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Yayan J, Franke KJ, Berger M, Windisch W, Rasche K. Early detection of tuberculosis: a systematic review. Pneumonia (Nathan) 2024; 16:11. [PMID: 38965640 PMCID: PMC11225244 DOI: 10.1186/s41479-024-00133-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 04/22/2024] [Indexed: 07/06/2024] Open
Abstract
Tuberculosis remains a significant global health challenge. Tuberculosis affects millions of individuals worldwide. Early detection of tuberculosis plays a relevant role in the management of treatment of tuberculosis. This systematic review will analyze the findings of several published studies on the topic of the early detection of tuberculosis. This systematic review highlights their methodologies and limitations as well as their contributions to our understanding of this pressing issue. Early detection of tuberculosis can be achieved through tuberculosis screening for contacts. Comprehensive health education for household contacts can be used as early detection. The in-house deep learning models can be used in the X-ray used for automatic detection of tuberculosis. Interferon gamma release assay, routine passive and active case detection, portable X-ray and nucleic acid amplification testing, and highly sensitive enzyme-linked immunosorbent assay tests play critical roles in improving tuberculosis detection.
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Affiliation(s)
- Josef Yayan
- Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, Witten/Herdecke University, HELIOS Clinic Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Germany.
| | - Karl-Josef Franke
- Department of Internal Medicine, Pulmonary Division, Internal Intensive Care Medicine, Infectiology, and Sleep Medicine, Märkische Clinics Health Holding Ltd, Clinic Lüdenscheid, Witten/Herdecke University, Lüdenscheid, Germany
| | - Melanie Berger
- Department of Pneumology, Cologne Merheim Hospital, Witten/Herdecke University, Cologne, Germany
| | - Wolfram Windisch
- Department of Pneumology, Cologne Merheim Hospital, Witten/Herdecke University, Cologne, Germany
| | - Kurt Rasche
- Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, Witten/Herdecke University, HELIOS Clinic Wuppertal, Heusnerstr. 40, 42283, Wuppertal, Germany
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K SP, Parivakkam Mani A, S G, Yadav S. Advancements in Artificial Intelligence for the Diagnosis of Multidrug Resistance and Extensively Drug-Resistant Tuberculosis: A Comprehensive Review. Cureus 2024; 16:e60280. [PMID: 38872656 PMCID: PMC11173349 DOI: 10.7759/cureus.60280] [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] [Accepted: 05/11/2024] [Indexed: 06/15/2024] Open
Abstract
Tuberculosis (TB) remains a significant global health concern, particularly with the emergence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). Traditional methods for diagnosing drug resistance in TB are time-consuming and often lack accuracy, leading to delays in appropriate treatment initiation and exacerbating the spread of drug-resistant strains. In recent years, artificial intelligence (AI) techniques have shown promise in revolutionizing TB diagnosis, offering rapid and accurate identification of drug-resistant strains. This comprehensive review explores the latest advancements in AI applications for the diagnosis of MDR-TB and XDR-TB. We discuss the various AI algorithms and methodologies employed, including machine learning, deep learning, and ensemble techniques, and their comparative performances in TB diagnosis. Furthermore, we examine the integration of AI with novel diagnostic modalities such as whole-genome sequencing, molecular assays, and radiological imaging, enhancing the accuracy and efficiency of TB diagnosis. Challenges and limitations surrounding the implementation of AI in TB diagnosis, such as data availability, algorithm interpretability, and regulatory considerations, are also addressed. Finally, we highlight future directions and opportunities for the integration of AI into routine clinical practice for combating drug-resistant TB, ultimately contributing to improved patient outcomes and enhanced global TB control efforts.
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Affiliation(s)
- Shanmuga Priya K
- Department of Pulmonology, Faculty of Medicine, Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, IND
| | - Anbumaran Parivakkam Mani
- Department of Respiratory Medicine, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Geethalakshmi S
- Department of Microbiology, Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, IND
| | - Sankalp Yadav
- Department of Medicine, Shri Madan Lal Khurana Chest Clinic, New Delhi, IND
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Ou CY, Chen IY, Chang HT, Wei CY, Li DY, Chen YK, Chang CY. Deep Learning-Based Classification and Semantic Segmentation of Lung Tuberculosis Lesions in Chest X-ray Images. Diagnostics (Basel) 2024; 14:952. [PMID: 38732366 PMCID: PMC11083603 DOI: 10.3390/diagnostics14090952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 04/24/2024] [Accepted: 04/29/2024] [Indexed: 05/13/2024] Open
Abstract
We present a deep learning (DL) network-based approach for detecting and semantically segmenting two specific types of tuberculosis (TB) lesions in chest X-ray (CXR) images. In the proposed method, we use a basic U-Net model and its enhanced versions to detect, classify, and segment TB lesions in CXR images. The model architectures used in this study are U-Net, Attention U-Net, U-Net++, Attention U-Net++, and pyramid spatial pooling (PSP) Attention U-Net++, which are optimized and compared based on the test results of each model to find the best parameters. Finally, we use four ensemble approaches which combine the top five models to further improve lesion classification and segmentation results. In the training stage, we use data augmentation and preprocessing methods to increase the number and strength of lesion features in CXR images, respectively. Our dataset consists of 110 training, 14 validation, and 98 test images. The experimental results show that the proposed ensemble model achieves a maximum mean intersection-over-union (MIoU) of 0.70, a mean precision rate of 0.88, a mean recall rate of 0.75, a mean F1-score of 0.81, and an accuracy of 1.0, which are all better than those of only using a single-network model. The proposed method can be used by clinicians as a diagnostic tool assisting in the examination of TB lesions in CXR images.
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Affiliation(s)
- Chih-Ying Ou
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, Douliu Branch, College of Medicine, National Cheng Kung University, Douliu City 64043, Taiwan; (C.-Y.O.); (I.-Y.C.)
| | - I-Yen Chen
- Division of Chest Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, Douliu Branch, College of Medicine, National Cheng Kung University, Douliu City 64043, Taiwan; (C.-Y.O.); (I.-Y.C.)
| | - Hsuan-Ting Chang
- Photonics and Information Laboratory, Department of Electrical Engineering, National Yunlin University of Science and Technology, Douliu City 64002, Taiwan; (C.-Y.W.); (D.-Y.L.); (Y.-K.C.)
| | - Chuan-Yi Wei
- Photonics and Information Laboratory, Department of Electrical Engineering, National Yunlin University of Science and Technology, Douliu City 64002, Taiwan; (C.-Y.W.); (D.-Y.L.); (Y.-K.C.)
| | - Dian-Yu Li
- Photonics and Information Laboratory, Department of Electrical Engineering, National Yunlin University of Science and Technology, Douliu City 64002, Taiwan; (C.-Y.W.); (D.-Y.L.); (Y.-K.C.)
| | - Yen-Kai Chen
- Photonics and Information Laboratory, Department of Electrical Engineering, National Yunlin University of Science and Technology, Douliu City 64002, Taiwan; (C.-Y.W.); (D.-Y.L.); (Y.-K.C.)
| | - Chuan-Yu Chang
- Department of Computer Science and Information Engineering, National Yunlin University of Science and Technology, Douliu City 64002, Taiwan;
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Grenier PA, Brun AL, Mellot F. [The contribution of artificial intelligence (AI) subsequent to the processing of thoracic imaging]. Rev Mal Respir 2024; 41:110-126. [PMID: 38129269 DOI: 10.1016/j.rmr.2023.12.001] [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: 10/24/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
The contribution of artificial intelligence (AI) to medical imaging is currently the object of widespread experimentation. The development of deep learning (DL) methods, particularly convolution neural networks (CNNs), has led to performance gains often superior to those achieved by conventional methods such as machine learning. Radiomics is an approach aimed at extracting quantitative data not accessible to the human eye from images expressing a disease. The data subsequently feed machine learning models and produce diagnostic or prognostic probabilities. As for the multiple applications of AI methods in thoracic imaging, they are undergoing evaluation. Chest radiography is a practically ideal field for the development of DL algorithms able to automatically interpret X-rays. Current algorithms can detect up to 14 different abnormalities present either in isolation or in combination. Chest CT is another area offering numerous AI applications. Various algorithms have been specifically formed and validated for the detection and characterization of pulmonary nodules and pulmonary embolism, as well as segmentation and quantitative analysis of the extent of diffuse lung diseases (emphysema, infectious pneumonias, interstitial lung disease). In addition, the analysis of medical images can be associated with clinical, biological, and functional data (multi-omics analysis), the objective being to construct predictive approaches regarding disease prognosis and response to treatment.
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Affiliation(s)
- P A Grenier
- Délégation à la recherche clinique et l'innovation, hôpital Foch, Suresnes, France.
| | - A L Brun
- Service de radiologie, hôpital Foch, Suresnes, France
| | - F Mellot
- Service de radiologie, hôpital Foch, Suresnes, France
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Yang Y, Xia L, Liu P, Yang F, Wu Y, Pan H, Hou D, Liu N, Lu S. A prospective multicenter clinical research study validating the effectiveness and safety of a chest X-ray-based pulmonary tuberculosis screening software JF CXR-1 built on a convolutional neural network algorithm. Front Med (Lausanne) 2023; 10:1195451. [PMID: 37649977 PMCID: PMC10463041 DOI: 10.3389/fmed.2023.1195451] [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: 03/28/2023] [Accepted: 07/24/2023] [Indexed: 09/01/2023] Open
Abstract
Background Chest radiography (chest X-ray or CXR) plays an important role in the early detection of active pulmonary tuberculosis (TB). In areas with a high TB burden that require urgent screening, there is often a shortage of radiologists available to interpret the X-ray results. Computer-aided detection (CAD) software employed with artificial intelligence (AI) systems may have the potential to solve this problem. Objective We validated the effectiveness and safety of pulmonary tuberculosis imaging screening software that is based on a convolutional neural network algorithm. Methods We conducted prospective multicenter clinical research to validate the performance of pulmonary tuberculosis imaging screening software (JF CXR-1). Volunteers under the age of 15 years, both with or without suspicion of pulmonary tuberculosis, were recruited for CXR photography. The software reported a probability score of TB for each participant. The results were compared with those reported by radiologists. We measured sensitivity, specificity, consistency rate, and the area under the receiver operating characteristic curves (AUC) for the diagnosis of tuberculosis. Besides, adverse events (AE) and severe adverse events (SAE) were also evaluated. Results The clinical research was conducted in six general infectious disease hospitals across China. A total of 1,165 participants were enrolled, and 1,161 were enrolled in the full analysis set (FAS). Men accounted for 60.0% (697/1,161). Compared to the results from radiologists on the board, the software showed a sensitivity of 94.2% (95% CI: 92.0-95.8%) and a specificity of 91.2% (95% CI: 88.5-93.2%). The consistency rate was 92.7% (91.1-94.1%), with a Kappa value of 0.854 (P = 0.000). The AUC was 0.98. In the safety set (SS), which consisted of 1,161 participants, 0.3% (3/1,161) had AEs that were not related to the software, and no severe AEs were observed. Conclusion The software for tuberculosis screening based on a convolutional neural network algorithm is effective and safe. It is a potential candidate for solving tuberculosis screening problems in areas lacking radiologists with a high TB burden.
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Affiliation(s)
- Yang Yang
- Department of Tuberculosis, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai, China
| | - Lu Xia
- Department of Pulmonary Medicine, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital/The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Ping Liu
- Department of Tuberculosis, Shanghai Public Health Clinical Center Affiliated to Fudan University, Shanghai, China
| | - Fuping Yang
- Department of Tuberculosis, Chongqing Public Health Medical Center, Southwest University, Chongqing, China
| | - Yuqing Wu
- Department of Tuberculosis, Jiangxi Chest Hospital, Nanchang, Jiangxi, China
| | - Hongqiu Pan
- Department of Tuberculosis, The Third Hospital of Zhenjiang, Zhenjiang, Jiangsu, China
| | - Dailun Hou
- Department of Radiology, Beijing Chest Hospital, Capital Medical University, Beijing, China
| | - Ning Liu
- Department of Tuberculosis, Hebei Chest Hospital, Shijiangzhuang, Hebei, China
| | - Shuihua Lu
- Department of Pulmonary Medicine, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital/The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China
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Naidu A, Nayak SS, Lulu S S, Sundararajan V. Advances in computational frameworks in the fight against TB: The way forward. Front Pharmacol 2023; 14:1152915. [PMID: 37077815 PMCID: PMC10106641 DOI: 10.3389/fphar.2023.1152915] [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: 01/28/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023] Open
Abstract
Around 1.6 million people lost their life to Tuberculosis in 2021 according to WHO estimates. Although an intensive treatment plan exists against the causal agent, Mycobacterium Tuberculosis, evolution of multi-drug resistant strains of the pathogen puts a large number of global populations at risk. Vaccine which can induce long-term protection is still in the making with many candidates currently in different phases of clinical trials. The COVID-19 pandemic has further aggravated the adversities by affecting early TB diagnosis and treatment. Yet, WHO remains adamant on its "End TB" strategy and aims to substantially reduce TB incidence and deaths by the year 2035. Such an ambitious goal would require a multi-sectoral approach which would greatly benefit from the latest computational advancements. To highlight the progress of these tools against TB, through this review, we summarize recent studies which have used advanced computational tools and algorithms for-early TB diagnosis, anti-mycobacterium drug discovery and in the designing of the next-generation of TB vaccines. At the end, we give an insight on other computational tools and Machine Learning approaches which have successfully been applied in biomedical research and discuss their prospects and applications against TB.
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Affiliation(s)
| | | | | | - Vino Sundararajan
- Department of Biotechnology, School of Bio Sciences and Technology, VIT University, Vellore, India
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Shin HJ, Lee S, Kim S, Son NH, Kim EK. Hospital-wide survey of clinical experience with artificial intelligence applied to daily chest radiographs. PLoS One 2023; 18:e0282123. [PMID: 36862644 PMCID: PMC9980810 DOI: 10.1371/journal.pone.0282123] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/07/2023] [Indexed: 03/03/2023] Open
Abstract
PURPOSE To assess experience with and perceptions of clinical application of artificial intelligence (AI) to chest radiographs among doctors in a single hospital. MATERIALS AND METHODS A hospital-wide online survey of the use of commercially available AI-based lesion detection software for chest radiographs was conducted with all clinicians and radiologists at our hospital in this prospective study. In our hospital, version 2 of the abovementioned software was utilized from March 2020 to February 2021 and could detect three types of lesions. Version 3 was utilized for chest radiographs by detecting nine types of lesions from March 2021. The participants of this survey answered questions on their own experience using AI-based software in daily practice. The questionnaires were composed of single choice, multiple choices, and scale bar questions. Answers were analyzed according to the clinicians and radiologists using paired t-test and the Wilcoxon rank-sum test. RESULTS One hundred twenty-three doctors answered the survey, and 74% completed all questions. The proportion of individuals who utilized AI was higher among radiologists than clinicians (82.5% vs. 45.9%, p = 0.008). AI was perceived as being the most useful in the emergency room, and pneumothorax was considered the most valuable finding. Approximately 21% of clinicians and 16% of radiologists changed their own reading results after referring to AI, and trust levels for AI were 64.9% and 66.5%, respectively. Participants thought AI helped reduce reading times and reading requests. They answered that AI helped increase diagnostic accuracy and were more positive about AI after actual usage. CONCLUSION Actual adaptation of AI for daily chest radiographs received overall positive feedback from clinicians and radiologists in this hospital-wide survey. Participating doctors preferred to use AI and regarded it more favorably after actual working with the AI-based software in daily clinical practice.
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Affiliation(s)
- Hyun Joo Shin
- Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea
- Center for Digital Health, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea
| | - Seungsoo Lee
- Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea
| | - Sungwon Kim
- Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Nak-Hoon Son
- Department of Statistics, Keimyung University, Daegu, Republic of Korea
| | - Eun-Kyung Kim
- Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea
- Center for Digital Health, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea
- * E-mail:
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Liang S, Ma J, Wang G, Shao J, Li J, Deng H, Wang C, Li W. The Application of Artificial Intelligence in the Diagnosis and Drug Resistance Prediction of Pulmonary Tuberculosis. Front Med (Lausanne) 2022; 9:935080. [PMID: 35966878 PMCID: PMC9366014 DOI: 10.3389/fmed.2022.935080] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022] Open
Abstract
With the increasing incidence and mortality of pulmonary tuberculosis, in addition to tough and controversial disease management, time-wasting and resource-limited conventional approaches to the diagnosis and differential diagnosis of tuberculosis are still awkward issues, especially in countries with high tuberculosis burden and backwardness. In the meantime, the climbing proportion of drug-resistant tuberculosis poses a significant hazard to public health. Thus, auxiliary diagnostic tools with higher efficiency and accuracy are urgently required. Artificial intelligence (AI), which is not new but has recently grown in popularity, provides researchers with opportunities and technical underpinnings to develop novel, precise, rapid, and automated implements for pulmonary tuberculosis care, including but not limited to tuberculosis detection. In this review, we aimed to introduce representative AI methods, focusing on deep learning and radiomics, followed by definite descriptions of the state-of-the-art AI models developed using medical images and genetic data to detect pulmonary tuberculosis, distinguish the infection from other pulmonary diseases, and identify drug resistance of tuberculosis, with the purpose of assisting physicians in deciding the appropriate therapeutic schedule in the early stage of the disease. We also enumerated the challenges in maximizing the impact of AI in this field such as generalization and clinical utility of the deep learning models.
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Affiliation(s)
- Shufan Liang
- Department of Respiratory and Critical Care Medicine, Med-X Center for Manufacturing, Frontiers Science Center for Disease-Related Molecular Network, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
- Precision Medicine Key Laboratory of Sichuan Province, Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jiechao Ma
- AI Lab, Deepwise Healthcare, Beijing, China
| | - Gang Wang
- Precision Medicine Key Laboratory of Sichuan Province, Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Shao
- Department of Respiratory and Critical Care Medicine, Med-X Center for Manufacturing, Frontiers Science Center for Disease-Related Molecular Network, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Jingwei Li
- Department of Respiratory and Critical Care Medicine, Med-X Center for Manufacturing, Frontiers Science Center for Disease-Related Molecular Network, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Hui Deng
- Department of Respiratory and Critical Care Medicine, Med-X Center for Manufacturing, Frontiers Science Center for Disease-Related Molecular Network, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
- Precision Medicine Key Laboratory of Sichuan Province, Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Hui Deng,
| | - Chengdi Wang
- Department of Respiratory and Critical Care Medicine, Med-X Center for Manufacturing, Frontiers Science Center for Disease-Related Molecular Network, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
- Chengdi Wang,
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, Med-X Center for Manufacturing, Frontiers Science Center for Disease-Related Molecular Network, West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
- Weimin Li,
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