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Article History

Received: 1 December 2025

Revised: 6 February 2026

Accepted: 18 February 2026

First Online: 28 February 2026

Declarations

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: This data analysis is based on data from the SHIP cohort study. The SHIP protocol was approved by the ethics committee of the University Medicine Greifswald (reference: BB 39/08) and complies with the 1964 Declaration of Helsinki in its current version. Written informed consent was obtained from all participants prior to inclusion. Participation was voluntary and could be withdrawn at any time without negative consequences.

: Although the co-author Thomas Penzel is the Editor of the journal, there was no involvement with the peer review process for this article. The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

: During the preparation of this work, the authors used ChatGPT (OpenAI) in order to improve the readability and language of the manuscript. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article.