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Optimizing Computer-Aided Diagnosis with Cost-Aware Deep Learning Models. 利用成本意识深度学习模型优化计算机辅助诊断。
Charmi Patel, Yiyang Wang, Thiruvarangan Ramaraj, Roselyne Tchoua, Jacob Furst, Daniela Raicu

Classical machine learning and deep learning models for Computer-Aided Diagnosis (CAD) commonly focus on overall classification performance, treating misclassification errors (false negatives and false positives) equally during training. This uniform treatment overlooks the distinct costs associated with each type of error, leading to suboptimal decision-making, particularly in the medical domain where it is important to improve the prediction sensitivity without significantly compromising overall accuracy. This study introduces a novel deep learning-based CAD system that incorporates a cost-sensitive parameter into the activation function. By applying our methodologies to two medical imaging datasets, our proposed study shows statistically significant increases of 3.84% and 5.4% in sensitivity while maintaining overall accuracy for Lung Image Database Consortium (LIDC) and Breast Cancer Histological Database (BreakHis), respectively. Our findings underscore the significance of integrating cost-sensitive parameters into future CAD systems to optimize performance and ultimately reduce costs and improve patient outcomes.

用于计算机辅助诊断(CAD)的经典机器学习和深度学习模型通常侧重于整体分类性能,在训练过程中同等对待误分类错误(假阴性和假阳性)。这种统一的处理方式忽略了与每种错误相关的不同成本,导致了决策的次优化,尤其是在医疗领域,提高预测灵敏度而不严重影响整体准确性非常重要。本研究介绍了一种基于深度学习的新型 CAD 系统,该系统在激活函数中加入了成本敏感参数。通过将我们的方法应用于两个医学影像数据集,我们提出的研究表明,在保持肺图像数据库联盟(LIDC)和乳腺癌组织学数据库(BreakHis)总体准确性的同时,灵敏度在统计学上分别显著提高了 3.84% 和 5.4%。我们的研究结果强调了将对成本敏感的参数整合到未来 CAD 系统中的重要性,以优化性能并最终降低成本和改善患者预后。
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引用次数: 0
Quantifying Health Outcome Disparity in Invasive Methicillin-Resistant Staphylococcus aureus Infection using Fairness Algorithms on Real-World Data. 在真实世界数据上使用公平算法量化侵袭性耐甲氧西林金黄色葡萄球菌感染的健康结果差异。
Inyoung Jun, Sarah E Ser, Scott A Cohen, Jie Xu, Robert J Lucero, Jiang Bian, Mattia Prosperi

This study quantifies health outcome disparities in invasive Methicillin-Resistant Staphylococcus aureus (MRSA) infections by leveraging a novel artificial intelligence (AI) fairness algorithm, the Fairness-Aware Causal paThs (FACTS) decomposition, and applying it to real-world electronic health record (EHR) data. We spatiotemporally linked 9 years of EHRs from a large healthcare provider in Florida, USA, with contextual social determinants of health (SDoH). We first created a causal structure graph connecting SDoH with individual clinical measurements before/upon diagnosis of invasive MRSA infection, treatments, side effects, and outcomes; then, we applied FACTS to quantify outcome potential disparities of different causal pathways including SDoH, clinical and demographic variables. We found moderate disparity with respect to demographics and SDoH, and all the top ranked pathways that led to outcome disparities in age, gender, race, and income, included comorbidity. Prior kidney impairment, vancomycin use, and timing were associated with racial disparity, while income, rurality, and available healthcare facilities contributed to gender disparity. From an intervention standpoint, our results highlight the necessity of devising policies that consider both clinical factors and SDoH. In conclusion, this work demonstrates a practical utility of fairness AI methods in public health settings.

本研究利用新型人工智能(AI)公平算法--公平感知因果关系分解(FACTS),并将其应用于真实世界的电子健康记录(EHR)数据,量化了侵袭性耐甲氧西林金黄色葡萄球菌(MRSA)感染的健康结果差异。我们将美国佛罗里达州一家大型医疗保健提供商的 9 年电子健康记录与健康的社会决定因素(SDoH)进行了时空关联。我们首先创建了一个因果结构图,将 SDoH 与入侵性 MRSA 感染诊断前/诊断时的个人临床测量、治疗、副作用和结果联系起来;然后,我们应用 FACTS 对不同因果途径(包括 SDoH、临床和人口统计学变量)的潜在结果差异进行量化。我们发现,在人口统计学和 SDoH 方面存在中等程度的差异,而在年龄、性别、种族和收入方面导致结果差异的所有排名靠前的途径都包括合并症。既往肾功能损害、万古霉素的使用和时间与种族差异有关,而收入、农村地区和可用的医疗设施则导致了性别差异。从干预的角度来看,我们的研究结果强调了制定同时考虑临床因素和 SDoH 的政策的必要性。总之,这项工作证明了公平人工智能方法在公共卫生领域的实用性。
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引用次数: 0
Deconvolution of Nascent Sequencing Data Using Transcriptional Regulatory Elements. 利用转录调控元件对新生测序数据进行解卷积。
Zachary Maas, Rutendo Sigauke, Robin Dowell

The problem of microdissection of heterogeneous tissue samples is of great interest for both fundamental biology and biomedical research. Until now, microdissection in the form of supervised deconvolution of mixed sequencing samples has been limited to assays measuring gene expression (RNA-seq) or chromatin accessibility (ATAC-seq). We present here the first attempt at solving the supervised deconvolution problem for run-on nascent sequencing data (GRO-seq and PRO-seq), a readout of active transcription. Then, we develop a novel filtering method suited to the mixed set of promoter and enhancer regions provided by nascent sequencing, and apply best-practice standards from the RNA-seq literature, using in-silico mixtures of cells. Using these methods, we find that enhancer RNAs are highly informative features for supervised deconvolution. In most cases, simple deconvolution methods perform better than more complex ones for solving the nascent deconvolution problem. Furthermore, undifferentiated cell types confound deconvolution of nascent sequencing data, likely as a consequence of transcriptional activity over the highly open chromatin regions of undifferentiated cell types. Our results suggest that while the problem of nascent deconvolution is generally tractable, stronger approaches integrating other sequencing protocols may be required to solve mixtures containing undifferentiated celltypes.

异质组织样本的显微切割问题对基础生物学和生物医学研究都具有重大意义。迄今为止,以监督解卷积形式对混合测序样本进行的微切片仅限于测量基因表达(RNA-seq)或染色质可及性(ATAC-seq)的检测。在此,我们首次尝试解决运行中新生测序数据(GRO-seq 和 PRO-seq)的监督解卷积问题,这是一种活跃转录的读数。然后,我们开发了一种适合新生测序所提供的启动子和增强子区域混合集的新型过滤方法,并采用 RNA-seq 文献中的最佳实践标准,使用了实验室内的细胞混合物。通过使用这些方法,我们发现增强子 RNA 是监督解卷积的高信息量特征。在大多数情况下,简单的解卷积方法比复杂的解卷积方法更能解决新生解卷积问题。此外,未分化细胞类型会混淆新生测序数据的解卷积,这可能是未分化细胞类型高度开放的染色质区域转录活动的结果。我们的研究结果表明,虽然新生儿解卷积问题总体上是可以解决的,但要解决含有未分化细胞类型的混合物问题,可能需要更强的整合其他测序协议的方法。
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引用次数: 0
Splitpea: quantifying protein interaction network rewiring changes due to alternative splicing in cancer. Splitpea:量化癌症中替代剪接导致的蛋白质相互作用网络重新布线的变化。
Ruth Dannenfelser, Vicky Yao

Protein-protein interactions play an essential role in nearly all biological processes, and it has become increasingly clear that in order to better understand the fundamental processes that underlie disease, we must develop a strong understanding of both their context specificity (e.g., tissue-specificity) as well as their dynamic nature (e.g., how they respond to environmental changes). While network-based approaches have found much initial success in the application of protein-protein interactions (PPIs) towards systems-level explorations of biology, they often overlook the fact that large numbers of proteins undergo alternative splicing. Alternative splicing has not only been shown to diversify protein function through the generation of multiple protein isoforms, but also remodel PPIs and affect a wide range diseases, including cancer. Isoform-specific interactions are not well characterized, so we develop a computational approach that uses domain-domain interactions in concert with differential exon usage data from The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression project (GTEx). Using this approach, we can characterize PPIs likely disrupted or possibly even increased due to splicing events for individual TCGA cancer patient samples relative to a matched GTEx normal tissue background.

蛋白质-蛋白质相互作用在几乎所有生物过程中都发挥着至关重要的作用,而且人们越来越清楚地认识到,为了更好地理解疾病的基本过程,我们必须深入了解它们的背景特异性(如组织特异性)及其动态性质(如它们如何对环境变化做出反应)。虽然基于网络的方法在应用蛋白质-蛋白质相互作用(PPIs)进行生物学系统级探索方面取得了很大的初步成功,但它们往往忽视了大量蛋白质会发生替代剪接这一事实。事实证明,替代剪接不仅能通过产生多种蛋白质异构体使蛋白质功能多样化,还能重塑蛋白质相互作用,影响包括癌症在内的多种疾病。异构体特异性相互作用还没有得到很好的表征,因此我们开发了一种计算方法,利用域-域相互作用与癌症基因组图谱(TCGA)和基因型-组织表达项目(GTEx)的不同外显子使用数据相结合。利用这种方法,我们可以描述 TCGA 癌症患者样本相对于匹配的 GTEx 正常组织背景的剪接事件可能导致的 PPIs 中断,甚至可能增加。
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引用次数: 0
Cluster Analysis reveals Socioeconomic Disparities among Elective Spine Surgery Patients. 聚类分析揭示了脊柱外科择期手术患者的社会经济差异。
Alena Orlenko, Philip J Freda, Attri Ghosh, Hyunjun Choi, Nicholas Matsumoto, Tiffani J Bright, Corey T Walker, Tayo Obafemi-Ajayi, Jason H Moore

This work demonstrates the use of cluster analysis in detecting fair and unbiased novel discoveries. Given a sample population of elective spinal fusion patients, we identify two overarching subgroups driven by insurance type. The Medicare group, associated with lower socioeconomic status, exhibited an over-representation of negative risk factors. The findings provide a compelling depiction of the interwoven socioeconomic and racial disparities present within the healthcare system, highlighting their consequential effects on health inequalities. The results are intended to guide design of fair and precise machine learning models based on intentional integration of population stratification.

这项工作展示了聚类分析在检测公平、无偏见的新发现方面的应用。在选择性脊柱融合术患者的样本人群中,我们发现了两个由保险类型驱动的总体亚群。医疗保险组与较低的社会经济地位相关,表现出过多的负面风险因素。研究结果令人信服地描述了医疗保健系统中存在的社会经济和种族差异,并强调了这些差异对健康不平等的影响。这些结果旨在指导设计基于有意整合人口分层的公平而精确的机器学习模型。
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引用次数: 0
Polygenic risk scores for cardiometabolic traits demonstrate importance of ancestry for predictive precision medicine. 心脏代谢特征的多基因风险评分显示了祖先对于预测性精准医疗的重要性。
Rachel L Kember, Shefali S Verma, Anurag Verma, Brenda Xiao, Anastasia Lucas, Colleen M Kripke, Renae Judy, Jinbo Chen, Scott M Damrauer, Daniel J Rader, Marylyn D Ritchie

Polygenic risk scores (PRS) have predominantly been derived from genome-wide association studies (GWAS) conducted in European ancestry (EUR) individuals. In this study, we present an in-depth evaluation of PRS based on multi-ancestry GWAS for five cardiometabolic phenotypes in the Penn Medicine BioBank (PMBB) followed by a phenome-wide association study (PheWAS). We examine the PRS performance across all individuals and separately in African ancestry (AFR) and EUR ancestry groups. For AFR individuals, PRS derived using the multi-ancestry LD panel showed a higher effect size for four out of five PRSs (DBP, SBP, T2D, and BMI) than those derived from the AFR LD panel. In contrast, for EUR individuals, the multi-ancestry LD panel PRS demonstrated a higher effect size for two out of five PRSs (SBP and T2D) compared to the EUR LD panel. These findings underscore the potential benefits of utilizing a multi-ancestry LD panel for PRS derivation in diverse genetic backgrounds and demonstrate overall robustness in all individuals. Our results also revealed significant associations between PRS and various phenotypic categories. For instance, CAD PRS was linked with 18 phenotypes in AFR and 82 in EUR, while T2D PRS correlated with 84 phenotypes in AFR and 78 in EUR. Notably, associations like hyperlipidemia, renal failure, atrial fibrillation, coronary atherosclerosis, obesity, and hypertension were observed across different PRSs in both AFR and EUR groups, with varying effect sizes and significance levels. However, in AFR individuals, the strength and number of PRS associations with other phenotypes were generally reduced compared to EUR individuals. Our study underscores the need for future research to prioritize 1) conducting GWAS in diverse ancestry groups and 2) creating a cosmopolitan PRS methodology that is universally applicable across all genetic backgrounds. Such advances will foster a more equitable and personalized approach to precision medicine.

多基因风险评分(PRS)主要来自对欧洲血统(EUR)个体进行的全基因组关联研究(GWAS)。在本研究中,我们对基于宾夕法尼亚医学生物库(PMBB)中五种心脏代谢表型的多血统 GWAS 的多基因风险评分进行了深入评估,随后又进行了全表型关联研究(PheWAS)。我们研究了所有个体的 PRS 性能,并分别研究了非洲血统 (AFR) 和欧洲血统群体的 PRS 性能。对于非洲裔个体,使用多血统 LD 面板得出的 PRS 在五个 PRS 中的四个(DBP、SBP、T2D 和 BMI)显示出比从非洲裔 LD 面板得出的 PRS 更高的效应大小。相比之下,对于欧洲人,多家系 LD 面板 PRS 在五个 PRS 中的两个(SBP 和 T2D)显示出比欧洲 LD 面板更高的效应大小。这些发现凸显了在不同遗传背景下利用多家系家系 LD 面板推导 PRS 的潜在益处,并证明了在所有个体中的整体稳健性。我们的研究结果还揭示了 PRS 与各种表型类别之间的重要关联。例如,CAD PRS 与 18 种表型(AFR)和 82 种表型(EUR)相关,而 T2D PRS 与 84 种表型(AFR)和 78 种表型(EUR)相关。值得注意的是,高脂血症、肾功能衰竭、心房颤动、冠状动脉粥样硬化、肥胖和高血压等症状在非洲裔美国人和欧洲裔美国人群体中的不同PRS中都存在关联,其效应大小和显著性水平各不相同。然而,与欧洲人相比,非洲裔美国人的 PRS 与其他表型相关的强度和数量普遍降低。我们的研究强调,未来的研究需要优先考虑:1)在不同的祖先群体中开展 GWAS;2)创建一种普遍适用于所有遗传背景的世界性 PRS 方法。这些进展将促进更公平、更个性化的精准医疗方法。
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引用次数: 0
Session Introduction: Digital health technology data in biocomputing: Research efforts and considerations for expanding access (PSB2024). 会议简介:生物计算中的数字健康技术数据:研究工作和扩大访问的考虑因素(PSB2024)。
Michelle Holko, Chris Lunt, Jessilyn Dunn

Data from digital health technologies (DHT), including wearable sensors like Apple Watch, Whoop, Oura Ring, and Fitbit, are increasingly being used in biomedical research. Research and development of DHT-related devices, platforms, and applications is happening rapidly and with significant private-sector involvement with new biotech companies and large tech companies (e.g. Google, Apple, Amazon, Uber) investing heavily in technologies to improve human health. Many academic institutions are building capabilities related to DHT research, often in cross-sector collaboration with technology companies and other organizations with the goal of generating clinically meaningful evidence to improve patient care, to identify users at an earlier stage of disease presentation, and to support health preservation and disease prevention. Large research consortia, cross-sector partnerships, and individual research labs are all represented in the current corpus of published studies. Some of the large research studies, like NIH's All of Us Research Program, make data sets from wearable sensors available to the research community, while the vast majority of data from wearable sensors and other DHTs are held by private sector organizations and are not readily available to the research community. As data are unlocked from the private sector and made available to the academic research community, there is an opportunity to develop innovative analytics and methods through expanded access. This is the second year for this Session which solicited research results leveraging digital health technologies, including wearable sensor data, describing novel analytical methods, and issues related to diversity, equity, inclusion (DEI) of the research, data, and the community of researchers working in this area. We particularly encouraged submissions describing opportunities for expanding and democratizing academic research using data from wearable sensors and related digital health technologies.

来自数字健康技术(DHT)的数据,包括 Apple Watch、Whoop、Oura Ring 和 Fitbit 等可穿戴传感器的数据,正越来越多地被用于生物医学研究。与数字健康技术相关的设备、平台和应用的研究与开发正在快速进行,新兴生物技术公司和大型科技公司(如谷歌、苹果、亚马逊、优步等)大量投资于改善人类健康的技术,私营部门也积极参与其中。许多学术机构正在建设与 DHT 研究相关的能力,通常是与技术公司和其他组织开展跨部门合作,目标是提供有临床意义的证据,以改善患者护理,在疾病的早期阶段识别用户,并支持健康保护和疾病预防。在目前已发表的研究成果中,大型研究联盟、跨部门合作以及单个研究实验室均有体现。一些大型研究,如美国国立卫生研究院的 "我们所有人研究计划",向研究界提供了来自可穿戴传感器的数据集,而来自可穿戴传感器和其他 DHT 的绝大多数数据都由私营部门组织掌握,不能随时向研究界提供。随着数据从私营部门解锁并提供给学术研究界,有机会通过扩大访问范围来开发创新的分析方法和手段。今年是该会议举办的第二年,会议征集了利用数字健康技术(包括可穿戴传感器数据)的研究成果,介绍了新颖的分析方法,以及与该领域的研究、数据和研究人员群体的多样性、公平性和包容性(DEI)相关的问题。我们特别鼓励在提交的论文中描述利用可穿戴传感器和相关数字健康技术的数据扩大学术研究并使之民主化的机会。
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引用次数: 0
Clinfo.ai: An Open-Source Retrieval-Augmented Large Language Model System for Answering Medical Questions using Scientific Literature. Clinfo.ai:利用科学文献回答医学问题的开源检索增强型大语言模型系统。
Alejandro Lozano, Scott L Fleming, Chia-Chun Chiang, Nigam Shah

The quickly-expanding nature of published medical literature makes it challenging for clinicians and researchers to keep up with and summarize recent, relevant findings in a timely manner. While several closed-source summarization tools based on large language models (LLMs) now exist, rigorous and systematic evaluations of their outputs are lacking. Furthermore, there is a paucity of high-quality datasets and appropriate benchmark tasks with which to evaluate these tools. We address these issues with four contributions: we release Clinfo.ai, an open-source WebApp that answers clinical questions based on dynamically retrieved scientific literature; we specify an information retrieval and abstractive summarization task to evaluate the performance of such retrieval-augmented LLM systems; we release a dataset of 200 questions and corresponding answers derived from published systematic reviews, which we name PubMed Retrieval and Synthesis (PubMedRS-200); and report benchmark results for Clinfo.ai and other publicly available OpenQA systems on PubMedRS-200.

已发表的医学文献数量迅速增加,这使得临床医生和研究人员及时了解和总结最新的相关研究成果变得十分困难。虽然目前已有几种基于大型语言模型(LLM)的闭源摘要工具,但对其输出结果缺乏严格而系统的评估。此外,用于评估这些工具的高质量数据集和适当的基准任务也非常缺乏。我们通过四项贡献来解决这些问题:我们发布了一个开源 WebApp Clinfo.ai,它可以根据动态检索到的科学文献回答临床问题;我们指定了一个信息检索和抽象摘要任务来评估此类检索增强型 LLM 系统的性能;我们发布了一个包含 200 个问题和相应答案的数据集,这些问题和答案来自已发表的系统性综述,我们将其命名为 PubMed Retrieval and Synthesis (PubMedRS-200);我们还报告了 Clinfo.ai 和其他公开可用的 OpenQA 系统在 PubMedRS-200 上的基准结果。
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引用次数: 0
Statistical analysis of single-cell protein data. 单细胞蛋白质数据统计分析。
Brooke L Fridley, Simon Vandekar, Inna Chervoneva, Julia Wrobel, Siyuan Ma

Immune modulation is considered a hallmark of cancer initiation and progression, with immune cell density being consistently associated with clinical outcomes of individuals with cancer. Multiplex immunofluorescence (mIF) microscopy combined with automated image analysis is a novel and increasingly used technique that allows for the assessment and visualization of the tumor microenvironment (TME). Recently, application of this new technology to tissue microarrays (TMAs) or whole tissue sections from large cancer studies has been used to characterize different cell populations in the TME with enhanced reproducibility and accuracy. Generally, mIF data has been used to examine the presence and abundance of immune cells in the tumor and stroma compartments; however, this aggregate measure assumes uniform patterns of immune cells throughout the TME and overlooks spatial heterogeneity. Recently, the spatial contexture of the TME has been explored with a variety of statistical methods. In this PSB workshop, speakers will present some of the state-of-the-art statistical methods for assessing the TIME from mIF data.

免疫调节被认为是癌症发生和发展的一个标志,免疫细胞密度一直与癌症患者的临床预后相关。多重免疫荧光(mIF)显微镜与自动图像分析相结合,是一种新颖的、应用日益广泛的技术,可对肿瘤微环境(TME)进行评估和可视化。最近,将这项新技术应用于组织微阵列(TMA)或大型癌症研究的整个组织切片已被用来描述肿瘤微环境中不同细胞群的特征,并提高了可重复性和准确性。一般来说,mIF 数据被用来检测肿瘤和基质区免疫细胞的存在和丰度;然而,这种综合测量方法假定整个 TME 中免疫细胞的模式是一致的,而忽略了空间异质性。最近,人们利用各种统计方法对肿瘤组织间质的空间背景进行了探索。在本次 PSB 研讨会上,演讲者将介绍从 mIF 数据中评估 TIME 的一些最新统计方法。
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引用次数: 0
Impact of Measurement Noise on Genetic Association Studies of Cardiac Function. 测量噪音对心功能遗传关联研究的影响。
Milos Vukadinovic, Gauri Renjith, Victoria Yuan, Alan Kwan, Susan C Cheng, Debiao Li, Shoa L Clarke, David Ouyang

Recent research has effectively used quantitative traits from imaging to boost the capabilities of genome-wide association studies (GWAS), providing further understanding of disease biology and various traits. However, it's important to note that phenotyping inherently carries measurement error and noise that could influence subsequent genetic analyses. The study focused on left ventricular ejection fraction (LVEF), a vital yet potentially inaccurate quantitative measurement, to investigate how imprecision in phenotype measurement affects genetic studies. Several methods of acquiring LVEF, along with simulating measurement noise, were assessed for their effects on ensuing genetic analyses. The results showed that by introducing just 7.9% of measurement noise, all genetic associations in an LVEF GWAS with almost forty thousand individuals could be eliminated. Moreover, a 1% increase in mean absolute error (MAE) in LVEF had an effect equivalent to a 10% reduction in the sample size of the cohort on the power of GWAS. Therefore, enhancing the accuracy of phenotyping is crucial to maximize the effectiveness of genome-wide association studies.

最近的研究有效地利用了成像的定量性状来提高全基因组关联研究(GWAS)的能力,从而进一步了解疾病生物学和各种性状。然而,值得注意的是,表型分析本身存在测量误差和噪声,可能会影响后续的遗传分析。这项研究以左心室射血分数(LVEF)为重点,研究表型测量的不精确性如何影响遗传研究。研究人员评估了几种获取 LVEF 的方法以及模拟测量噪音对后续遗传分析的影响。结果显示,只需引入 7.9% 的测量噪声,就能消除近四万人的 LVEF GWAS 中的所有遗传关联。此外,LVEF 平均绝对误差(MAE)每增加 1%,对 GWAS 功率的影响相当于队列样本量减少 10%。因此,提高表型分析的准确性对于最大限度地提高全基因组关联研究的效果至关重要。
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引用次数: 0
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Pacific Symposium on Biocomputing. Pacific Symposium on Biocomputing
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