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Article History

Received: 23 April 2026

Accepted: 25 June 2026

First Online: 21 July 2026

Declarations

Ethics approval and consent to participate: The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Boards of Cedars-Sinai Medical Center (IRB# STUDY00000451, approved on 14 February 2020) and University of British Columbia (IRB # H09-01628, H16-01490, H20-02726, approved on Jan 2009, Jan 2016 and Jan 2020, respectively). Written informed consent was obtained for the University of British Columbia, while consent was waived for Cedars-Sinai Medical Center due to the use of archived, de-identified samples and clinical data.

Consent for publication: For the cohort of the University of British Columbia, written informed consent for participation and publication of anonymized data was obtained from all participants. For the Cedars-Sinai Medical Center cohort, consent for publication was waived by the Institutional Review Boards, as only de-identified archived samples and clinical data were used in accordance with institutional and national regulations.

Competing interests: C.J.R. is a founder and CEO of Nonagen Bioscience Corp. Other authors have no potential conflicts of interest to disclose, financial or otherwise.