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Article History

Received: 16 May 2025

Accepted: 25 May 2026

First Online: 5 June 2026

Declarations

:

: This study was conducted in accordance with the Declaration of Helsinki. Ethical approval for NHANES was granted by the US National Center for Health Statistics Research Ethics Review Board (Protocol No. 98 − 12, 2011-17, 2018-01). All participants provided written informed consent. As the NHANES data are anonymized and publicly available, this secondary analysis was exempt from additional ethical review under 45 CFR 46.104.

: Not applicable.

: The authors declare no competing interests.