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Article History

Received: 25 August 2025

Revised: 20 January 2026

Accepted: 28 April 2026

First Online: 13 May 2026

Competing interests

: The authors have no competing interests to declare.

: All methods were performed in accordance with the relevant guidelines and regulations. The present study is based on publicly available data from the National Health and Nutrition Examination Survey (NHANES), conducted by the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC). The NHANES protocol was reviewed and approved by the NCHS Research Ethics Review Board (ERB) (Protocol #2021–2023). Detailed documentation of ethical approval is available on the NHANES website. Written informed consent was obtained from all participants by NHANES prior to data collection. The current analysis used de-identified publicly available data and therefore did not require additional institutional ethics approval. No identifiable images of human participants are included in this manuscript. Therefore, written informed consent for publication of identifiable images was not required.