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Article History

Received: 5 September 2025

Accepted: 16 November 2025

First Online: 27 November 2025

Declarations

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: Data from this study are freely available on the NHANES homepage ( ) which has been approved by the NCHS Institutional Review Board of the CDC. All participants provided informed written consent at the time of enrollment to the NHANES study. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). As the NHANES datasets constitute publicly accessible de-identified resources, no supplementary ethics committee approval was required for secondary data analysis, which references guidance on secondary analysis of existing datasets ( ).

: The authors declare no competing interests.