Bibliographic record
Abstract
Sex Hormones and AsthmaA potential causal association between changes in sex hormones and asthma incidence or severity has long been supported by several well-known epidemiological observations; for example, asthma is more prevalent and severe in male children, yet after childhood, women are more commonly affected throughout adulthood (1).Perimenstrual worsening has been reported to occur in 20-40% of patients with severe or difficult-to-control asthma, particularly among obese females (2).On the basis of this information, suppressing sex hormone fluctuations through hormonal replacement therapy (HRT) would indeed make logical sense to reduce asthma incidence or potentially improve asthma outcomes; however, this has not been consistently shown, and in fact, some longitudinal studies have shown that HRT actually increased the odds of developing this disease (3,4).Several factors such as the type and timing of HRT, the type study design, and individual characteristics (obese vs. nonobese) may potentially explain the variability in response to this treatment.It may also imply, however, that we do not fully understand how variations in sex hormone levels affect asthma, and therefore, we do not know in whom and when HRT could be useful.To this effect, in this issue of the Journal, Han and colleagues (pp.158-166) present the first large population-representative study evaluating the association between serum estradiol and serum free testosterone levels with self-referred current asthma diagnosis in men and women participating in the National Health and Nutrition Examination Survey (5).This cross-sectional analysis of 7,615 (3,953 men and 3,662 women) adults shows that women with higher serum testosterone levels have between 30% and 44% lower odds of current asthma when compared with the women with the lowest testosterone levels.Given the significant interaction found between obesity and sex hormones on asthma, the authors showed in the fully adjusted model that in obese women, higher serum estradiol and serum free testosterone were, respectively, associated with a 40% and a 40-50% reduction in the odds of current asthma.The associations in men were less impressive, as only the highest serum estradiol quartile, relative to the lowest, was associated with reduced asthma odds in nonobese subjects.Whereas prior large-scale epidemiological studies have attributed changes in asthma-related outcomes to sex hormones only by proxy (i.e., puberty or menstrual period), the results from this study, by directly measuring serum levels, significantly strengthen causality.Further, the association with testosterone, which had been largely overlooked in many prior asthma studies,
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
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".