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Article History

Received: 17 July 2025

Accepted: 29 July 2026

First Online: 5 August 2026

Declarations

Ethics approval and consent to participate: This research was conducted using secondary data and has been determined to be exempt from IRB review under the University of Wisconsin-Madison Institutional Review Board policies with a formal IRB waiver. De-identified data were obtained from the NIH All of Us Research Program, which implements a broad informed consent model under rigorous ethical and regulatory oversight. The NIH All of Us Research Program collects biospecimens and electronic health records under an IRB-approved protocol that adheres to federal regulations including the Common Rule (45 CFR 46). Participants voluntarily enroll and provide electronic informed consent through a process that includes multimedia materials to enhance understanding, covering topics such as data sharing, privacy protections, and withdrawal rights. Information on this consent process and governance is available at .

Consent for publication: Not applicable, as the manuscript does not contain any identifiable individual person’s data.

Competing interests: T.L. has been consulting for Five Prime Sciences Inc. for research programs unrelated to this study. W.Z. is an employee of Regeneron Pharmaceuticals, Inc., and the employer had no role in the design, conduct, or reporting of this research. The other authors declare no conflict of interest.