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Because of the retrospective design, the use of routinely collected clinical records, the absence of identifiable patient data in the manuscript and the use of an opt-in digital questionnaire containing explicit consent for anonymized scientific analysis, formal Ethics Committee approval was not required according to local practice and applicable institutional procedures. The WhatsApp invitation contained no sensitive clinical details. Survey responses were linked to clinical records through a pseudonymized alphanumeric code; the linkage key was stored separately and removed before aggregate analysis. 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