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In Saudi Arabia, approvals were granted by the Research Ethics Committee of King Abdulaziz University (KAU) (257-07-21), the Institutional Review Board of the Ministry of Health in Jeddah (H-02-J-002), the Institutional Review Board of the Ministry of Health in Riyadh (H-01-R012), the Research Ethics Committee of King Fahd Armed Forces Hospital (KFAFH) (REC-391), and the Institutional Review Board of the Ministry of National Guard at King Abdullah International Medical Research Center (KAIMRC) (H-01-R-005). Additional approvals were obtained from King Fahad Medical City (20\u2013642), the Jordan University of Science and Technology (104\/147\/2022) in Jordan, the Scientific Ethics Committee of Fayoum University (R446-session 105) in Egypt, and the Institutional Review Board of Kuwait (IRB#2017\u2009\u2212\u2009562). Informed consent was obtained from the parents or legal guardians of all participants, in accordance with the Declaration of Helsinki. 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