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Article History

Accepted: 21 May 2026

First Online: 22 June 2026

Declarations

:

: This work was supported by the Intramural Research Program of the Fundação Oswaldo Cruz (Bruno B. Andrade). Beatriz Barreto-Duarte received a fellowship from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Finance code: 001). Bruno B. Andrade is a senior investigator and Fellow of the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil. The funders had no role in the study design, data collection, and interpretation, or the decision to submit the work for publication.

: Deivide Oliveira-de-Souza, Diego Viana Gomes, Juliano Spineti, Antônio Pedro Farias Net, Humberto Miranda, Bruna Karoline Lima Piazera, Ricardo Luzardo, Artur TL Queiroz, Beatriz Barreto-Duarte, and Bruno B. Andrade have no conflicts of interest that are directly relevant to the content of this arricle.

: All clinical procedures were conducted in accordance with the principles expressed in the Declaration of Helsinki. The study protocol was reviewed and approved by the Research Ethics Committee of Centro Universitário de Volta Redonda/Fundação Oswaldo Aranha (UNIFOA), approval number 68281723.4.0000.5237.

: All participants were fully informed about the objectives and procedures of the study and provided written informed consent to participate prior to enrollment.

: Not applicable.

: The data that support the findings of this study are available from the corresponding author upon reasonable request.

: Not applicable.

: BBA, DVG, BBD, and DOS designed the study and mentored the work; JS, APFN, HM, BKLP, and RL performed the experiments and data collection; BBA, DOS, and ATLQ performed the data analyses; ATLQ contributed to methodological refinement, and DOS wrote the first draft of the manuscript. All authors reviewed and approved the final version of the manuscript.