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Article History

Received: 19 March 2025

Accepted: 26 December 2025

First Online: 2 January 2026

Declarations

:

: This study received approval from the Institutional Review Board (IRB) at Guilan University of Medical Sciences (GUMS) in Rasht, Iran, under the authorization number IR.GUMS.REC.1402.316. It adheres to the ethical principles outlined in the 2013 Helsinki Declaration. A clear and comprehensive explanation of the study’s objectives was provided to all participants, who then gave their written informed consent voluntarily. Participant privacy and anonymity were preserved, with no personal information disclosed, and all individuals were treated equally. Participation was entirely voluntary, and individuals could withdraw at any time without penalty. The use of a coded questionnaire helped maintain confidentiality and address privacy concerns. Participants also had the right to benefit from the researchers’ knowledge and expertise.

: Not applicable.

: The authors declare no competing interests.