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Article History

Received: 17 July 2025

Accepted: 7 October 2025

First Online: 28 October 2025

Declarations

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: The present study was conducted in accordance with the Declaration of Helsinki and adhered to the applicable Brazilian Resolutions on research involving human beings. The research protocol was initially reviewed and approved for feasibility by the Technical Research Chamber of the New Knowledge Nucleus of the Hospital Sírio-Libanês Assistance Directorate. It was subsequently approved by the Education and Research Directorate of Hospital Sírio-Libanês (Project ID HSL 3060). Finally, it was submitted to and formally approved by the Human Research Ethics Committee – São Paulo (Comitê de Ética em Pesquisa com Seres Humanos – São Paulo - CEPesq–SP), of Sociedade Beneficente de Senhoras Hospital Sírio-Libanês (the proposing institution), under the approval protocol number CAAE: 68671023.2.0000.5461 and the substantiated opinion number 6.048.425. The requirement for the application of the ICF was waived by CEPesq-SP, as provided in Item IV.8 of Resolution nº 466/2012 of the Brazilian National Health Council (Conselho Nacional de Saúde). This waiver was granted because the project has a retrospective design, involving the collection of a large volume of patient data from the institution’s electronic health records, which would make it impractical to obtain individual consent from all participants. Additionally, the researchers committed to fully anonymizing the database before conducting the analyses, thereby ensuring the confidentiality of information and the privacy of patient data. The researchers involved committed to maintaining the confidentiality of all data.

: Not applicable. This manuscript does not contain any individual person’s data in any form (e.g., details, images, or videos) that would require consent for publication.

: The authors declare no competing interests.