Inland Container Transportation System Planning with Reference to Korean Ports
Notice bibliographique
Résumé
Background Gastro oesophageal reflux disease (GORD) is a leading cause of morbidity and economic importance worldwide. It is currently defined by the Montreal definition as a condition, which develops when the reflux of gastric content causes troublesome symptoms or complications. This definition based on symptoms is all encompassing, and further classification is made based on macroscopic mucosal injury as seen on gastroscopy, increased distal oesophageal acid and non acid exposure, based on 24 hour pH and impedance pH testing, and reflux symptom association. Thus, GORD may be sub classified into the following conditions – erosive reflux disease (ERD), non erosive reflux disease (NERD), reflux hypersensitivity (RH), functional heartburn (FH) and functional chest pain (FCP). Treatment of GORD is with acid suppression therapy, anti reflux therapy and pain modulation. The pathophysiology of GORD is thought to occur in a spectrum, with varying contributions from direct mucosal injury to peripheral sensitization and central sensitization. Further efforts to phenotype GORD populations, investigate mechanisms of symptom evolution and treatments are driven by a significant proportion of patients who are refractory to currently available therapies. Aims The aim of this body of work was to phenotype patients with RH, the least studied subtype of GORD, to investigate the effect of ONO 8539, a novel antagonist to the Prostaglandin E 1 receptor thought to be involved in pain perception on acid induced oesophageal pain hypersensitivity in patients with NERD, to investigate the effect of transcutaneous vagal nerve stimulation (tVNS) on an oesophageal pain model in healthy volunteers, and to investigate the effect of slow deep breathing on oesophageal pain hypersensitivity in patients with NERD. Methods I investigated the above aims in a retrospective cohort study on patients referred to the gastro intestinal physiology unit of the Royal London Hospital for investigation of typical GORD symptoms, a double blind placebo controlled two period cross over study in patients with NERD, a single blind sham controlled two period cross over study in healthy volunteers and single blind sham controlled parallel study in patients with NERD respectively. The first study was done as a service evaluation exercise and the latter three studies had ethical approval from the National Research and Ethics Service (NRES), QMUL Ethics and NRES respectively. Results I demonstrated that phenotypic characteristics in patients with RH were distinct from NERD and FH/FCP. This was the largest cohort of RH patients evaluated, and this body of work will contribute to further research on mechanisms, pathophysiology and treatments in RH. In my second study, I was not able to demonstrate an anti nociceptive effect of ONO 8539 versus placebo on oesophageal pain hypersensitivity in patients with NERD. In my third study, I was able to demonstrate an increase in anti nociceptive parasympathetic tone, and an increase in pain tolerance threshold with tVNS compared to sham stimulation in an oesophageal pain hypersensitivity model in healthy volunteers. In my final study, I was able to demonstrate an increase in parasympathetic tone, but no improvement in lag time to pain perception with a slow deep breathing protocol compared to a sham breathing protocol in a Modified Bernstein test model of distal oesophageal acid infusion in patients with NERD. Conclusions This body of work improves upon current knowledge of the phenotypic characteristics of RH, adding further weight to the definition of RH as a distinct condition. tVNS and deep slow breathing were shown to increase parasympathetic tone in healthy volunteers and patients with NERD respectively. The anti nociceptive effect of raising parasympathetic tone was only demonstrated in the healthy volunteer model of oesophageal pain hypersensitivity. The performance of the MBT model used in the two patient studies was not as reliable as the healthy volunteer model, and a new oesophageal pain hypersensitivity model for patients with NERD was proposed
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».