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Article History

Received: 6 February 2026

Accepted: 12 August 2026

First Online: 14 August 2026

Declarations

Ethics approval and consent to participate: Ethical approval for this study was granted by the Research Ethics Committee on Human Subjects of Universidad San Francisco de Quito (CEISH-USFQ) (Reference: 2025-101IN).The study complied with the ethical principles outlined in the Declaration of Helsinki (2013 revision).Ethical approval was obtained from CEISH-USFQ because data collection was conducted in Ecuador, and this committee is nationally accredited to review research involving human participants within the country. Although the authors are affiliated with other institutions, CEISH-USFQ served as the legally authorized ethics body for this study.Informed consent was obtained electronically from all participants prior to participation in the survey. Participants were first presented with an information page describing the study objectives, voluntary nature of participation, confidentiality of responses, and their right to withdraw at any time without consequences. Only participants who agreed to participate were allowed to proceed to the questionnaire.

Consent for publication: Not applicable.

Competing interests: The authors declare no competing interests.