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Prospective ethics approvals and written informed consent were obtained as follows: Fujian Medical University Union Hospital: Approval 2020YF013 (UnionH-1 and UnionH-2 cohorts); Zhangzhou Affiliated Hospital of Fujian Medical University: Approval 2023LWB046 (UnionH-3 cohort). All patients provided written informed consent prior to sample collection and analysis.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable (no individual person\u2019s identifiable data are included).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"23"}}