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Article History

Received: 9 February 2026

Accepted: 15 May 2026

First Online: 4 June 2026

Declarations

:

: The Cohort 1 study was approved by the Institutional Review Boards (IRBs) at the State University of New York, Stony Brook (1985–1992) and North Shore University Hospital, Manhasset, NY (1992–2005). All patients provided informed consent to participate. For Cohorts 2 and 3, IRB approval was waived, and consent was not required, for review of anonymized data obtained for clinical purposes (Cohort 2, IRB at Mayo Clinic, Rochester MN; Cohort 3, IRB at Atlantic Health, Morristown NJ). All studies were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

: Not applicable.

: The authors declare no competing interests.