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Article History

Received: 31 December 2024

Accepted: 21 May 2025

First Online: 30 May 2025

Declarations

:

: This study was approved by the ethics committees of the Guilan University of Medical Sciences [پ/3/132/3422]. The methods were carried out in agreement with the principles and propositions established in the Declaration of Helsinki for all human or animal subjects.

: We informed all participants provided verbal consent to participate in the study and signed the consent form in the presence of a witness. Written consent was obtained from literate individuals. In cases where the participants were unable to sign a form, because of a language barrier or cognitive decline, their legal guardian/family or an appropriate representative gave informed consent to participate on their behalf and signed a form in a written format.

: Not applicable.

: The authors declare no competing interests.