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Article History

Received: 20 December 2024

Accepted: 14 November 2025

First Online: 30 January 2026

Declarations

:

: This study was conducted in accordance with the ethical standards of the Institutional Review Board (IRB) of the University of Tennessee Health Science Center (UTHSC). The study protocol was approved by the UTHSC Institutional Review Board (IRB) under protocol number 21-07972-XP. The study utilized retrospective, identifiable medical record data accessed from the UTHSC-ORNL Center for Biomedical Informatics (CBMI) Research Enterprise Data Warehouse (rEDW). Because the research involved secondary use of existing data, the requirement for informed consent was waived in accordance with federal regulations governing human-subjects research (45 CFR 46.116(d)). The IRB reviewed all study materials and determined that the project complied with the regulatory requirements for the protection of human subjects and that appropriate measures were in place to safeguard participant privacy and data confidentiality. This research complied with the 1964 Declaration of Helsinki and its later amendments, adhering to the principles of ethical oversight, participant privacy and protection, risk minimization, and transparency in conduct and reporting.

: Not applicable.

: The authors declare no competing interests.