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After approval, the process was conducted from December 2025 to June 2026 in Iraq. No human or animal samples were used in this study. This study was not a clinical trial. All methods were performed in accordance with the relevant guidelines and regulations. All authors declare that during the preparation of this manuscript, the authors used the following artificial intelligence (AI) tool: QuillBot (Chicago, USA) available from:\n                      \n                      . The AI tool was used solely for the following purposes: language editing and grammatical correction, text refinement, and paraphrase. AI tools were not listed as authors. All AI-assisted content was carefully reviewed and verified by the authors to ensure accuracy and to prevent fabricated data, references, or unsupported claims. The authors accept full responsibility and accountability for the accuracy and integrity of the data and the originality of the contents. Clinical trial number: not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Clinical trial number","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1654"}}