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Article History

Received: 2 June 2025

Accepted: 9 September 2025

First Online: 3 November 2025

Declarations

:

: This manuscript is an original work and is being submitted for first publication in this journal. No part of it has been published elsewhere, nor is any part of it under consideration for publication in another journal.

: For this study was obtained from the Loma Linda University Institutional Review Board (IRB #518068).

: Participants were provided with a written informed consent document in their preferred language outlining the study’s purpose, procedures, risks, and benefits. They were also informed of their right to withdraw at any time. Each of the participants provided voluntary and informed consent in writing before participating in the study. In the case of participants with low literacy, the informed consent was slowly and clearly read by a study researcher and the participant was allowed to enroll in the study by “making their mark” instead of providing their signature. An unbiased witness who was neither a study team member nor a family member of the participant observed the process.

: not applicable.

: The authors declare no competing interests.