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Each sample was rarefied to 12,409 sequences (size of the smallest sample) for further downstream analyses such as calculation of richness, diversity and community compositional indices and matrices
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After reviewing literature and conducting a two-round Delphi survey with 42 experts, a consensus emerged that emphasizes prioritizing clinical symptoms in diagnosis, with serum B12 as a screening marker supported by methylmalonic acid or homocysteine levels for additional confirmation
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