Fetal therapy for congenital diaphragmatic hernia: past, present and future
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Congenital diaphragmatic hernia (CDH) affects 1/2500-5000 infants and is associated with significant neonatal morbidity and mortality related to pulmonary hypoplasia and pulmonary hypertension. Current estimates of perinatal mortality are between 30-40%. With advances in neonatal and surgical management and now improvements in prenatal diagnosis and intervention, further reduction in mortality is anticipated. Data from the international Tracheal Occlusion to Accelerate Lung Growth (TOTAL) trials, have demonstrated the efficacy of fetal endoscopic tracheal occlusion (FETO) in severe left CDH (LCDH). Although promising, this intervention also has potential for significant morbidity related to prematurity and iatrogenic mortality if reversal of tracheal occlusion is unsuccessful. The implementation of FETO must proceed cautiously within Level III fetal therapy centers and with rigorous outcomes monitoring of centers offering this therapy, ensuring that they are experienced in antenatal severity assessment of CDH, FETO insertion and removal and are integrated with expert, standardized neonatal CDH centers with availability of Extracorporeal life support (ECLS). Further research is needed to better understand the impact of prematurity on FETO survivors, the role of FETO in moderate LCDH, Right CDH (RCDH) and non-isolated CDH in carefully selected circumstances as well as the development of alternative, less invasive, fetal therapies that can specifically target both pulmonary hypoplasia and pulmonary hypertension.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.002 | 0.001 |
| 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) | 0.000 | 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 it