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Article History

Received: 29 November 2025

Accepted: 7 May 2026

First Online: 20 May 2026

Declarations

:

: The study protocol was reviewed and approved by the Ethics Committee of Mazandaran University of Medical Sciences (IR.MAZUMS.REC.1403.513). All procedures involving human participants were conducted in accordance with institutional and national ethical standards and the 1964 Helsinki Declaration, including its later amendments. Permission to conduct the study was obtained from the relevant authorities. Before data collection, a trained researcher explained the study objectives to participants and emphasized that participation was voluntary, with no negative consequences for refusal. Written informed consent was obtained from all participants. Confidentiality and anonymity were strictly maintained, and access to the data was limited to the research team.

: Not applicable.

: The authors declare no competing interests.