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Article History

Received: 13 January 2026

Accepted: 20 March 2026

First Online: 26 March 2026

Declarations

:

: This study was conducted using data from the TriNetX Global Collaborative Network, which provides access only to de-identified and aggregated electronic health record data. Investigators did not have access to protected health information, and no direct interaction with human participants was involved. According to U.S. federal regulations (45 CFR 46), research involving exclusively de-identified data does not constitute human subjects research and does not require institutional review board (IRB) approval or informed consent. Accordingly, this study was reviewed and deemed exempt from ethics approval, and the requirement for informed consent was waived by the Western Institutional Review Board (WIRB). All study procedures were conducted in accordance with the ethical principles outlined in the Declaration of Helsinki.

: Not applicable.

: The authors declare no competing interests.