Novel therapies in the management of chronic obstructive pulmonary disease (COPD): Addressing genetic, immunologic, and physiologic principles of disease
Bibliographic record
Abstract
Chronic obstructive pulmonary disease (COPD) is a heterogeneous chronic lung disease characterized by airway inflammation, which in certain patients results in immune mediated airway remodeling, gas trapping, and/or loss in lung density with emphysema. As a result, patients have airflow obstruction associated with symptoms of cough, sputum production, dyspnea and wheeze, which are worsened during periods of exacerbation, and ultimately contributes to significant morbidity and mortality for patients, progressive lung function decline, worsening dyspnea and increased healthcare costs.Citation1 In recent years, maintenance inhaled triple therapy has been shown to reduce mortality for those at high risk of exacerbation; however, newer research has evolved our understanding of treating aspects of the pathophysiology of the disease that, until now, have not been addressed. Newer biologic medications, such as Dupilumab, address the inflammatory and immune responses of the disease by targeting pathways that lead to airway remodeling, decreasing exacerbations, lung function decline and symptoms. Endobronchial valve placement addresses the gross physiology of lung gas trapping present in COPD as a means of improving forced expiratory volume in one second (FEV1) and hyperinflation, measured on pulmonary function tests as well as validated dyspnea scores. Alpha-1 antitrypsin augmentation therapy addresses the underlying genetics of the disease by reducing the rate of lung density loss. Each of these therapies has shown promising outcomes to further improve the management of COPD, as highlighted in the following articles.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.009 | 0.002 |
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".