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Brickman A, Baykara Y, Carabaño M, Hacking SM. Whole slide images as non-fungible tokens: A decentralized approach to secure, scalable data storage and access. J Pathol Inform 2024; 15:100350. [PMID: 38162951 PMCID: PMC10757022 DOI: 10.1016/j.jpi.2023.100350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/06/2023] [Indexed: 01/03/2024] Open
Abstract
Background Distributed ledger technology (DLT) enables the creation of tamper-resistant, decentralized, and secure digital ledgers. A non-fungible token (NFT) represents a record on-chain associated with a digital or physical asset, such as a whole-slide image (WSI). The InterPlanetary File System (IPFS) represents an off-chain network, hypermedia, and file sharing peer-to-peer protocol for storing and sharing data in a distributed file system. Today, we need cheaper, more efficient, highly scalable, and transparent solutions for WSI data storage and access of medical records and medical imaging data. Methods WSIs were created from non-human tissues and H&E-stained sections were scanned on a Philips Ultrafast WSI scanner at 40× magnification objective lens (1 μm/pixel). TIFF images were stored on IPFS, while NFTs were minted on the Ethereum blockchain network in ERC-1155 standard. WSI-NFTs were stored on MetaMask and OpenSea was used to display the WSI-NFT collection. Filebase storage application programing interface (API) were used to create dedicated gateways and content delivery networks (CDN). Results A total of 10 WSI-NFTs were minted on the Ethereum blockchain network, found on our collection "Whole Slide Images as Non-fungible Tokens Project" on Open Sea: https://opensea.io/collection/untitled-collection-126765644. WSI TIFF files ranged in size from 1.6 to 2.2 GB and were stored on IPFS and pinned on 3 separate nodes. Under optimal conditions, and using a dedicated CDN, WSI reached retrieved at speeds of over 10 mb/s, however, download speeds and WSI retrieval times varied significantly depending on the file and gateway used. Overall, the public IPFS gateway resulted in variably poorer WSI download retrieval performance compared to gateways provided by Filebase storage API. Conclusion Whole-slide images, as the most complex and substantial data files in healthcare, demand innovative solutions. In this technical report, we identify pitfalls in IPFS, and demonstrate proof-of-concept using a 3-layer architecture for scalable, decentralized storage, and access. Optimized through dedicated gateways and CDNs, which can be effectively applied to all medical data and imaging modalities across the healthcare sector. DLT and off-chain network solutions present numerous opportunities for advancements in clinical care, education, and research. Such approaches uphold the principles of equitable healthcare data ownership, security, and democratization, and are poised to drive significant innovation.
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Affiliation(s)
- Arlen Brickman
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Yigit Baykara
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Miguel Carabaño
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Sean M. Hacking
- Department of Pathology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
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Staehelin D, Dolata M, Stöckli L, Schwabe G. How Patient-Generated Data Enhance Patient-Provider Communication in Chronic Care: Field Study in Design Science Research. JMIR Med Inform 2024; 12:e57406. [PMID: 39255481 PMCID: PMC11422739 DOI: 10.2196/57406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/25/2024] [Accepted: 07/21/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Modern approaches such as patient-centered care ask health care providers (eg, nurses, physicians, and dietitians) to activate and include patients to participate in their health care. Mobile health (mHealth) is integral in this endeavor to be more patient centric. However, structural and regulatory barriers have hindered its adoption. Existing mHealth apps often fail to activate and engage patients sufficiently. Moreover, such systems seldom integrate well with health care providers' workflow. OBJECTIVE This study investigated how patient-provider communication behaviors change when introducing patient-generated data into patient-provider communication. METHODS We adopted the design science approach to design PatientHub, an integrated digital health system that engages patients and providers in patient-centered care for weight management. PatientHub was developed in 4 iterations and was evaluated in a 3-week field study with 27 patients and 6 physicians. We analyzed 54 video recordings of PatientHub-supported consultations and interviews with patients and physicians. RESULTS PatientHub introduces patient-generated data into patient-provider communication. We observed 3 emerging behaviors when introducing patient-generated data into consultations. We named these behaviors emotion labeling, expectation decelerating, and decision ping-pong. Our findings show how these behaviors enhance patient-provider communication and facilitate patient-centered care. Introducing patient-generated data leads to behaviors that make consultations more personal, actionable, trustworthy, and equal. CONCLUSIONS The results of this study indicate that patient-generated data facilitate patient-centered care by activating and engaging patients and providers. We propose 3 design principles for patient-centered communication. Patient-centered communication informs the design of future mHealth systems and offers insights into the inner workings of mHealth-supported patient-provider communication in chronic care.
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Affiliation(s)
- Dario Staehelin
- Department of Informatics, University of Zurich, Zurich, Switzerland
- Department for Information and Process Management, Eastern Switzerland University of Applied Sciences, St Gallen, Switzerland
| | - Mateusz Dolata
- Department of Informatics, University of Zurich, Zurich, Switzerland
| | - Livia Stöckli
- Department of Informatics, University of Zurich, Zurich, Switzerland
| | - Gerhard Schwabe
- Department of Informatics, University of Zurich, Zurich, Switzerland
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Proffer SL, Reinhart J, Ridgeway JL, Barry B, Kamath C, Gerdes EW, Todd A, Cervenka DJ, DiCaudo DJ, Sokumbi O, Johnson EF, Peters MS, Wieland CN, Comfere NI. Digital dermatopathology implementation: Experience at a multisite academic institution. J Cutan Pathol 2024; 51:696-704. [PMID: 38783791 DOI: 10.1111/cup.14629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/01/2024] [Accepted: 04/13/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Technology has revolutionized not only direct patient care but also diagnostic care processes. This study evaluates the transition from glass-slide microscopy to digital pathology (DP) at a multisite academic institution, using mixed methods to understand user perceptions of digitization and key productivity metrics of practice change. METHODS Participants included dermatopathologists, pathology reporting specialists, and clinicians. Electronic surveys and individual or group interviews included questions related to technology comfort, trust in DP, and rationale for DP adoption. Case volumes and turnaround times were abstracted from the electronic health record from Qtr 4 2020 to Qtr 1 2023 (inclusive). Data were analyzed descriptively, while interviews were analyzed using methods of content analysis. RESULTS Thirty-four staff completed surveys and 22 participated in an interview. Case volumes and diagnostic turnaround time did not differ across the institution during or after implementation timelines (p = 0.084; p = 0.133, respectively). 82.5% (28/34) of staff agreed that DP improved the sign-out experience, with accessibility, ergonomics, and annotation features described as key factors. Clinicians reported positive perspectives of DP impact on patient safety and interdisciplinary collaboration. CONCLUSIONS Our study demonstrates that DP has a high acceptance rate, does not adversely impact productivity, and may improve patient safety and care collaboration.
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Affiliation(s)
- Sydney L Proffer
- Department of Dermatology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Jacob Reinhart
- Department of Dermatology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Jennifer L Ridgeway
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Barbara Barry
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Celia Kamath
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Erin Wissler Gerdes
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - Austin Todd
- Division of Clinical Trials and Biostatistics of the Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Derek J Cervenka
- Department of Dermatology, Mayo Clinic Rochester, Rochester, Minnesota, USA
| | - David J DiCaudo
- Department of Dermatology, Mayo Clinic, Scottsdale, Arizona, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Arizona, USA
| | | | - Emma F Johnson
- Department of Dermatology, Mayo Clinic Rochester, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Margot S Peters
- Department of Dermatology, Mayo Clinic Rochester, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Carilyn N Wieland
- Department of Dermatology, Mayo Clinic Rochester, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Nneka I Comfere
- Department of Dermatology, Mayo Clinic Rochester, Rochester, Minnesota, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
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Nunes T, da Cunha PR, de Abreu JM, Duarte J, Corte-Real A. Non-Fungible Tokens (NFTs) in Healthcare: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:965. [PMID: 39200576 PMCID: PMC11353309 DOI: 10.3390/ijerph21080965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/19/2024] [Accepted: 07/22/2024] [Indexed: 09/02/2024]
Abstract
Amid global health challenges, resilient health systems require continuous innovation and progress. Stakeholders highlight the critical role of digital technologies in accelerating this progress. However, the digital health field faces significant challenges, including the sensitivity of health data, the absence of evidence-based standards, data governance issues, and a lack of evidence on the impact of digital health strategies. Overcoming these challenges is crucial to unlocking the full potential of digital health innovations in enhancing healthcare delivery and outcomes. Prioritizing security and privacy is essential in developing digital health solutions that are transparent, accessible, and effective. Non-fungible tokens (NFTs) have gained widespread attention, including in healthcare, offering innovative solutions and addressing challenges through blockchain technology. This paper addresses the gap in systematic-level studies on NFT applications in healthcare, aiming to comprehensively analyze use cases and associated research challenges. The search included primary studies published between 2014 and November 2023, searching in a balanced set of databases compiling articles from different fields. A review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework and strictly focusing on research articles related to NFT applications in the healthcare sector. The electronic search retrieved 1902 articles, ultimately resulting in 15 articles for data extraction. These articles span applications of NFTs in medical devices, pathology exams, diagnosis, pharmaceuticals, and other healthcare domains, highlighting their potential to eliminate centralized trust sources in health informatics. The review emphasizes the adaptability and versatility of NFT-based solutions, indicating their broader applicability across various healthcare stages and expansion into diverse industries. Given their role in addressing challenges associated with enhancing data integrity, availability, non-repudiation, and authentication, NFTs remain a promising avenue for future research within digital health solutions.
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Affiliation(s)
- Tiago Nunes
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
| | - Paulo Rupino da Cunha
- Centre for Informatics and Systems of the University of Coimbra (CISUC), Department of Informatics Engineering, University of Coimbra, 3030-790 Coimbra, Portugal
| | - João Mendes de Abreu
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
- Clinical and Academic Centre of Coimbra, 3004-561 Coimbra, Portugal
| | - Joana Duarte
- Associated Laboratory for Energy, Transports and Aeronautics (LAETA-PROA), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
| | - Ana Corte-Real
- Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal
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Magalhães G, Calisto R, Freire C, Silva R, Montezuma D, Canberk S, Schmitt F. Invisible for a few but essential for many: the role of Histotechnologists in the establishment of digital pathology. J Histotechnol 2024; 47:39-52. [PMID: 37869882 DOI: 10.1080/01478885.2023.2268297] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/03/2023] [Indexed: 10/24/2023]
Abstract
Digital pathology (DP) is indisputably the future for histopathology laboratories. The process of digital implementation requires deep workflow reorganisation which involves an interdisciplinary team. This transformation may have the greatest impact on the Histotechnologist (HTL) profession. Our review of the literature has clearly revealed that the role of HTLs in the establishment of DP is being unnoticed and guidance is limited. This article aims to bring HTLs from behind-the-scenes into the spotlight. Our objective is to provide them guidance and practical recommendations to successfully contribute to the implementation of a new digital workflow. Furthermore, it also intends to contribute for improvement of study programs, ensuring the role of HTL in DP is addressed as part of graduate and post-graduate education. In our review, we report on the differences encountered between workflow schemes and the limitations observed in this process. The authors propose a digital workflow to achieve its limitless potential, focusing on the HTL's role. This article explores the novel responsibilities of HTLs during specimen gross dissection, embedding, microtomy, staining, digital scanning, and whole slide image quality control. Furthermore, we highlight the benefits and challenges that DP implementation might bring the HTLs career. HTLs have an important role in the digital workflow: the responsibility of achieving the perfect glass slide.
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Affiliation(s)
- Gisela Magalhães
- Histopathology Department, Portsmouth Hospital University NHS Trust, Portsmouth, UK
- Department of Pathological Anatomy, School of Health Polytechnic of Porto (ESS|P.PORTO), Porto, Portugal
| | - Rita Calisto
- Department of Pathological Anatomy, School of Health Polytechnic of Porto (ESS|P.PORTO), Porto, Portugal
- Department of Pathological Anatomy, Hospital do Divino Espírito Santo, Ponta Delgada, Portugal
| | - Catarina Freire
- Department of Pathological Anatomy, School of Health Polytechnic of Porto (ESS|P.PORTO), Porto, Portugal
- Department of Pathological Anatomy, Hospital do Divino Espírito Santo, Ponta Delgada, Portugal
| | - Regina Silva
- Department of Pathological Anatomy, School of Health Polytechnic of Porto (ESS|P.PORTO), Porto, Portugal
- Centro de Investigação em Saúde e Ambiente, ESS,P.PORTO, Porto, Portugal
| | - Diana Montezuma
- Research & Development Unit, IMP Diagnostics, Porto, Portugal
- School of Medicine and Biomedical Sciences, University of Porto (ICBAS-UP), Porto, Portugal
| | - Sule Canberk
- Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal
- Cancer Signalling & Metabolism, Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal
- Faculty of Medicine of the University of Porto (FMUP), Porto, Portugal
| | - Fernando Schmitt
- Department of Pathology, Faculty of Medicine of University of Porto, Porto, Portugal
- CINTESIS@RISE, Health Research Network, Alameda Prof. Hernâni Monteiro, Portugal
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Skalidis I, Muller O, Fournier S. CardioVerse: The cardiovascular medicine in the era of Metaverse. Trends Cardiovasc Med 2023; 33:471-476. [PMID: 35568263 DOI: 10.1016/j.tcm.2022.05.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/28/2022] [Accepted: 05/07/2022] [Indexed: 01/04/2023]
Abstract
The recent pandemic launched an acceleration in adopting telemedicine by cardiovascular health and triggered the flourishing of technological advancements, such as the metaverse, which is a novel interactive mix of digital worlds that leverages augmented reality with virtual reality. The CardioVerse represents a theoretical term for the embracement of the metaverse by cardiovascular medicine, encompassing the endless possibilities as well as the challenges that it holds and introduces new dimensions to disease education, prevention and diagnosis. Its applications are numerous, notably in enhancing medical visits, assisting cardiovascular interventions and reshaping the way medical education is provided. Although obstacles are expected in diverse domains such as security, technical, legislative and regulatory, the utilization of non-fungible tokens as a security asset for patient data appears as potential solution.
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Affiliation(s)
- Ioannis Skalidis
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.; Faculty of Medicine, University of Crete, Crete, Greece.
| | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Stephane Fournier
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
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HUANG CONGGAI, LUO XING, WANG SHAOHUA, WAN YU, WANG JIEQIONG, TANG XIAOQIN, SCHATZ CHRISTOPH, ZHANG HUILING, HAYBAECK JOHANNES, YANG ZHIHUI. Minimally Invasive Cytopathology and Accurate Diagnosis: Technical Procedures and Ancillary Techniques. In Vivo 2023; 37:11-21. [PMID: 36593030 PMCID: PMC9843757 DOI: 10.21873/invivo.13050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 01/03/2023]
Abstract
In recent years, the demand for cytopathological accurate diagnoses has increased as expanding minimally invasive procedures obtain materials from patients with advanced cancer for diagnostic, prognostic, and predictive purposes. However, inadequate knowledge of cytopathological technical procedures and ancillary techniques by clinicians remains the most common reason for the limited availability of cytopathology. The objectives of this review were to understand the technical procedures, ancillary techniques, and application and effectiveness of various types of tests in cytopathology. Each of the many ancillary technologies described in the literature has specific advantages and limitations and laboratories select one or more methods depending on their infrastructure and expertise to achieve the goal from initial screening of the disease to the final diagnosis of the cytopathology. This paper systematically reviews the development of cytopathology, summarizes the existing problems in cytopathology and the new progress of auxiliary examination, to provide a theoretical basis for the advanced development of cytopathological diagnostic technologies and to consolidate the minimally invasive and accurate diagnosis of cytopathologies for clinicians. Cytopathology offers many advantages over other clinical examinations, particularly for minimally invasive and accurate diagnosis.
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Affiliation(s)
- CONGGAI HUANG
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, P.R. China
| | - XING LUO
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, P.R. China
| | - SHAOHUA WANG
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, P.R. China
| | - YU WAN
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, P.R. China
| | - JIEQIONG WANG
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, P.R. China
| | - XIAOQIN TANG
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, P.R. China
| | - CHRISTOPH SCHATZ
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
| | - HUILING ZHANG
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, P.R. China
| | - JOHANNES HAYBAECK
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria,Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - ZHIHUI YANG
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, P.R. China
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Muacevic A, Adler JR. Dynamics of Metaverse and Medicine: A Review Article. Cureus 2022; 14:e31232. [PMID: 36514576 PMCID: PMC9733816 DOI: 10.7759/cureus.31232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022] Open
Abstract
Metaverse is a relatively new concept of technological advancement for the world. Various sectors such as finance, entertainment, and communication are the forefront admirers of these innovations. Alongside these, the field of medicine has recently been on the list of metaverse-benefiting domains. Various aspects of medicine, such as educational and teaching purposes, surgical simulations, conferences and meetings, awareness programmes, research programmes, and many more, are under research. Depending on the requirement, the metaverse is a versatile platform which can be modulated accordingly, thus providing a flexible tool for medical development. In this review article, these domains are discussed in depth along with the pros and cons of the same, which positively affect the productivity of the field of medicine. All these headings have been through minimal study and experimentation, and the results obtained from them are satisfactory in terms of study. The primary purpose of the review article is to provide a suggestive statement regarding domains of the metaverse and their usage as a vital tool of operation in the future of medicine.
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A multi-view deep learning model for pathology image diagnosis. APPL INTELL 2022. [DOI: 10.1007/s10489-022-03918-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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