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Adobe Presenter在E-learning中的应用 被引量:3
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作者 陈松 顾凯鸣 《中国教育信息化(高教职教)》 2012年第2期91-92,共2页
Microsoft Office PowerPoint在目前的多媒体课件制作软件中占据了主导地位,但PPT课件用在基于网络的数字化教学中有着先天性的不足。本文从适用性、易用性、功能性和知识产权保护等多个方面对Adobe Presenter在E-learning中的优势进行... Microsoft Office PowerPoint在目前的多媒体课件制作软件中占据了主导地位,但PPT课件用在基于网络的数字化教学中有着先天性的不足。本文从适用性、易用性、功能性和知识产权保护等多个方面对Adobe Presenter在E-learning中的优势进行了分析。 展开更多
关键词 E—learning ADOBE presenter 多媒体课件
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Adobe Presenter在多媒体课件中的应用 被引量:4
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作者 李华新 《教育信息技术》 2010年第6期51-52,共2页
使用Adobe公司的Presenter软件能够配合PowerPoint轻松地制作出生动的交互式课件。本文主要介绍了AdobePresenter软件的一般使用方法及课件发布方式。
关键词 ADOBE presenter 多媒体课件 使用方法 课件发布
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基于Adobe Presenter开发高中英语阅读互动教学软件——以模块三第一单元M3U1“Festivals around the World”为例
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作者 肖卫红 沈琴 况姗芸 《教育信息技术》 2013年第12期52-54,共3页
英语阅读教学在高中英语教学中占有非常重要的地位,但当前高中英语阅读教学中困难多多,英语阅读互动教学的设计与开发能有助于解决教学困境。本文在分析互动教学软件制作途径的基础上,推介了Adobe Presenter这一适用于高中英语教师开发... 英语阅读教学在高中英语教学中占有非常重要的地位,但当前高中英语阅读教学中困难多多,英语阅读互动教学的设计与开发能有助于解决教学困境。本文在分析互动教学软件制作途径的基础上,推介了Adobe Presenter这一适用于高中英语教师开发互动教学内容的教学软件,并结合高中英语第三模块第一单元的"Festivals around the World",具体分析了基于Adobe Presenter的英语阅读互动教学软件的开发。 展开更多
关键词 ADOBE presenter 高中 英语阅读 互动教学软件
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Adobe Presenter 7在网络课件中的应用
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作者 陆春雨 丁穗娟 谢帆 《电脑编程技巧与维护》 2014年第8期82-83,共2页
介绍了用Adobe Presenter 7制作网络课件的一般方法,并分析了该软件在实际应用中的优势和不足。
关键词 presenter软件 网络课件
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长着“蓝牙”的鼠标—罗技Cordless Presenter
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《计算机应用文摘》 2002年第8期105-105,共1页
关键词 “蓝牙” 鼠标 罗技 CORDLESS presenter
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“主题陈述+应用实践”模式在“社会学概论”课程教学中的运用——以H高校社会工作专业为例
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作者 闵兢 李波 《改革与开放》 2024年第8期32-38,共7页
文章通过对H高校“社会学概论”课程传统教学模式进行诊析,发现存在教学内容上重知识传授、轻立德树人;教学设计上重理论灌输、轻实践教学;教学方法上重教师主导、轻学生参与等问题。因此,课程教学团队以建构主义学习理论为指导,秉持“... 文章通过对H高校“社会学概论”课程传统教学模式进行诊析,发现存在教学内容上重知识传授、轻立德树人;教学设计上重理论灌输、轻实践教学;教学方法上重教师主导、轻学生参与等问题。因此,课程教学团队以建构主义学习理论为指导,秉持“为学习者设计教学”的理念,创新性地提出以“主题陈述+应用实践”(Presentation+Practice)为核心的教学模式。该模式在理论教学部分增设“悦读经典”新环节,与学生共同选择高质量文献进行研讨,培养学生的研究能力与表达能力;在实践教学部分,创造性地移植并导入工科专业的“课程设计”环节,要求学生选择研究主题进行社会实践、撰写研究报告,帮助学生初步形成了运用专业理论知识和技术解决相关工作中实际问题的本领,提升了学生的能力。这一教学模式的创新契合“00后”大学生的学情特点,取得了显著的教学成效。 展开更多
关键词 主题陈述(Presentation) 应用实践(Practice) 课程设计
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Chlorfenapyr poisoning:mechanisms,clinical presentations,and treatment strategies
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作者 Ji Cheng Yulu Chen +4 位作者 Weidong Wang Xueqi Zhu Zhenluo Jiang Peng Liu Liwen Du 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第3期214-219,共6页
BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus insecticides.Chlorfenapyr poisoning has a high mortality rate and is difficult to treat.This article aims to review the mechanisms... BACKGROUND:Chlorfenapyr is used to kill insects that are resistant to organophosphorus insecticides.Chlorfenapyr poisoning has a high mortality rate and is difficult to treat.This article aims to review the mechanisms,clinical presentations,and treatment strategies for chlorfenapyr poisoning.DATA RESOURCES:We conducted a review of the literature using PubMed,Web of Science,and SpringerLink from their beginnings to the end of October 2023.The inclusion criteria were systematic reviews,clinical guidelines,retrospective studies,and case reports on chlorfenapyr poisoning that focused on its mechanisms,clinical presentations,and treatment strategies.The references in the included studies were also examined to identify additional sources.RESULTS:We included 57 studies in this review.Chlorfenapyr can be degraded into tralopyril,which is more toxic and reduces energy production by inhibiting the conversion of adenosine diphosphate to adenosine triphosphate.High fever and altered mental status are characteristic clinical presentations of chlorfenapyr poisoning.Once it occurs,respiratory failure occurs immediately,ultimately leading to cardiac arrest and death.Chlorfenapyr poisoning is diflcult to treat,and there is no specific antidote.CONCLUSION:Chlorfenapyr is a new pyrrole pesticide.Although it has been identified as a moderately toxic pesticide by the World Health Organization(WHO),the mortality rate of poisoned patients is extremely high.There is no specific antidote for chlorfenapyr poisoning.Therefore,based on the literature review,future efforts to explore rapid and effective detoxification methods,reconstitute intracellular oxidative phosphorylation couplings,identify early biomarkers of chlorfenapyr poisoning,and block the conversion of chlorfenapyr to tralopyril may be helpful for emergency physicians in the diagnosis and treatment of this disease. 展开更多
关键词 Chlorfenapyr poisoning MECHANISM Clinical presentation TREATMENT
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Recent Advances for Global Perspectives on Etiology, Pathophysiology, Clinical Presentations, and Management of Moyamoya Disease
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作者 Maiko Charles Mkwambe Dongchi Zhao Youping Deng 《World Journal of Neuroscience》 CAS 2024年第1期6-23,共18页
Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in redu... Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in reduced blood flow and oxygen to the brain, leading to progressive symptoms and potential complications. The underlying pathophysiological mechanism remains elucidated. However, recent studies have highlighted numerous etiologic factors: abnormal immune complex responses, susceptibility genes, branched-chain amino acids, antibodies, heritable diseases, and acquired diseases, which may be the great potential triggers for the development of moyamoya disease. Its clinical presentation has varying degrees from transient asymptomatic events to significant neurological deficits. Moyamoya disease (MMD) shows different patterns in children and adults. Children with MMD are more susceptible to ischemic events due to decreased blood flow to the brain. Conversely, adults with MMD are more prone to hemorrhagic events involving brain bleeding. Children with MMD may experience a range of symptoms including motor impairments, sensory issues, seizures, headaches, dizziness, cognitive delays, or ongoing neurological problems. Although adults may present with similar clinical symptoms as children, they are more prone to experiencing sudden onset intraventricular, subarachnoid, or intracerebral hemorrhages. One of the challenges in moyamoya disease is the potential for misdiagnosis or delayed diagnosis, particularly when physicians fail to consider MMD as a possible cause in stroke patients. This review aims to provide a comprehensive overview of recent global studies on the pathophysiology of MMD, along with advancements in its management. Additionally, the review will delve into various surgical treatment options for MMD, as well as its rare occurrence alongside atrioventricular malformations. Exciting prospects include the use of autologous bone marrow transplant and the potential role of Connexin 43 protein treatment in the development of moyamoya disease. 展开更多
关键词 Moyamoya Disease (MMD) ETIOLOGY PATHOPHYSIOLOGY Clinical Presentations MANAGEMENT Future Promising Avenues
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Clinical Presentation and Treatment Outcomes of Pregnancy-Related Acute Kidney Injury among Pregnant Women Admitted at the Benjamin Mkapa Hospital in Tanzania
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作者 Kessy Shija Hindu Ibrahim +3 位作者 Sylvia Jumbe Bushi Lugoba Stephen Mathew Kibusi Alphonce Chandika 《Open Journal of Nephrology》 2024年第2期157-175,共19页
Background: Globally, PRAKI is among the leading causes of death in pregnant women. The prevalence, causes and outcome of this condition vary among countries due to differences in environmental, socioeconomic, and hea... Background: Globally, PRAKI is among the leading causes of death in pregnant women. The prevalence, causes and outcome of this condition vary among countries due to differences in environmental, socioeconomic, and health delivery systems. The common causes that have been reported in several studies are PIH, Haemorrhages and Sepsis while the outcomes may be either complete renal recovery, progression to CKD and hence dialysis dependency or death. This study aimed at determining clinical presentation and treatment outcomes of Pregnancy-Related Acute Kidney Injury in Pregnant women admitted at the Benjamin Mkapa Hospital, Dodoma, Tanzania. Results: Out of 4007 pregnant women who were admitted to the maternity ward 51 pregnant women were found to have PRAKI. Of those with PRAKI, 74.5% were between 21 to 25 years. The leading causes of PRAKI were PPH 12 (23.53%), Eclampsia 12 (23.53%), and pre-eclampsia 12 (23.5%). Hemodialysis therapy was provided to 22 (43.1%) patients, 15 (29.4%) individuals recovered spontaneously with medical management and 14 (27.5%) missed haemodialysis therapy due to various reasons. The mortality due to PRAKI was 17 (33.3%). Conclusion and Recommendation: Pre-eclampsia/eclampsia and post-partum haemorrhage were found to be the main causes of PRAKI. The mortality related to PRAKI is high and Hemodialysis therapy is vital help to prevent deaths for pregnant women with PRAKI. Pregnant women who develop acute kidney injury should be followed closely and a nephrologist should be consulted early. Early referral should be done by the lower level facilities for all at-risk pregnant women to a specialized multidisciplinary health facility. 展开更多
关键词 Clinical Presentation Treatment Outcomes Pregnancy-Related Acute Kidney Injury
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Research on Strategies for Enhancing the Ability of Chinese German Learners to Tell Chinese Stories Through Short Videos
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作者 YU Ji-kun BIAN Hong 《Journal of Literature and Art Studies》 2024年第5期335-342,共8页
In the age of new media,short videos play an increasingly important role in international cultural exchange.However,German learners often encounter challenges when producing and sharing short videos due to factors suc... In the age of new media,short videos play an increasingly important role in international cultural exchange.However,German learners often encounter challenges when producing and sharing short videos due to factors such as technology and language proficiency.Such challenges can affect the professionalism and attractiveness of the videos.This study focuses on German learners at the University of Shanghai for Science and Technology.The aim of this study is to investigate students’experiences in producing short videos,identify issues through surveys and interviews,and concentrate on editing skills,language proficiency,and intercultural communication abilities.It proposes strategies for developing these skills and aims to provide insights for German and other foreign language learners in telling Chinese stories using short videos. 展开更多
关键词 short video better presentation of Chinese stories intercultural communication
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Fournier’s Gangrene: 13-Year Experience in a Tertiary Center, North Eastern Nigeria
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作者 Makama Baje Salihu Haruna Liman +4 位作者 Stephen Yusuf Aminu Umar Oladimeji Abraham Tunde Ayodele Olufikayo Oshagbemi Amur Ibrahim 《Open Journal of Urology》 2024年第7期407-414,共8页
Background: Fournier’s gangrene is a fulminant infection of the genitourinary tract characterized by progressive necrosis of the skin and subcutaneous tissue of the external genitalia. Initially mainly seen involving... Background: Fournier’s gangrene is a fulminant infection of the genitourinary tract characterized by progressive necrosis of the skin and subcutaneous tissue of the external genitalia. Initially mainly seen involving the scrotum of elderly men with different moods of occurrence each unpleasantly lethal. With varying types of presentation only one thing has remained constant;the poor prognosis of this condition. Purpose/Aim: Thus, it’s important to study the trends of the presentation of this condition laying emphasis on the challenges in the management of these patients;both the negative and positive prognostic factors. Materials and Methods: Urology ward record books, clinic record books and operating theater records were used to identify patients managed for Fournier gangrene in ATBUTH Bauchi. A retrospective study of the medical files of all the patients managed from January 2011 to January 2024 was done. Data was analyzed using SPSS version 29. Results: Data from 47 patients seen during the period of study were carefully collected and analyzed. The age range is 2 weeks to 97 years. There were two neonates, one at 2nd week of life and the other at 3rd week. Mortality rate is 36%. The average time duration before presentation for patients that died was two weeks, a minimum of 9 days prior to presentation and a maximum of 21 days, about 10 of which came in septic shock and the remaining presented with fever and very extensive necrotizing fasciitis of the perineum. All the patients that died had diabetes mellitus as a comorbidity except the neonate. All the patients that survived were much younger, all were below 60 years of age (2 weeks - 53 years). Conclusion: Here, we share our experience managing patients with Fournier’s gangrene in our facility in the past 13-year period from January 2011 to January 2024. . 展开更多
关键词 Fournier’s Gangrene Prognosis ELDERLY Presentation Treatment
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基于Present算法的无线网络通信数据安全加密方法
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作者 王辰阳 王志刚 刘成 《长江信息通信》 2024年第1期164-166,共3页
为降低无线网络通信中数据传输节点的损失系数,引进Present算法,设计一种针对无线网络通信数据的安全加密方法。将贝叶斯定理作为参照,计算得到无线网络通信中数据处于安全状态的概率,推断得到数据通信的安全等级,实现对无线网络通信数... 为降低无线网络通信中数据传输节点的损失系数,引进Present算法,设计一种针对无线网络通信数据的安全加密方法。将贝叶斯定理作为参照,计算得到无线网络通信中数据处于安全状态的概率,推断得到数据通信的安全等级,实现对无线网络通信数据类别的划分;引进Present算法,生成无线网络通信数据轮密钥;根据窗口分割的结果,提取通信网络敏感数据,设定无线网络通信数据的时间序列,实现对无线网络通信数据中敏感数据的主动安全加密。实验结果表明:所提方法应用效果较好,可以将加密后节点损失系数控制在一个相对较低的水平,通过此种方式,降低节点在通信与传输信息时的损失。 展开更多
关键词 Present算法 敏感数据 轮密钥 安全加密方法 通信数据 无线网络
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KAI-LIMA Model,TV Presenter and Founder of Mopsi
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《城市漫步(上海版、英文)》 2018年第9期15-15,共1页
Ever since she was discovered by a modeling agency at the age of 13.Hamburg native Kai-LiMa has appeared in the TV commercials,bllboard ads and fashion shows for some of the world's biggest brands.Eartier this yea... Ever since she was discovered by a modeling agency at the age of 13.Hamburg native Kai-LiMa has appeared in the TV commercials,bllboard ads and fashion shows for some of the world's biggest brands.Eartier this year,the Shanghai based model establishedher own streetwear label Mopsi,which is named after an anti social‘Unipig’that she created. 展开更多
关键词 presenter WEAR OWN
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KAI-LI MA Model,TV Presenterand Founder of Mopsi
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《城市漫步(GBA版)》 2018年第9期19-19,共1页
Ever since she was discovered by a modeling agency at the age of 13,Hamburg native Kai-Li Ma has appeared in the TV commercials,billboard ads and fashion shows for some of the worlds biggest brands.Earlier this year,t... Ever since she was discovered by a modeling agency at the age of 13,Hamburg native Kai-Li Ma has appeared in the TV commercials,billboard ads and fashion shows for some of the worlds biggest brands.Earlier this year,the Shanghai-based model established her own streetwear label M叩si,which is named after an anti-social^nipig1 that she created. 展开更多
关键词 presenter WEAR OWN
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PRESENT轻量级密码的中间相遇统计故障分析 被引量:3
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作者 李玮 朱晓铭 +2 位作者 谷大武 李嘉耀 蔡天培 《计算机学报》 EI CAS CSCD 北大核心 2023年第2期353-370,共18页
PRESENT算法是于2007年在国际密码硬件与嵌入式系统会议提出的一种轻量级分组密码,2012年成为国际轻量级算法标准ISO/IEC-29192-2,适用于物联网中射频识别标签、网络传感器、智能卡等设备的数据保护.本文结合PRESENT密码的设计结构和实... PRESENT算法是于2007年在国际密码硬件与嵌入式系统会议提出的一种轻量级分组密码,2012年成为国际轻量级算法标准ISO/IEC-29192-2,适用于物联网中射频识别标签、网络传感器、智能卡等设备的数据保护.本文结合PRESENT密码的设计结构和实现特点,基于统计分析和中间相遇分析策略,提出了一种中间相遇统计故障分析方法,设计了皮尔逊相关系数-汉明重量、库尔贝克莱布勒散度-汉明重量区分器和杰卡德相似系数-汉明重量-极大似然估计等区分器,可以分别破译PRESENT密码全部版本的80比特和128比特原始密钥.该方法攻击轮数更深,故障数和耗时更少,有效地扩展了攻击范围,提升了攻击能力.结果表明,中间相遇统计故障分析对PRESENT密码构成了严重威胁.该研究为轻量级密码的实现安全研究提供了有价值的参考. 展开更多
关键词 轻量级密码 PRESENT 故障分析 中间相遇分析 密码分析
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基于Present算法的通信网络自主防御数据安全加密方法 被引量:3
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作者 周峰 《数字通信世界》 2023年第3期27-29,共3页
由于传统的通信网络数据加密方法受到攻击时节点损失系数较大,无法保证加密后的数据安全性,文章提出一种基于Present算法的通信网络自主防御数据安全加密方法。提取通信网络自主防御敏感数据,利用混沌条件量生成Present算法的轮密钥,实... 由于传统的通信网络数据加密方法受到攻击时节点损失系数较大,无法保证加密后的数据安全性,文章提出一种基于Present算法的通信网络自主防御数据安全加密方法。提取通信网络自主防御敏感数据,利用混沌条件量生成Present算法的轮密钥,实现敏感数据的加密。实验结果表明:经过此方法加密后的通信网络自主防御数据,受到攻击时节点损失系数仅有0.06,具有较好的加密性能。 展开更多
关键词 Present算法 通信网络 自主防御 数据安全 加密方法
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A Flexible Architecture for Cryptographic Applications: ECC and PRESENT
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作者 Muhammad Rashid Omar S.Sonbul +3 位作者 Muhammad Arif Furqan Aziz Qureshi Saud.S.Alotaibi Mohammad H.Sinky 《Computers, Materials & Continua》 SCIE EI 2023年第7期1009-1025,共17页
This work presents a flexible/unified hardware architecture of Elliptic-curve Cryptography(ECC)and PRESENT for cryptographic applications.The features of the proposed work are(i)computation of only the point multiplic... This work presents a flexible/unified hardware architecture of Elliptic-curve Cryptography(ECC)and PRESENT for cryptographic applications.The features of the proposed work are(i)computation of only the point multiplication operation of ECC over GF(2163)for a 163-bit key generation,(ii)execution of only the variant of an 80-bit PRESENT block cipher for data encryption&decryption and(iii)execution of point multiplication operation(ECC algorithm)along with the data encryption and decryption(PRESENT algorithm).To establish an area overhead for the flexible design,dedicated hardware architectures of ECC and PRESENT are implemented in the first step,and a sum of their hardware area is computed.Then,the implementation of the proposed flexible architecture for ECC and PRESENT algorithms is presented.Implementation results regarding the area,clock cycles,latency,clock frequency,and power after the place-and-route level on Xilinx Virtex-5,Virtex-6,and Virtex-7 FPGA devices are presented.Hence,the implementation results and comparisons show that the proposed architecture suits applications demanding flexible implementation of cryptographic applications. 展开更多
关键词 Flexible UNIFIED design ECC PRESENT FPGA
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Clinical analysis of Wernicke encephalopathy after liver transplantation
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作者 Li-Min Ding Li-Shan Deng +3 位作者 Jun-Jie Qian Gang Liu Lin Zhou Shu-Sen Zheng 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2023年第4期352-357,共6页
Background:Wernicke encephalopathy(WE)is an acute neurological disease resulting from vitamin B1 deficiency,and there are only very few case reports of WE after liver transplantation.The present study aimed to investi... Background:Wernicke encephalopathy(WE)is an acute neurological disease resulting from vitamin B1 deficiency,and there are only very few case reports of WE after liver transplantation.The present study aimed to investigate the clinical characteristics,etiology,magnetic resonance imaging(MRI)features,treatment and prognosis of patients with WE after liver transplantation.Methods:Twenty-three patients with WE after liver transplantation from the First Affiliated Hospital,Zhejiang University School of Medicine and Jiangxi Provincial People’s Hospital between January 2011 and December 2021 were retrospectively analyzed.Results:Among the 23 patients diagnosed with WE after liver transplantation,6(26%)had a classic triad of impaired consciousness,oculomotor palsy and ataxia,and 17(74%)had two features.The misdiagno-sis rate was 65%.After treatment with high-dose vitamin B1,19(83%)patients showed improvement,whereas 4(17%)showed no improvement,including 3 with residual short-term memory impairments and 1 with residual spatial and temporal disorientation and ataxia.Conclusions:The misdiagnosis rate is high in the early stage of WE,and the prognosis is closely asso-ciated with whether WE is diagnosed early and treated timely.High-dose glucose or glucocorticoids can trigger WE and cannot be administered before vitamin B1 treatment.Vitamin B1 is suggested to be used as a prophylactic treatment for patients with WE after liver transplantation. 展开更多
关键词 Liver transplantation Wernicke encephalopathy Vitamin B1 Clinical presentations Imaging features DIAGNOSIS TREATMENT PROGNOSIS
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Celebrating the 70th Anniversary--National University of Defense Technology,1953-2023 Special Section on Complex Systems Theory and Practice
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《Journal of Systems Engineering and Electronics》 SCIE EI CSCD 2023年第3期F0002-F0002,共1页
In the 21st century,a new round of scientifi c and technological revolution represented by digitalization,networking and intelligence has caused a change in the scientific research paradigm,and the research of complex... In the 21st century,a new round of scientifi c and technological revolution represented by digitalization,networking and intelligence has caused a change in the scientific research paradigm,and the research of complex systems has become the main driving force for the change of the scientific research paradigm. 展开更多
关键词 COMPLEX driving PRESENTED
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Regional variation in routes to diagnosis of cholangiocarcinoma in England from 2006 to 2017
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作者 Amy Zalin-Miller Sophie Jose +5 位作者 Craig Knott Lizz Paley Daniela Tataru Helen Morement Mireille B Toledano Shahid A Khan 《World Journal of Gastroenterology》 SCIE CAS 2023年第24期3825-3842,共18页
BACKGROUND Incidence of cholangiocarcinoma(CCA)is rising,with overall prognosis remaining very poor.Reasons for the high mortality of CCA include its late presentation in most patients,when curative options are no lon... BACKGROUND Incidence of cholangiocarcinoma(CCA)is rising,with overall prognosis remaining very poor.Reasons for the high mortality of CCA include its late presentation in most patients,when curative options are no longer feasible,and poor response to systemic therapies for advanced disease.Late presentation presents a large barrier to improving outcomes and is often associated with diagnosis via mergency presentation(EP).Earlier diagnoses may be made by Two Week Wait(TWW)referrals through General practitioner(GP).We hypothesise that TWW referrals and EP routes to diagnosis differ across regions in England.AIM To investigate routes to diagnosis of CCA over time,regional variation and influencing factors.METHODS We linked patient records from the National Cancer Registration Dataset to Hospital Episode Statistics,Cancer Waiting Times and Cancer Screening Programme datasets to define routes to diagnosis and certain patient characteristics for patients diagnosed 2006-2017 in England.We used linear probability models to investigate geographic variation by assessing the proportions of patients diagnosed via TWW referral or EP across Cancer Alliances in England,adjusting for potential confounders.Correlation between the proportion of people diagnosed by TWW referral and EP was investigated with Spearman’s correlation coefficient.RESULTS Of 23632 patients diagnosed between 2006-2017 in England,the most common route to diagnosis was EP(49.6%).Non-TWW GP referrals accounted for 20.5%of diagnosis routes,13.8%were diagnosed by TWW referral,and the remainder 16.2%were diagnosed via an‘other’or Unknown route.The proportion diagnosed via a TWW referral doubled between 2006-2017 rising from 9.9%to 19.8%,conversely EP diagnosis route declined,falling from 51.3%to 46.0%.Statistically significant variation in both the TWW referral and EP proportions was found across Cancer Alliances.Age,presence of comorbidity and underlying liver disease were independently associated with both a lower proportion of patients diagnosed via TWW referral,and a higher proportion diagnosed by EP after adjusting for other potential confounders.CONCLUSION There is significant geographic and socio-demographic variation in routes to diagnosis of CCA in England.Knowledge sharing of best practice may improve diagnostic pathways and reduce unwarranted variation. 展开更多
关键词 CHOLANGIOCARCINOMA Route to diagnosis Two Week Wait Emergency presentation Regional variation
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