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Article History

Received: 9 April 2025

Accepted: 25 September 2025

First Online: 31 October 2025

Declarations

:

: This study received ethical approval from the Research Ethics Committee of Kermanshah University of Medical Sciences and was conducted in accordance with national guidelines and standards for medical research in Iran (Approval Code: IR.KUMS.REC.1402.592). All procedures adhered to the ethical principles outlined by the institutional and national research committees, as well as the Declaration of Helsinki (1964) and its subsequent revisions. Before enrolling in the study, participants were provided with detailed information regarding the research objectives, methodology, potential risks and benefits, and their rights as participants. They were clearly informed that participation was entirely voluntary and that they could withdraw from the study at any time without consequence. Each participant received an information sheet and provided written informed consent. To maintain confidentiality, all data were anonymized and securely stored. No personally identifiable information was linked to the responses.

: Not applicable.

: The authors declare no competing interests.