Article History
Received: 22 September 2025
Revised: 3 March 2026
Accepted: 25 March 2026
First Online: 15 April 2026
Competing interests
: The authors declare no competing interests.
: The study was approved by Penn State College of Medicine’s Institutional Review Board, STUDY00025368. The study was performed in accordance with the Declaration of Helsinki. Because analyzed data were deidentified, no consent to participate was obtained.