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Article History

Received: 8 September 2025

Accepted: 7 November 2025

First Online: 25 November 2025

Declarations

:

: The authors declare no competing interests.

: This study was conducted in accordance with the Declaration of Helsinki and received approval from the Ethics Committee of Mazandaran University of Medical Sciences in Sari, Iran (code: IR.MAZUMS.REC.1404.133). Prior to data collection, participants received detailed information about the study’s objectives, procedures, potential risks, and benefits. They were given the opportunity to ask questions before providing written informed consent. For individuals unable to consent independently, written consent was obtained from their legal guardians. The consent forms emphasized voluntary participation, confidentiality, anonymity, and the right to withdraw at any time without consequences. All procedures adhered to relevant ethical guidelines, including those set by the World Medical Association. Permissions to use data collection tools were obtained from their developers. The study was designed to minimize risks while safeguarding participant rights and well-being. Data were handled in compliance with institutional guidelines, ensuring secure storage and transparency regarding data usage in research dissemination.