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Contributors All authors contributed to the work, have read the final submission, and approved it.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study was awarded Institutional Review Board (IRB) Review Exempt status by the Lake Erie College of Osteopathic Medicine (LECOM).
Provenance and peer review Not commissioned; externally peer reviewed.