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Authors
de Araújo, Alda Neis Miranda https://orcid.org/0000-0003-3649-8683
Ferreira, Vinicius Guimarães https://orcid.org/0000-0001-8053-3867
Leroux, Isabelle Nogueira https://orcid.org/0000-0003-1475-2281
de Oliveira, Danilo Cardoso
Porcari, Andreia M. https://orcid.org/0000-0003-4244-8594
Olympio, Kelly Polido Kaneshiro https://orcid.org/0000-0002-4257-8295
de Assunção, Nilson Antônio https://orcid.org/0000-0002-3747-0415
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Funding
Funding for this research was provided by:
Universidade De São Paulo
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Article History
Received: 25 November 2025
Accepted: 6 April 2026
First Online: 16 April 2026
Declarations
Ethics Approval and Consent to Participate: This study was approved by the Research Ethics Committee (Comitê de Ética em Pesquisa – CEP, in Portuguese) of the School of Public Health, University of São Paulo (FSP/USP) (CAAE No. 41965115.0.0000.5421; Approval No. 2.570.584), by the CEP of the Federal University of São Paulo (UNIFESP) (CAAE No. 04354818.0.1001.5505; Approval No. 3.647.533), and by the Brazilian National Research Ethics Commission (Conselho Nacional de Ética em Pesquisa - CONEP, in Portuguese) (CAAE No. 13458919.7.0000.5421; Approval No. 3.537.461). All participants voluntarily agreed to participate in the study and signed a standardized informed consent form. Participant confidentiality was maintained throughout, with no identifying information included in the manuscript. All procedures followed institutional ethical standards and the 1964 Helsinki Declaration and its later amendments.
Consent for Publication: Not applicable.
Competing interests: The authors declare no competing interests.
Clinical Trial Number: Not applicable.
Declaration of Generative AI in Scientific Writing: During the preparation of this work, the authors used ChatGPT and perplexity to improve English language and style. ChatGPT was also used to generate preliminary illustrative concepts, which served only as inspiration. All final figures were manually created by the authors, who take full responsibility for the content of the manuscript.
