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Ethics and Consent
This study was approved by the institutional review board at the Ralph H Johnson VAMC. Patient consent was not required to review medical records and this was not completed owing to the time frame of the study (many years and some patient deaths unrelated to the study). Patient consent was obtained for any necessary procedure or intervention that was included in the study. The consent was obtained at the time the original study was completed. Patients were deidentified to ensure that no patient information was exposed, in compliance with the Declaration of Helsinki.
Disclosure
The authors report no conflicts of interest for this work.