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Article History

Received: 28 April 2025

Accepted: 3 November 2025

First Online: 25 November 2025

Declarations

:

: This research project was approved by the Ethics Committee of Mazandaran University of Medical Sciences (code no. IR.MAZUMS.REC.1400.093), Sari, Iran. Also registered under number the Iranian Clinical Trials Center (IRCT20091220002898N14, 01/07/2022), All the procedures implemented in this study involving human participants were also in accordance with the ethical standards of the Institutional and/or National Research Ethics Committee and the Declaration of Helsinki 1964 and its later amendments or comparable ethical protocols. To comply with the ethical considerations, informed consent was obtained from the participants upon explaining the study objectives, and they were ensured about the confidentiality of their information and responses.

: Not applicable.

: The authors acknowledge that artificial intelligence tools, including language models and Grammarly, were used to assist in improving the translation, paraphrasing, and grammar of the manuscript. The scientific content, study design, data analysis, and interpretations were entirely performed and verified by the authors.

: The authors declare no competing interests.