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Grignaffini F, Barbuto F, Troiano M, Piazzo L, Simeoni P, Mangini F, De Stefanis C, Onetti Muda A, Frezza F, Alisi A. The Use of Artificial Intelligence in the Liver Histopathology Field: A Systematic Review. Diagnostics (Basel) 2024; 14:388. [PMID: 38396427 PMCID: PMC10887838 DOI: 10.3390/diagnostics14040388] [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: 12/27/2023] [Revised: 02/02/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Digital pathology (DP) has begun to play a key role in the evaluation of liver specimens. Recent studies have shown that a workflow that combines DP and artificial intelligence (AI) applied to histopathology has potential value in supporting the diagnosis, treatment evaluation, and prognosis prediction of liver diseases. Here, we provide a systematic review of the use of this workflow in the field of hepatology. Based on the PRISMA 2020 criteria, a search of the PubMed, SCOPUS, and Embase electronic databases was conducted, applying inclusion/exclusion filters. The articles were evaluated by two independent reviewers, who extracted the specifications and objectives of each study, the AI tools used, and the results obtained. From the 266 initial records identified, 25 eligible studies were selected, mainly conducted on human liver tissues. Most of the studies were performed using whole-slide imaging systems for imaging acquisition and applying different machine learning and deep learning methods for image pre-processing, segmentation, feature extractions, and classification. Of note, most of the studies selected demonstrated good performance as classifiers of liver histological images compared to pathologist annotations. Promising results to date bode well for the not-too-distant inclusion of these techniques in clinical practice.
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Affiliation(s)
- Flavia Grignaffini
- Department of Information Engineering, Electronics and Telecommunications (DIET), “La Sapienza”, University of Rome, 00184 Rome, Italy; (F.G.); (F.B.); (L.P.); (F.M.); (F.F.)
| | - Francesco Barbuto
- Department of Information Engineering, Electronics and Telecommunications (DIET), “La Sapienza”, University of Rome, 00184 Rome, Italy; (F.G.); (F.B.); (L.P.); (F.M.); (F.F.)
| | - Maurizio Troiano
- Research Unit of Genetics of Complex Phenotypes, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (M.T.); (C.D.S.)
| | - Lorenzo Piazzo
- Department of Information Engineering, Electronics and Telecommunications (DIET), “La Sapienza”, University of Rome, 00184 Rome, Italy; (F.G.); (F.B.); (L.P.); (F.M.); (F.F.)
| | - Patrizio Simeoni
- National Transport Authority (NTA), D02 WT20 Dublin, Ireland;
- Faculty of Lifelong Learning, South East Technological University (SETU), R93 V960 Carlow, Ireland
| | - Fabio Mangini
- Department of Information Engineering, Electronics and Telecommunications (DIET), “La Sapienza”, University of Rome, 00184 Rome, Italy; (F.G.); (F.B.); (L.P.); (F.M.); (F.F.)
| | - Cristiano De Stefanis
- Research Unit of Genetics of Complex Phenotypes, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (M.T.); (C.D.S.)
| | | | - Fabrizio Frezza
- Department of Information Engineering, Electronics and Telecommunications (DIET), “La Sapienza”, University of Rome, 00184 Rome, Italy; (F.G.); (F.B.); (L.P.); (F.M.); (F.F.)
| | - Anna Alisi
- Research Unit of Genetics of Complex Phenotypes, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (M.T.); (C.D.S.)
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Balsano C, Burra P, Duvoux C, Alisi A, Piscaglia F, Gerussi A. Artificial Intelligence and liver: Opportunities and barriers. Dig Liver Dis 2023; 55:1455-1461. [PMID: 37718227 DOI: 10.1016/j.dld.2023.08.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 09/19/2023]
Abstract
Artificial Intelligence (AI) has recently been shown as an excellent tool for the study of the liver; however, many obstacles still have to be overcome for the digitalization of real-world hepatology. The authors present an overview of the current state of the art on the use of innovative technologies in different areas (big data, translational hepatology, imaging, and transplant setting). In clinical practice, physicians must integrate a vast array of data modalities (medical history, clinical data, laboratory tests, imaging, and pathology slides) to achieve a diagnostic or therapeutic decision. Unfortunately, machine learning and deep learning are still far from really supporting clinicians in real life. In fact, the accuracy of any technological support has no value in medicine without the support of clinicians. To make better use of new technologies, it is essential to improve clinicians' knowledge about them. To this end, the authors propose that collaborative networks for multidisciplinary approaches will improve the rapid implementation of AI systems for developing disease-customized AI-powered clinical decision support tools. The authors also discuss ethical, educational, and legal challenges that must be overcome to build robust bridges and deploy potentially effective AI in real-world clinical settings.
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Affiliation(s)
- Clara Balsano
- Department of Life, Health and Environmental Sciences-MESVA, School of Emergency-Urgency Medicine, University of L'Aquila, Piazzale Salvatore Tommasi 1, Coppito, L'Aquila 67100, Italy.
| | - Patrizia Burra
- Multivisceral Transplant Unit Gastroenterology Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, Padua, Italy
| | - Christophe Duvoux
- Department of Hepatology, Medical Liver Transplant Unit, Hospital Henri Mondor AP-HP, University of Paris-Est Créteil (UPEC), France
| | - Anna Alisi
- Research Unit of Molecular Genetics of Complex Phenotypes, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Fabio Piscaglia
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alessio Gerussi
- Division of Gastroenterology, Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
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Allaume P, Rabilloud N, Turlin B, Bardou-Jacquet E, Loréal O, Calderaro J, Khene ZE, Acosta O, De Crevoisier R, Rioux-Leclercq N, Pecot T, Kammerer-Jacquet SF. Artificial Intelligence-Based Opportunities in Liver Pathology-A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13101799. [PMID: 37238283 DOI: 10.3390/diagnostics13101799] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Artificial Intelligence (AI)-based Deep Neural Networks (DNNs) can handle a wide range of applications in image analysis, ranging from automated segmentation to diagnostic and prediction. As such, they have revolutionized healthcare, including in the liver pathology field. OBJECTIVE The present study aims to provide a systematic review of applications and performances provided by DNN algorithms in liver pathology throughout the Pubmed and Embase databases up to December 2022, for tumoral, metabolic and inflammatory fields. RESULTS 42 articles were selected and fully reviewed. Each article was evaluated through the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool, highlighting their risks of bias. CONCLUSIONS DNN-based models are well represented in the field of liver pathology, and their applications are diverse. Most studies, however, presented at least one domain with a high risk of bias according to the QUADAS-2 tool. Hence, DNN models in liver pathology present future opportunities and persistent limitations. To our knowledge, this review is the first one solely focused on DNN-based applications in liver pathology, and to evaluate their bias through the lens of the QUADAS2 tool.
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Affiliation(s)
- Pierre Allaume
- Department of Pathology CHU de Rennes, Rennes 1 University, Pontchaillou Hospital, 2 rue Henri Le Guilloux, CEDEX 09, 35033 Rennes, France
| | - Noémie Rabilloud
- Impact TEAM, Laboratoire Traitement du Signal et de l'Image (LTSI) INSERM, Rennes 1 University, Pontchaillou Hospital, 35033 Rennes, France
| | - Bruno Turlin
- Department of Pathology CHU de Rennes, Rennes 1 University, Pontchaillou Hospital, 2 rue Henri Le Guilloux, CEDEX 09, 35033 Rennes, France
- Research Unit n°UMR1341 NuMeCan-Nutrition, Métabolismes et Cancer, Rennes 1 University, Pontchaillou Hospital, 2 rue Henri Le Guilloux, CEDEX 09, 35033 Rennes, France
| | - Edouard Bardou-Jacquet
- Research Unit n°UMR1341 NuMeCan-Nutrition, Métabolismes et Cancer, Rennes 1 University, Pontchaillou Hospital, 2 rue Henri Le Guilloux, CEDEX 09, 35033 Rennes, France
- Department of Liver Diseases CHU de Rennes, Rennes 1 University, Pontchaillou Hospital, 35033 Rennes, France
| | - Olivier Loréal
- Research Unit n°UMR1341 NuMeCan-Nutrition, Métabolismes et Cancer, Rennes 1 University, Pontchaillou Hospital, 2 rue Henri Le Guilloux, CEDEX 09, 35033 Rennes, France
| | - Julien Calderaro
- Assistance Publique-Hôpitaux de Paris, Department of Pathology Henri Mondor, 94000 Créteil, France
- INSERM U955, Team Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers, 94000 Créteil, France
| | - Zine-Eddine Khene
- Impact TEAM, Laboratoire Traitement du Signal et de l'Image (LTSI) INSERM, Rennes 1 University, Pontchaillou Hospital, 35033 Rennes, France
- Department of Urology, CHU de Rennes, Rennes 1 University, Pontchaillou Hospital, 2 rue Henri Le Guilloux, CEDEX 09, 35033 Rennes, France
| | - Oscar Acosta
- Impact TEAM, Laboratoire Traitement du Signal et de l'Image (LTSI) INSERM, Rennes 1 University, Pontchaillou Hospital, 35033 Rennes, France
| | - Renaud De Crevoisier
- Impact TEAM, Laboratoire Traitement du Signal et de l'Image (LTSI) INSERM, Rennes 1 University, Pontchaillou Hospital, 35033 Rennes, France
- Department of Radiotherapy, Centre Eugène Marquis, 35033 Rennes, France
| | - Nathalie Rioux-Leclercq
- Department of Pathology CHU de Rennes, Rennes 1 University, Pontchaillou Hospital, 2 rue Henri Le Guilloux, CEDEX 09, 35033 Rennes, France
| | - Thierry Pecot
- Biosit Platform UAR 3480 CNRS US18 INSERM U955, Rennes 1 University, Pontchaillou Hospital, 35033 Rennes, France
| | - Solène-Florence Kammerer-Jacquet
- Department of Pathology CHU de Rennes, Rennes 1 University, Pontchaillou Hospital, 2 rue Henri Le Guilloux, CEDEX 09, 35033 Rennes, France
- Impact TEAM, Laboratoire Traitement du Signal et de l'Image (LTSI) INSERM, Rennes 1 University, Pontchaillou Hospital, 35033 Rennes, France
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Harabor V, Mogos R, Nechita A, Adam AM, Adam G, Melinte-Popescu AS, Melinte-Popescu M, Stuparu-Cretu M, Vasilache IA, Mihalceanu E, Carauleanu A, Bivoleanu A, Harabor A. Machine Learning Approaches for the Prediction of Hepatitis B and C Seropositivity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2380. [PMID: 36767747 PMCID: PMC9915359 DOI: 10.3390/ijerph20032380] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: The identification of patients at risk for hepatitis B and C viral infection is a challenge for the clinicians and public health specialists. The aim of this study was to evaluate and compare the predictive performances of four machine learning-based models for the prediction of HBV and HCV status. (2) Methods: This prospective cohort screening study evaluated adults from the North-Eastern and South-Eastern regions of Romania between January 2022 and November 2022 who underwent viral hepatitis screening in their family physician's offices. The patients' clinical characteristics were extracted from a structured survey and were included in four machine learning-based models: support vector machine (SVM), random forest (RF), naïve Bayes (NB), and K nearest neighbors (KNN), and their predictive performance was assessed. (3) Results: All evaluated models performed better when used to predict HCV status. The highest predictive performance was achieved by KNN algorithm (accuracy: 98.1%), followed by SVM and RF with equal accuracies (97.6%) and NB (95.7%). The predictive performance of these models was modest for HBV status, with accuracies ranging from 78.2% to 97.6%. (4) Conclusions: The machine learning-based models could be useful tools for HCV infection prediction and for the risk stratification process of adult patients who undergo a viral hepatitis screening program.
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Affiliation(s)
- Valeriu Harabor
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania
| | - Raluca Mogos
- Department of Mother and Child, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Aurel Nechita
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania
| | - Ana-Maria Adam
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania
| | - Gigi Adam
- Department of Pharmaceutical Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania
| | - Alina-Sinziana Melinte-Popescu
- Department of Mother and Newborn Care, Faculty of Medicine and Biological Sciences, ‘Ștefan cel Mare’ University, 720229 Suceava, Romania
| | - Marian Melinte-Popescu
- Department of Internal Medicine, Faculty of Medicine and Biological Sciences, ‘Ștefan cel Mare’ University, 720229 Suceava, Romania
| | - Mariana Stuparu-Cretu
- Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania
| | - Ingrid-Andrada Vasilache
- Department of Mother and Child, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Mihalceanu
- Department of Mother and Child, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alexandru Carauleanu
- Department of Mother and Child, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Anca Bivoleanu
- Department of Mother and Child, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Anamaria Harabor
- Clinical and Surgical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800216 Galati, Romania
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Ullal TV, Lakin S, Gallagher B, Sbardellati N, Abdo Z, Twedt DC. Demographic and histopathologic features of dogs with abnormally high concentrations of hepatic copper. J Vet Intern Med 2022; 36:2016-2027. [DOI: 10.1111/jvim.16580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Steven Lakin
- Colorado State University Fort Collins Colorado USA
| | | | | | - Zaid Abdo
- Colorado State University Fort Collins Colorado USA
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6
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Carteri RB, Grellert M, Borba DL, Marroni CA, Fernandes SA. Machine learning approaches using blood biomarkers in non-alcoholic fatty liver diseases. Artif Intell Gastroenterol 2022; 3:80-87. [DOI: 10.35712/aig.v3.i3.80] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/15/2022] [Accepted: 05/08/2022] [Indexed: 02/06/2023] Open
Abstract
The prevalence of nonalcoholic fatty liver disease (NAFLD) is an important public health concern. Early diagnosis of NAFLD and potential progression to nonalcoholic steatohepatitis (NASH), could reduce the further advance of the disease, and improve patient outcomes. Aiming to support patient diagnostic and predict specific outcomes, the interest in artificial intelligence (AI) methods in hepatology has dramatically increased, especially with the application of less-invasive biomarkers. In this review, our objective was twofold: Firstly, we presented the most frequent blood biomarkers in NAFLD and NASH and secondly, we reviewed recent literature regarding the use of machine learning (ML) methods to predict NAFLD and NASH in large cohorts. Strikingly, these studies provide insights into ML application in NAFLD patients' prognostics and ranked blood biomarkers are able to provide a recognizable signature allowing cost-effective NAFLD prediction and also differentiating NASH patients. Future studies should consider the limitations in the current literature and expand the application of these algorithms in different populations, fortifying an already promising tool in medical science.
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Affiliation(s)
- Randhall B Carteri
- Department of Nutrition, Methodist University Center - IPA, Porto Alegre 90420-060, Rio Grande do Sul, Brazil
- Department of Health and Behaviour, Catholic University of Pelotas, Pelotas 96015-560, Rio Grande do Sul, Brazil
| | - Mateus Grellert
- Department of Informatics and Statistics, Federal University of Santa Catarina, Florianópolis 88040-900, Santa Catarina, Brazil
| | - Daniela Luisa Borba
- Postgraduate Program in Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Rio Grande do Sul, Brazil
| | - Claudio Augusto Marroni
- Department of Gastroenterology and Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Rio Grande do Sul, Brazil
| | - Sabrina Alves Fernandes
- Postgraduate Program in Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Rio Grande do Sul, Brazil
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Taha A, Ochs V, Kayhan LN, Enodien B, Frey DM, Krähenbühl L, Taha-Mehlitz S. Advancements of Artificial Intelligence in Liver-Associated Diseases and Surgery. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58040459. [PMID: 35454298 PMCID: PMC9029673 DOI: 10.3390/medicina58040459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 02/06/2023]
Abstract
Background and Objectives: The advancement of artificial intelligence (AI) based technologies in medicine is progressing rapidly, but the majority of its real-world applications has not been implemented. The establishment of an accurate diagnosis with treatment has now transitioned into an artificial intelligence era, which has continued to provide an amplified understanding of liver cancer as a disease and helped to proceed better with the method of procurement. This article focuses on reviewing the AI in liver-associated diseases and surgical procedures, highlighting its development, use, and related counterparts. Materials and Methods: We searched for articles regarding AI in liver-related ailments and surgery, using the keywords (mentioned below) on PubMed, Google Scholar, Scopus, MEDLINE, and Cochrane Library. Choosing only the common studies suggested by these libraries, we segregated the matter based on disease. Finally, we compiled the essence of these articles under the various sub-headings. Results: After thorough review of articles, it was observed that there was a surge in the occurrence of liver-related surgeries, diagnoses, and treatments. Parallelly, advanced computer technologies governed by AI continue to prove their efficacy in the accurate screening, analysis, prediction, treatment, and recuperation of liver-related cases. Conclusions: The continual developments and high-order precision of AI is expanding its roots in all directions of applications. Despite being novel and lacking research, AI has shown its intrinsic worth for procedures in liver surgery while providing enhanced healing opportunities and personalized treatment for liver surgery patients.
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Affiliation(s)
- Anas Taha
- Department of Biomedical Engineering, Faculty of Medicine, University of Basel, 4123 Allschwil, Switzerland
- Correspondence:
| | - Vincent Ochs
- Roche Innovation Center Basel, Department of Pharma Research & Early Development, 4070 Basel, Switzerland;
| | - Leos N. Kayhan
- Department of Surgery, Canntonal Hospital Luzern, 6004 Luzern, Switzerland;
| | - Bassey Enodien
- Department of Surgery, Wetzikon Hospital, 8620 Wetzikon, Switzerland; (B.E.); (D.M.F.)
| | - Daniel M. Frey
- Department of Surgery, Wetzikon Hospital, 8620 Wetzikon, Switzerland; (B.E.); (D.M.F.)
| | | | - Stephanie Taha-Mehlitz
- Clarunis, University Centre for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, 4002 Basel, Switzerland;
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Zhang Z, Liu N, Meng Q, Su L. Editorial: Clinical Application of Artificial Intelligence in Emergency and Critical Care Medicine, Volume I. Front Med (Lausanne) 2021; 8:809478. [PMID: 34938754 PMCID: PMC8685312 DOI: 10.3389/fmed.2021.809478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/22/2021] [Indexed: 02/05/2023] Open
Affiliation(s)
- Zhongheng Zhang
- Department of Emergency Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Zhongheng Zhang
| | - Nan Liu
- Programme in Health Services and Systems Research, Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Qinghe Meng
- Department of Surgery, State University of New York Upstate Medical University, Syracuse, NY, United States
| | - Longxiang Su
- State Key Laboratory of Complex Severe and Rare Diseases, Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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