Bibliographic record
Abstract
The purpose of this presentation is to provide quantitative evidence that the small conducting airways narrow and disappear before emphysematous destruction becomes visible with the naked eye in patients with COPD. This new data was obtained from unused donor lungs (n = 4) that served as controls for lungs removed from patients receiving lung transplants for centrilobular emphysema (n = 4), panlobular emphysema caused by alpha1-antitrypsin deficiency (n = 8) and one case of pure airway obstruction without evidence of emphysematous destruction. Multi Detector computed tomography (MDCT) was used to measure the numbers of visible smaller airways in each generation of airway branching. Micro-CT was used to measure total number and lumen caliber of terminal bronchioles as well as the alveolar surface area and average alveolar dimension (Lm). These micro-CT measurements were correlated with the inflammatory immune cell infiltration and collagen remodelling measured by histology. The results show that the number of small airways that can be visualised beyond generation 7 in MDCT scans is reduced in persons with very severe(GOLD-4) COPD compared to controls (p = 0.02). In addition the micro-CT studies showed that the terminal bronchioles are reduced approximately 10-fold (p < 0.001) in CLE, 4-fold in A1AT deficiency but remained within the control range in one transplant subject without emphysema. However the minimum lumen cross-sectional area of the terminal bronchioles was reduced approximately 100-fold in CLE, 6 fold in A1AT deficiency and pure airway obstruction respectively (p < 0.001). This reduction in terminal bronchiolar number and alveolar surface area was also associated with a pattern of inflammatory immune cell infiltration and collagen reduction and remodelling observed during repetitive injury. We conclude that pre-terminal and terminal bronchioles are substantially narrowed and reduced in number in the lungs of patients with COPD before emphysematous destruction becomes visible to the naked eye. Supported by the US NIH, The Canadian Institute of Health Research (CIHR), a jointly sponsored CIHR Industry Program in which GSK served as the industry sponsor and by The BC lung Association.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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 teacher head, 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".