Nieuwe interventies voor aangeboren diafragmatische hernia.
Bibliographic record
Abstract
Congenital diaphragmatic hernia (CDH) is a congenital birth defect occurring in 2.3/10,000 live births in Europe. Despite the progress in neonatal care, average mortality is still 30% due to disturbed lung development, which leads to ventilatory insufficiency and persistent pulmonary hypertension. In the Western countries >70% of cases are diagnosed prenatally. In isolated cases, prenatal tests also allow to make an individualized prognosis. The ability to identify a future non-survivor prenatally warrants the search for a prenatal intervention that can improve outcome. Fetoscopic endoluminal tracheal occlusion (FETO) is the most promising experimental therapy, associated with an apparent increase in survival from <15% to 50 % in severe cases. Unfortunately, FETO is invasive and has an up to 25% risk for preterm delivery, partly offsetting the beneficial effects. Also, the maximum post-FETO survival reported is only 50-60%. Finally, this technique requires a second invasive procedure for balloon removal in order to ensure airway patency at birth. Therefore novel medical, less invasive solutions to prevent or reduce the grade of pulmonary hypoplasia need to be explored. 1- An experimental in the CDH rabbit model will be performed to modulate the expression of miR200b in early gestation and following tracheal occlusion. miR-200b regulates distal airway development. The group of Prf Deprest (KU LEUVEN) together with Prof R Keijzer (Winnipeg) has shown abnormal expression of miR-200b in the context of human pulmonary hypoplasia in congenital diaphragmatic hernia (CDH) [7]. We also recently confirmed that similar changes in miR-200b expression are present in the CDH rabbit model [Eastwood et al, publication submitted], opening possibility for further therapeutic studies to reduce the degree of pulmonary hypoplasia. 2- The role of fetal lung Renin-Angiotensin system (RAS) will be investigated in a rabbit model. There is evidence that RAS has implications on fetal lung development, thus further knowledge concerning it pathway could lead to novel treatments. Nogueira-Silva previously studied RAS in the rat model for CDH with promising results. Confirmation of these results in a higher animal model (the rabbit) is necessary in the translational process. Such system might then be targeted prenatally to stimulate lung growth. 3- In an attempt to reduce the invasiveness of the current fetal treatment, the candidate will also test in the CDH sheep model a novel FETO balloon that does not require prenatal surgical removal, therefore reducing the incidence of preterm rupture of membranes and of complications in infants born with balloon in situ.
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.
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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.114 | 0.021 |
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".