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Article History

Received: 23 August 2025

Accepted: 6 November 2025

First Online: 1 December 2025

Declarations

:

: This study was approved by the Ethics Committee of Hamadan University of Medical Sciences (Ethics Code: IR.UMSHA.REC.1401.656; Clinical Trial Registration Number: IRCT20211227053551N3; Registration Date: 2022-11-26). Prior to data collection, participants were provided with a clear explanation of the study’s objectives and procedures, and written informed consent was obtained in accordance with institutional and national ethical guidelines, as well as the Declaration of Helsinki. No names or personally identifiable information (e.g., contact details or ID numbers) were collected. To ensure anonymity and confidentiality, each participant was assigned a unique identification code, and all electronic data were stored on a password-protected computer accessible only to the research team. Hard copy materials were secured in a locked cabinet. Participants were informed that they could withdraw from the study at any stage without any consequences, and that all collected information would remain confidential and used solely for research purposes.Written informed consent was obtained from all individual participants included in the study.

: Not applicable.

: The authors declare no competing interests.