{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:03:13Z","timestamp":1783699393439,"version":"3.55.0"},"reference-count":92,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Outcome predictions of patients with congenital diaphragmatic hernia (CDH) still have some limitations in the prenatal estimate of postnatal pulmonary hypertension (PH). We propose applying Machine Learning (ML), and Deep Learning (DL) approaches to fetuses and newborns with CDH to develop forecasting models in prenatal epoch, based on the integrated analysis of clinical data, to provide neonatal PH as the first outcome and, possibly: favorable response to fetal endoscopic tracheal occlusion (FETO), need for Extracorporeal Membrane Oxygenation (ECMO), survival to ECMO, and death. Moreover, we plan to produce a (semi)automatic fetus lung segmentation system in Magnetic Resonance Imaging (MRI), which will be useful during project implementation but will also be an important tool itself to standardize lung volume measures for CDH fetuses.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and analytics<\/jats:title>\n<jats:p>Patients with isolated CDH from singleton pregnancies will be enrolled, whose prenatal checks were performed at the Fetal Surgery Unit of the Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico (Milan, Italy) from the 30<jats:sup>th<\/jats:sup> week of gestation. A retrospective data collection of clinical and radiological variables from newborns\u2019 and mothers\u2019 clinical records will be performed for eligible patients born between 01\/01\/2012 and 31\/12\/2020. The native sequences from fetal magnetic resonance imaging (MRI) will be collected. Data from different sources will be integrated and analyzed using ML and DL, and forecasting algorithms will be developed for each outcome. Methods of data augmentation and dimensionality reduction (feature selection and extraction) will be employed to increase sample size and avoid overfitting. A software system for automatic fetal lung volume segmentation in MRI based on the DL 3D U-NET approach will also be developed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Ethics and dissemination<\/jats:title>\n<jats:p>This retrospective study received approval from the local ethics committee (Milan Area 2, Italy). The development of predictive models in CDH outcomes will provide a key contribution in disease prediction, early targeted interventions, and personalized management, with an overall improvement in care quality, resource allocation, healthcare, and family savings. Our findings will be validated in a future prospective multicenter cohort study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Registration<\/jats:title>\n<jats:p>The study was registered at ClinicalTrials.gov with the identifier NCT04609163.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0259724","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T18:49:43Z","timestamp":1636483783000},"page":"e0259724","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":23,"title":["A maChine and deep Learning Approach to predict pulmoNary hyperteNsIon in newbornS with congenital diaphragmatic Hernia (CLANNISH): Protocol for a retrospective study"],"prefix":"10.1371","volume":"16","author":[{"given":"Ilaria","family":"Amodeo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"De Nunzio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genny","family":"Raffaeli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Borzani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Griggio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana","family":"Conte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Macchini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Cond\u00f2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Persico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Fabietti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Ghirardello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Pierro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Tafuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Como","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donato","family":"Cascio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariarosa","family":"Colnaghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Mosca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4921-1437","authenticated-orcid":true,"given":"Giacomo","family":"Cavallaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"pone.0259724.ref001","first-page":"571","volume-title":"Lung development: embryology, growth, maturation, and developmental biology.","author":"MV Fraga","year":"2012","edition":"9"},{"issue":"6","key":"pone.0259724.ref002","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.siny.2017.11.002","article-title":"Current and future antenatal management of isolated congenital diaphragmatic hernia.","volume":"22","author":"FM Russo","year":"2017","journal-title":"Seminars in Fetal and Neonatal Medicine"},{"issue":"8","key":"pone.0259724.ref003","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1016\/0022-3468(90)90190-K","article-title":"Nitrofen-induced diaphragmatic hernias in rats: an animal model","volume":"25","author":"D Kluth","year":"1990","journal-title":"J Pediatr Surg"},{"issue":"4","key":"pone.0259724.ref004","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1016\/S0002-9440(10)65000-6","article-title":"Dual-hit hypothesis explains pulmonary hypoplasia in the nitrofen model of congenital diaphragmatic hernia","volume":"156","author":"R Keijzer","year":"2000","journal-title":"The American journal of pathology"},{"issue":"2","key":"pone.0259724.ref005","doi-asserted-by":"crossref","first-page":"L423","DOI":"10.1152\/ajplung.1999.277.2.L423","article-title":"Vitamin A decreases the incidence and severity of nitrofen-induced congenital diaphragmatic hernia in rats","volume":"277","author":"B Th\u00e9baud","year":"1999","journal-title":"American Journal of Physiology-Lung Cellular and Molecular Physiology"},{"issue":"4","key":"pone.0259724.ref006","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1542\/peds.2010-0521","article-title":"Retinol status of newborn infants is associated with congenital diaphragmatic hernia","volume":"126","author":"LW Beurskens","year":"2010","journal-title":"Pediatrics"},{"issue":"1","key":"pone.0259724.ref007","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1002\/bdra.23093","article-title":"Dietary vitamin A intake below the recommended daily intake during pregnancy and the risk of congenital diaphragmatic hernia in the offspring.","volume":"97","author":"LW Beurskens","year":"2013","journal-title":"Birth Defects Res Part A: Clin Mol Teratol."},{"issue":"1","key":"pone.0259724.ref008","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1146\/annurev.ph.58.030196.000445","article-title":"Formation of pulmonary alveoli and gas-exchange surface area: quantitation and regulation","volume":"58","author":"GD Massaro","year":"1996","journal-title":"Annual review of physiology"},{"issue":"6","key":"pone.0259724.ref009","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.siny.2014.09.008","article-title":"Understanding and treating pulmonary hypertension in congenital diaphragmatic hernia","volume":"19","author":"M Pierro","year":"2014","journal-title":"Seminars in Fetal and Neonatal Medicine"},{"issue":"1","key":"pone.0259724.ref010","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.yexmp.2012.09.010","article-title":"Premature differentiation of vascular smooth muscle cells in human congenital diaphragmatic hernia","volume":"94","author":"I Sluiter","year":"2013","journal-title":"Experimental and Molecular Pathology"},{"issue":"21","key":"pone.0259724.ref011","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1161\/CIRCULATIONAHA.114.009124","article-title":"Existence, functional impairment, and lung repair potential of endothelial colony-forming cells in oxygen-induced arrested alveolar growth","volume":"129","author":"RS Alphonse","year":"2014","journal-title":"Circulation"},{"issue":"1","key":"pone.0259724.ref012","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jpeds.2014.09.010","article-title":"Histologic identification of prominent intrapulmonary anastomotic vessels in severe congenital diaphragmatic hernia","volume":"166","author":"SN Acker","year":"2015","journal-title":"The Journal of pediatrics"},{"issue":"12","key":"pone.0259724.ref013","doi-asserted-by":"crossref","first-page":"L943","DOI":"10.1152\/ajplung.00226.2013","article-title":"Pulmonary artery endothelial cell dysfunction and decreased populations of highly proliferative endothelial cells in experimental congenital diaphragmatic hernia","volume":"305","author":"SN Acker","year":"2013","journal-title":"American Journal of Physiology-Lung Cellular and Molecular Physiology"},{"issue":"3","key":"pone.0259724.ref014","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/j.jpeds.2013.04.010","article-title":"Cord blood endothelial colony-forming cells from newborns with congenital diaphragmatic hernia","volume":"163","author":"CD Baker","year":"2013","journal-title":"The Journal of pediatrics"},{"issue":"2","key":"pone.0259724.ref015","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1590\/1414-431X20133221","article-title":"VEGF receptor expression decreases during lung development in congenital diaphragmatic hernia induced by nitrofen","volume":"47","author":"L Sbragia","year":"2014","journal-title":"Brazilian Journal of Medical and Biological Research"},{"issue":"6","key":"pone.0259724.ref016","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1016\/j.jpedsurg.2004.02.015","article-title":"VEGF expression is downregulated in nitrofen-induced congenital diaphragmatic hernia","volume":"39","author":"R Chang","year":"2004","journal-title":"J Pediatr Surg"},{"issue":"5","key":"pone.0259724.ref017","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1136\/thx.54.5.427","article-title":"Enhanced expression of vascular endothelial growth factor in lungs of newborn infants with congenital diaphragmatic hernia and pulmonary hypertension","volume":"54","author":"SM Shehata","year":"1999","journal-title":"Thorax"},{"issue":"6","key":"pone.0259724.ref018","doi-asserted-by":"crossref","first-page":"L849","DOI":"10.1152\/ajplung.00333.2009","article-title":"Defective angiogenesis in hypoplastic human fetal lungs correlates with nitric oxide synthase deficiency that occurs despite enhanced angiopoietin-2 and VEGF.","volume":"298","author":"O Boucherat","year":"2010","journal-title":"American Journal of Physiology-Lung Cellular and Molecular Physiology."},{"issue":"1","key":"pone.0259724.ref019","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1159\/000480451","article-title":"Congenital diaphragmatic hernia: 10-year evaluation of survival, extracorporeal membrane oxygenation, and foetoscopic endotracheal occlusion in four high-volume centres.","volume":"113","author":"KG Snoek","year":"2018","journal-title":"Neonatology"},{"issue":"7","key":"pone.0259724.ref020","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1016\/j.jpedsurg.2015.10.082","article-title":"Prenatally diagnosed severe CDH: mortality and morbidity remain high","volume":"51","author":"MA Coughlin","year":"2016","journal-title":"J Pediatr Surg"},{"issue":"6","key":"pone.0259724.ref021","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.siny.2014.09.004","article-title":"The congenital diaphragmatic hernia study group registry update.","volume":"19","author":"MT Harting","year":"2014","journal-title":"Seminars in Fetal and Neonatal Medicine"},{"issue":"1","key":"pone.0259724.ref022","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1002\/uog.4052","article-title":"Observed to expected lung area to head circumference ratio in the prediction of survival in fetuses with isolated diaphragmatic hernia","volume":"30","author":"J Jani","year":"2007","journal-title":"Ultrasound in obstetrics & gynecology"},{"issue":"6","key":"pone.0259724.ref023","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.siny.2017.11.002","article-title":"Current and future antenatal management of isolated congenital diaphragmatic hernia.","volume":"22","author":"FM Russo","year":"2017","journal-title":"Semin Fetal Neonatal Med"},{"issue":"1","key":"pone.0259724.ref024","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s10397-018-1041-9","article-title":"Fetoscopic endoluminal tracheal occlusion and reestablishment of fetal airways for congenital diaphragmatic hernia.","volume":"15","author":"L Van der Veeken","year":"2018","journal-title":"Gynecol Surg"},{"issue":"3","key":"pone.0259724.ref025","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1542\/peds.2007-3282","article-title":"Postdischarge follow-up of infants with congenital diaphragmatic hernia.","volume":"121","author":"AAoPSo Surgery","year":"2008","journal-title":"Pediatrics"},{"issue":"6","key":"pone.0259724.ref026","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/j.siny.2014.09.006","article-title":"Prenatal management of the fetus with isolated congenital diaphragmatic hernia in the era of the TOTAL trial.","volume":"19","author":"J Deprest","year":"2014","journal-title":"Seminars in Fetal and Neonatal Medicine"},{"issue":"2","key":"pone.0259724.ref027","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1056\/NEJMoa2027030","article-title":"Randomized Trial of Fetal Surgery for Severe Left Diaphragmatic Hernia","volume":"385","author":"JA Deprest","year":"2021","journal-title":"N Engl J Med"},{"issue":"2","key":"pone.0259724.ref028","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1056\/NEJMoa2026983","article-title":"Randomized Trial of Fetal Surgery for Moderate Left Diaphragmatic Hernia","volume":"385","author":"JA Deprest","year":"2021","journal-title":"N Engl J Med"},{"issue":"1","key":"pone.0259724.ref029","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1159\/000444210","article-title":"Standardized postnatal management of infants with congenital diaphragmatic hernia in Europe: the CDH EURO consortium consensus-2015 update.","volume":"110","author":"KG Snoek","year":"2016","journal-title":"Neonatology"},{"issue":"1","key":"pone.0259724.ref030","doi-asserted-by":"crossref","first-page":"151171","DOI":"10.1053\/j.semperi.2019.07.010","article-title":"Long term follow-up in congenital diaphragmatic hernia.","volume":"44","author":"LE Hollinger","year":"2020","journal-title":"Semin Perinatol."},{"issue":"21","key":"pone.0259724.ref031","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1161\/CIR.0000000000000329","article-title":"Pediatric Pulmonary Hypertension: Guidelines from the American Heart Association and American Thoracic Society","volume":"132","author":"SH Abman","year":"2015","journal-title":"Circulation"},{"key":"pone.0259724.ref032","article-title":"Neonatal respiratory and cardiac ECMO in Europe","author":"I Amodeo","year":"2021","journal-title":"Eur J Pediatr"},{"issue":"1","key":"pone.0259724.ref033","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1053\/j.semperi.2005.02.007","article-title":"The effect of extracorporeal life support on the brain: a focus on ECMO","volume":"29","author":"BL Short","year":"2005","journal-title":"Semin Perinatol"},{"issue":"6","key":"pone.0259724.ref034","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/S0022-3476(09)90013-0","article-title":"Congenital diaphragmatic hernia: long-term outcome in neonates treated with extracorporeal membrane oxygenation","volume":"122","author":"K Van Meurs","year":"1993","journal-title":"The Journal of pediatrics"},{"issue":"6","key":"pone.0259724.ref035","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1002\/uog.16000","article-title":"Lung size and liver herniation predict need for extracorporeal membrane oxygenation but not pulmonary hypertension in isolated congenital diaphragmatic hernia: systematic review and meta\u2010analysis","volume":"49","author":"FM Russo","year":"2017","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"1","key":"pone.0259724.ref036","doi-asserted-by":"crossref","first-page":"51163","DOI":"10.1053\/j.semperi.2019.07.002","article-title":"Prenatal diagnosis, imaging, and prognosis in Congenital Diaphragmatic Hernia.","volume":"44","author":"A-G Cordier","year":"2020","journal-title":"Semin Perinatol."},{"issue":"8","key":"pone.0259724.ref037","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/j.ejmg.2014.04.012","article-title":"The genetics of common disorders\u2013congenital diaphragmatic hernia","volume":"57","author":"AM Slavotinek","year":"2014","journal-title":"Eur J Med Genet"},{"issue":"8","key":"pone.0259724.ref038","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1242\/dmm.028365","article-title":"Congenital diaphragmatic hernias: from genes to mechanisms to therapies.","volume":"10","author":"G Kardon","year":"2017","journal-title":"Dis Model Mech"},{"issue":"6","key":"pone.0259724.ref039","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1016\/j.jpedsurg.2013.03.010","article-title":"The presence of a hernia sac in congenital diaphragmatic hernia is associated with better fetal lung growth and outcomes","volume":"48","author":"IJ Zamora","year":"2013","journal-title":"J Pediatr Surg"},{"issue":"9","key":"pone.0259724.ref040","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1002\/pd.5326","article-title":"Congenital diaphragmatic hernia has a better prognosis when associated with a hernia sac","volume":"38","author":"H Bouchghoul","year":"2018","journal-title":"Prenatal Diagnosis"},{"issue":"9","key":"pone.0259724.ref041","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1002\/pd.5297","article-title":"Proposal for standardized prenatal ultrasound assessment of the fetus with congenital diaphragmatic hernia by the European reference network on rare inherited and congenital anomalies (ERNICA).","volume":"38","author":"FM Russo","year":"2018","journal-title":"Prenatal Diagnosis"},{"issue":"6","key":"pone.0259724.ref042","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.siny.2014.09.005","article-title":"Advances in prenatal diagnosis of congenital diaphragmatic hernia","volume":"19","author":"A Benachi","year":"2014","journal-title":"Seminars in Fetal and Neonatal Medicine"},{"issue":"5","key":"pone.0259724.ref043","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/j.jpedsurg.2018.02.015","article-title":"Pulmonary hypertension in congenital diaphragmatic hernia patients: prognostic markers and long-term outcomes","volume":"53","author":"M Wong","year":"2018","journal-title":"J Pediatr Surg"},{"key":"pone.0259724.ref044","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.bpobgyn.2018.12.010","article-title":"Prenatal diagnosis and management of congenital diaphragmatic hernia.","volume":"58","author":"D Basurto","year":"2019","journal-title":"Best Practice & Research Clinical Obstetrics & Gynaecology."},{"issue":"1","key":"pone.0259724.ref045","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1067\/mob.2003.69","article-title":"Antenatal prediction of pulmonary hypoplasia by acceleration time\/ejection time ratio of fetal pulmonary arteries by Doppler blood flow velocimetry.","volume":"188","author":"S Fuke","year":"2003","journal-title":"American journal of obstetrics and gynecology"},{"issue":"2","key":"pone.0259724.ref046","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1046\/j.1469-0705.1996.08020087.x","article-title":"Blood flow velocity waveforms from peripheral pulmonary arteries in normally grown and growth\u2010retarded fetuses.","volume":"8","author":"G Rizzo","year":"1996","journal-title":"Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology."},{"issue":"2","key":"pone.0259724.ref047","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.ajog.2006.02.009","article-title":"Fetal pulmonary artery diameter measurements as a predictor of morbidity in antenatally diagnosed congenital diaphragmatic hernia: a prospective study.","volume":"195","author":"J Sokol","year":"2006","journal-title":"American journal of obstetrics and gynecology"},{"issue":"6","key":"pone.0259724.ref048","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1016\/j.ajog.2006.05.010","article-title":"Quantitative analysis of fetal pulmonary vasculature by 3-dimensional power Doppler ultrasonography in isolated congenital diaphragmatic hernia","volume":"195","author":"R Ruano","year":"2006","journal-title":"American journal of obstetrics and gynecology"},{"issue":"4","key":"pone.0259724.ref049","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/uog.1003","article-title":"Fractional moving blood volume estimation in the fetal lung using power Doppler ultrasound: a reproducibility study.","volume":"23","author":"E Hernandez\u2010Andrade","year":"2004","journal-title":"Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology."},{"issue":"1","key":"pone.0259724.ref050","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1002\/uog.11212","article-title":"Usefulness of lung\u2010to\u2010head ratio and intrapulmonary arterial Doppler in predicting neonatal morbidity in fetuses with congenital diaphragmatic hernia treated with fetoscopic tracheal occlusion.","volume":"41","author":"R Cruz\u2010Martinez","year":"2013","journal-title":"Ultrasound Obstet Gynecol."},{"issue":"10","key":"pone.0259724.ref051","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1002\/pd.4408","article-title":"Assessment of pulmonary vascular reactivity to oxygen using fractional moving blood volume in fetuses with normal lung development and pulmonary hypoplasia in congenital diaphragmatic hernia","volume":"34","author":"P DeKoninck","year":"2014","journal-title":"Prenatal diagnosis"},{"issue":"1","key":"pone.0259724.ref052","first-page":"14","article-title":"Big data in medicine is driving big changes.","volume":"9","author":"F Martin-Sanchez","year":"2014","journal-title":"Yearb Med Inform"},{"issue":"4","key":"pone.0259724.ref053","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1016\/j.athoracsur.2020.03.128","article-title":"Predicting Survival after Extracorporeal Membrane Oxygenation using Machine Learning","volume":"110","author":"B Ayers","year":"2020","journal-title":"The Annals of Thoracic Surgery"},{"issue":"2","key":"pone.0259724.ref054","doi-asserted-by":"crossref","first-page":"e0212665","DOI":"10.1371\/journal.pone.0212665","article-title":"Machine learning models for early sepsis recognition in the neonatal intensive care unit using readily available electronic health record data.","volume":"14","author":"AJ Masino","year":"2019","journal-title":"PLoS One"},{"issue":"1","key":"pone.0259724.ref055","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1080\/14767058.2018.1487395","article-title":"Estimating risk of severe neonatal morbidity in preterm births under 32 weeks of gestation.","volume":"33","author":"EF Hamilton","year":"2020","journal-title":"The Journal of Maternal-Fetal & Neonatal Medicine"},{"issue":"2","key":"pone.0259724.ref056","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1136\/amiajnl-2013-001854","article-title":"Medical decision support using machine learning for early detection of late-onset neonatal sepsis","volume":"21","author":"S Mani","year":"2014","journal-title":"Journal of the American Medical Informatics Association"},{"issue":"1","key":"pone.0259724.ref057","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40168-018-0493-5","article-title":"The developing premature infant gut microbiome is a major factor shaping the microbiome of neonatal intensive care unit rooms","volume":"6","author":"B Brooks","year":"2018","journal-title":"Microbiome"},{"issue":"1","key":"pone.0259724.ref058","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-018-31920-6","article-title":"A machine learning approach to estimating preterm infants survival: development of the Preterm Infants Survival Assessment (PISA) predictor.","volume":"8","author":"M Podda","year":"2018","journal-title":"Sci Rep."},{"key":"pone.0259724.ref059","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.jss.2017.09.002","article-title":"Postoperative neonatal mortality prediction using superlearning","volume":"221","author":"JN Cooper","year":"2018","journal-title":"J Surg Res"},{"issue":"11","key":"pone.0259724.ref060","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.3390\/ijerph15112509","article-title":"Estimation of neonatal intestinal perforation associated with necrotizing enterocolitis by machine learning reveals new key factors","volume":"15","author":"C Irles","year":"2018","journal-title":"International journal of environmental research and public health"},{"issue":"4","key":"pone.0259724.ref061","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1055\/s-0038-1655755","article-title":"Prioritization of candidate genes for congenital diaphragmatic hernia in a critical region on chromosome 4p16 using a machine-learning algorithm","volume":"7","author":"DA Callaway","year":"2018","journal-title":"Journal of pediatric genetics"},{"issue":"9","key":"pone.0259724.ref062","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.earlhumdev.2011.08.001","article-title":"Results of fetal endoscopic tracheal occlusion for congenital diaphragmatic hernia and the set up of the randomized controlled TOTAL trial.","volume":"87","author":"P DeKoninck","year":"2011","journal-title":"Early Hum Dev"},{"issue":"1","key":"pone.0259724.ref063","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.siny.2008.08.010","article-title":"Antenatal prediction of lung volume and in-utero treatment by fetal endoscopic tracheal occlusion in severe isolated congenital diaphragmatic hernia","volume":"14","author":"JA Deprest","year":"2009","journal-title":"Seminars in Fetal and Neonatal Medicine"},{"issue":"1","key":"pone.0259724.ref064","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1002\/pd.5401","article-title":"Longitudinal changes in lung size and intrapulmonary\u2010artery Doppler during the second half of pregnancy in fetuses with congenital diaphragmatic hernia","volume":"39","author":"R Cruz\u2010Martinez","year":"2019","journal-title":"Prenatal Diagnosis"},{"issue":"2","key":"pone.0259724.ref065","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1002\/uog.14759","article-title":"Stomach position in prediction of survival in left\u2010sided congenital diaphragmatic hernia with or without fetoscopic endoluminal tracheal occlusion.","volume":"46","author":"AG Cordier","year":"2015","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"2","key":"pone.0259724.ref066","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1159\/000512966","article-title":"Early, Postnatal Pulmonary Hypertension Severity Predicts Inpatient Outcomes in Congenital Diaphragmatic Hernia.","volume":"118","author":"DM Ferguson","year":"2021","journal-title":"Neonatology."},{"key":"pone.0259724.ref067","doi-asserted-by":"crossref","first-page":"692210","DOI":"10.3389\/fped.2021.692210","article-title":"Relationship Between Radiographic Pulmonary Area and Pulmonary Hypertension, Mortality, and Hernia Recurrence in Newborns With CDH.","volume":"9","author":"I Amodeo","year":"2021","journal-title":"NeoAPACHE II.Front Pediatr."},{"issue":"2","key":"pone.0259724.ref068","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1097\/PCC.0b013e3181b806fc","article-title":"Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass.","volume":"11","author":"MG Gaies","year":"2010","journal-title":"Pediatr Crit Care Med"},{"key":"pone.0259724.ref069","article-title":"Fetal MRI mediastinal shift angle and respiratory and cardiovascular pharmacological support in newborns with congenital diaphragmatic hernia","author":"I Amodeo","year":"2021","journal-title":"Eur J Pediatr"},{"issue":"2","key":"pone.0259724.ref070","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s00383-017-4184-2","article-title":"The fetal lung-to-liver signal intensity ratio on magnetic resonance imaging as a predictor of outcomes from isolated congenital diaphragmatic hernia.","volume":"34","author":"M Yamoto","year":"2018","journal-title":"Pediatr Surg Int"},{"key":"pone.0259724.ref071","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/14767058.2020.1716714","article-title":"Comparison of mediastinal shift angles obtained with ultrasound and magnetic resonance imaging in fetuses with isolated left sided congenital diaphragmatic hernia.","author":"A Romiti","year":"2020","journal-title":"The Journal of Maternal-Fetal & Neonatal Medicine."},{"issue":"6","key":"pone.0259724.ref072","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1002\/uog.7326","article-title":"Diffusion\u2010weighted MRI in lungs of normal fetuses and those with congenital diaphragmatic hernia.","volume":"34","author":"M Cannie","year":"2009","journal-title":"Ultrasound in Obstetrics and Gynecology"},{"issue":"1","key":"pone.0259724.ref073","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1148\/radiology.219.1.r01ap18236","article-title":"Fetal lung volume: estimation at MR imaging\u2014initial results","volume":"219","author":"F Rypens","year":"2001","journal-title":"Radiology"},{"issue":"8","key":"pone.0259724.ref074","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1002\/pd.3890","article-title":"Use of magnetic resonance imaging in prenatal prognosis of the fetus with isolated left congenital diaphragmatic hernia","volume":"32","author":"T Victoria","year":"2012","journal-title":"Prenatal diagnosis"},{"issue":"6","key":"pone.0259724.ref075","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1002\/uog.13223","article-title":"Fetal lung volume and quantification of liver herniation by magnetic resonance imaging in isolated congenital diaphragmatic hernia","volume":"43","author":"R Ruano","year":"2014","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"1","key":"pone.0259724.ref076","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1002\/pd.5619","article-title":"Fetal MRI assessment of mediastinal shift angle in isolated left congenital diaphragmatic hernia: A new postnatal survival predictive tool?","volume":"40","author":"S Savelli","year":"2020","journal-title":"Prenatal Diagnosis"},{"issue":"8","key":"pone.0259724.ref077","first-page":"1330","article-title":"Ultrasonographic assessment of mediastinal shift angle (MSA) in isolated left congenital diaphragmatic hernia for the prediction of postnatal survival.","volume":"33","author":"A Romiti","year":"2020","journal-title":"The Journal of Maternal-Fetal & Neonatal Medicine"},{"issue":"6","key":"pone.0259724.ref078","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1097\/PCC.0000000000001912","article-title":"Prediction of mortality in newborn infants with severe congenital diaphragmatic hernia using the chest radiographic thoracic area.","volume":"20","author":"T Dassios","year":"2019","journal-title":"Pediatric Critical Care Medicine| Society of Critical Care Medicine."},{"key":"pone.0259724.ref079","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2020.581809","article-title":"The NeoAPACHE Study Protocol I: Assessment of the Radiographic Pulmonary Area and Long-Term Respiratory Function in Newborns With Congenital Diaphragmatic Hernia.","volume":"8","author":"I Amodeo","year":"2020","journal-title":"Frontiers in Pediatrics"},{"key":"pone.0259724.ref080","volume-title":"Pattern Classification","author":"RO Duda","year":"2000","edition":"2"},{"key":"pone.0259724.ref081","first-page":"424","volume-title":"3D U-Net: learning dense volumetric segmentation from sparse annotation.","author":"\u00d6 \u00c7i\u00e7ek","year":"2016"},{"key":"pone.0259724.ref082","first-page":"234","volume-title":"U-Net: Convolutional Networks for Biomedical Image Segmentation","author":"O Ronneberger","year":"2015"},{"key":"pone.0259724.ref083","volume-title":"3D U2-Net: A 3D Universal U-Net for Multi-Domain Medical Image Segmentation.","author":"C Huang","year":"2019"},{"issue":"1","key":"pone.0259724.ref084","doi-asserted-by":"crossref","DOI":"10.1186\/s40537-019-0197-0","article-title":"A survey on Image Data Augmentation for Deep Learning","volume":"6","author":"C Shorten","year":"2019","journal-title":"Journal of Big Data"},{"issue":"4","key":"pone.0259724.ref085","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.ejca.2011.11.036","article-title":"Radiomics: Extracting more information from medical images using advanced feature analysis","volume":"48","author":"P Lambin","year":"2012","journal-title":"Eur J Cancer"},{"key":"pone.0259724.ref086","doi-asserted-by":"crossref","unstructured":"Bellman R. Adaptive control processes: a guided tour princeton university press. Princeton, New Jersey, USA. 1961:96.","DOI":"10.1515\/9781400874668"},{"key":"pone.0259724.ref087","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4615-5725-8","volume-title":"Feature extraction, construction and selection: A data mining perspective","author":"H Liu","year":"1998"},{"key":"pone.0259724.ref088","article-title":"How much is the black box? The value of explainability in machine learning models.","author":"J Wanner","year":"2020"},{"issue":"19","key":"pone.0259724.ref089","doi-asserted-by":"crossref","first-page":"6940","DOI":"10.3390\/app10196940","article-title":"Performance of Fine-Tuning Convolutional Neural Networks for HEp-2 Image Classification.","volume":"10","author":"V Taormina","year":"2020","journal-title":"Applied Sciences."},{"issue":"1","key":"pone.0259724.ref090","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10916-020-01691-7","article-title":"The Potential of Big Data Research in HealthCare for Medical Doctors\u2019 Learning.","volume":"45","author":"M Au-Yong-Oliveira","year":"2021","journal-title":"J Med Syst."},{"issue":"1","key":"pone.0259724.ref091","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.jacr.2020.09.050","article-title":"In the Era of Deep Learning, Why Reconstruct an Image at All?","volume":"18","author":"C Chung","year":"2021","journal-title":"J Am Coll Radiol."},{"key":"pone.0259724.ref092","first-page":"978","article-title":"Deep learning and convolutional neural networks for medical image computing. Precision Medicine, High Performance and Large-Scale Datasets.","volume":"10","author":"L Lu","year":"2017","journal-title":"Part of the Advances in Computer Vision and Pattern Recognition book series (ACVPR)"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0259724","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T18:50:50Z","timestamp":1636483850000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0259724"}},"subtitle":[],"editor":[{"given":"Rogelio","family":"Cruz-Martinez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,11,9]]},"references-count":92,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0259724","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,9]]}}}