current predicted 5-year survival rate of HCC patients in India is less than 15%.The aim of transplantation is to achieve at least a 60%5-year disease free survival rate,which will provide relief to the prediction of an HCC surge over the next 20 years.The current worldwide criteria(Milan/UCSF)may have a higher 5-year survival(>70%);however,the majority of patients still do not fit these criteria and are dependent on other suboptimal modes of treatment,with much lower survival rates.To make predictions for 2040,we must prepare to arm ourselves with less stringent selection criteria to widen the pool of patients who may undergo transplantation and have a chance of a better outcome.With more advanced technology and better donor outcomes,LDLT will provide a cutting edge in the fight against liver cancer over the next two decades.
文摘Chinese education in America is a cultural product of Chinese immigrants to the United States.In 1848,the California Gold Rush attracted many Chinese to the United States,and gradually formed Chinese communities in the local area,and then spontaneously produced Chinese education.At that time,San Francisco Chinatown was the largest Chinatown in the United States,and its Chinese education showed representative characteristics.By studying the origin and development of Chinese education in San Francisco,this paper analyzes the characteristics of Chinese education in the United States,in order to provide experience and reference for contemporary Chinese education in the United States.
