The secret life of steroids in asthma
Bibliographic record
Abstract
Asthma is an inflammatory disease. Who is still questioning this paradigm? In the Global Initiative for Asthma (GINA) guidelines the disease is defined as a chronic inflammatory disorder of the airways 1. The evidence for this is overwhelming, and comes from observational studies as well as experimental models. The proof of the pudding has been provided by numerous studies with anti-inflammatory interventions. Ever since the early 1950s 2, the efficacy of both short courses and maintenance treatment with corticosteroids in asthma has been beyond any discussion 1. Hence, the evidence that inflammation is causally involved in the pathophysiology of asthma nicely meets Koch’s postulations. Therefore, it is no surprise that ever since this key mechanism of the disease was identified, many academic and industrial groups rushed to develop the most selective and potent anti-inflammatory compounds for suppression, prevention or perhaps even cure of the disease. Remarkably, during the past 20 yrs the development of new anti-inflammatory therapies for asthma has been less successful than was hoped and expected 3. Can’t we identify the responsible inflammatory targets? Should such targets be combined? Certainly, this cannot be excluded and deserves an even more intensive search. But, is it not frustrating to see our neighbour rheumatologists successfully testing and implementing one novel anti-inflammatory after the other 4? Of course, asthma is a complex disease, perhaps even more complex than arthritis. But what does that mean? If anything, that must be the key point. Complexity requires multi-dimensional approaches. Should we keep on addressing asthma as reductionists, or does the disease require a more integrative approach, by taking the elaborate dynamics of the organ and the organism into account rather than singling out molecular pathways? It seems that the puzzle of asthma demands the latter. Fortunately, we are moving on to …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.004 | 0.005 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.011 |
| Insufficient payload (model declined to judge) | 0.011 | 0.006 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".