{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T22:31:06Z","timestamp":1789079466870,"version":"build-2803163510"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Discov Ment Health"],"DOI":"10.1007\/s44192-026-00405-8","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T06:05:46Z","timestamp":1773727546000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring the Association Between Psychological Stress and Dermatological Conditions in Jordanian Medical Students"],"prefix":"10.1007","volume":"6","author":[{"given":"Rand","family":"Murshidi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assem","family":"Al Refaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour","family":"Shewaikani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jehad Feras","family":"AlSamhori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haneen","family":"Alassaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghad","family":"Owais","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Alshumemry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmeen","family":"Aburomman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour","family":"Saifan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muayyad","family":"Murshidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salsabiela","family":"Bani Hamad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"405_CR1","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1146\/annurev-psych-062520-122331","volume":"72","author":"DB O\u2019Connor","year":"2021","unstructured":"O\u2019Connor DB, Thayer JF, Vedhara K. Stress and health: A review of psychobiological processes. Annu Rev Psychol. 2021;72:663\u201388.","journal-title":"Annu Rev Psychol"},{"issue":"39","key":"405_CR2","doi-asserted-by":"publisher","first-page":"14126","DOI":"10.3748\/wjg.v20.i39.14126","volume":"20","author":"HY Qin","year":"2014","unstructured":"Qin HY, Cheng CW, Tang XD, Bian ZX. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014;20(39):14126\u201331.","journal-title":"World J Gastroenterol"},{"key":"405_CR3","unstructured":"The stress of life. [Internet]. [cited 2023 Nov 28]. Available from: https:\/\/psycnet.apa.org\/record\/1957-08247-000"},{"issue":"1","key":"405_CR4","doi-asserted-by":"publisher","first-page":"146","DOI":"10.3390\/stresses2010011","volume":"2","author":"JA Hinds","year":"2022","unstructured":"Hinds JA, Sanchez ER. The role of the hypothalamus\u2013pituitary\u2013adrenal (HPA) axis in test-induced anxiety: assessments, physiological responses, and molecular Details. Stresses 2022;2(1):146\u201355. https:\/\/www.mdpi.com\/2673-7140\/2\/1\/11\/htm","journal-title":"Stresses"},{"key":"405_CR5","doi-asserted-by":"publisher","first-page":"108687","DOI":"10.1016\/j.biopsycho.2023.108687","volume":"183","author":"R von K\u00e4nel","year":"2023","unstructured":"von K\u00e4nel R, Princip M, Holzgang SA, Sivakumar S, Pazhenkottil AP, Gomez Vieito D et al. Sympathetic nervous system responses to acute psychosocial stress in male physicians with clinical burnout. Biol Psychol. 2023;183: 108687","journal-title":"Biol Psychol."},{"key":"405_CR6","doi-asserted-by":"crossref","unstructured":"Rosiek A, Rosiek-Kryszewska A, Leksowski \u0141, Leksowski K. Chronic stress and suicidal thinking among medical students. Int J Environ Res Public Health. 2016;13(2)","DOI":"10.3390\/ijerph13020212"},{"issue":"7\u20138","key":"405_CR7","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1080\/09540261.2019.1670402","volume":"31","author":"R Masri","year":"2019","unstructured":"Masri R, Kadhum M, Farrell SM, Khamees A, Al-Taiar H, Molodynski A. Wellbeing and mental health amongst medical students in Jordan: a descriptive study. Int Rev Psychiatry. 2019;31(7\u20138):619\u201325. .","journal-title":"Int Rev Psychiatry"},{"key":"405_CR8","doi-asserted-by":"publisher","first-page":"605676","DOI":"10.3389\/fpsyt.2021.605676","volume":"12","author":"H Saadeh","year":"2021","unstructured":"Saadeh H, Saadeh M, Almobaideen W, Al Refaei A, Shewaikani N, Al Fayez RQ, et al. Effect of COVID-19 quarantine on the sleep quality and the depressive symptom levels of university students in Jordan during the spring of 2020. Front Psychiatry. 2021;12:605676.","journal-title":"Front Psychiatry"},{"issue":"1","key":"405_CR9","first-page":"13","volume":"39","author":"L Pukas","year":"2022","unstructured":"Pukas L, Rabkow N, Keuch L, Ehring E, Fuchs S, Stoevesandt D et al. Prevalence and predictive factors for depressive symptoms among medical students in Germany \u2013 a cross-sectional study. GMS J Med Educ . 2022;39(1) :13.","journal-title":"GMS J Med Educ"},{"issue":"5","key":"405_CR10","doi-asserted-by":"publisher","first-page":"516","DOI":"10.3329\/jhpn.v29i5.8906","volume":"29","author":"HM Abdulghani","year":"2011","unstructured":"Abdulghani HM, AlKanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris EA. Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia. J Health Popul Nutr. 2011;29(5):516\u201322.","journal-title":"J Health Popul Nutr"},{"key":"405_CR11","doi-asserted-by":"publisher","first-page":"969","DOI":"10.2147\/AMEP.S371053","volume":"13","author":"Y Mahgoub","year":"2022","unstructured":"Mahgoub Y, Daher-Nashif S, Al-Shebly R, Wali HS, Khan A, Almarkhi A et al. Prevalence and determinants of mental health problems and mental health stigma among medical students of different nationalities in Qatar. Adv Med Educ Pract . 2022;13:969\u201379.","journal-title":"Adv Med Educ Pract"},{"issue":"1","key":"405_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40359-022-00739-2","volume":"10","author":"E Maalouf","year":"2022","unstructured":"Maalouf E, Hallit S, Obeid S. Personality traits and quality of life among Lebanese medical students: any mediating effect of emotional intelligence? A path analysis approach. BMC Psychol. 2022;10(1):1\u201312. https:\/\/doi.org\/10.1186\/s40359-022-00739-2","journal-title":"BMC Psychol"},{"issue":"1","key":"405_CR13","doi-asserted-by":"publisher","first-page":"62","DOI":"10.36849\/JDD.5608","volume":"20","author":"MD Sun","year":"2021","unstructured":"Sun MD, Rieder EA. Psychosocial stress and mechanisms of skin health: a comprehensive update. J Drugs Dermatol. 2021;20(1):62\u20139.","journal-title":"J Drugs Dermatol"},{"issue":"1","key":"405_CR14","doi-asserted-by":"publisher","first-page":"6334","DOI":"10.1038\/s41598-018-24653-z","volume":"8","author":"SJ Choe","year":"2018","unstructured":"Choe SJ, Kim D, Kim EJ, Ahn JS, Choi EJ, Son ED et al. Psychological stress deteriorates skin barrier function by activating 11\u03b2-Hydroxysteroid dehydrogenase 1 and the HPA axis. Sci Rep. 2018;8(1): 6334.","journal-title":"Sci Rep"},{"issue":"1","key":"405_CR15","first-page":"11","volume":"2012","author":"JMF Hall","year":"2012","unstructured":"Hall JMF, Cruser D, Podawiltz A, Mummert DI, Jones H, Mummert ME. Psychological stress and the cutaneous immune response: roles of the HPA axis and the sympathetic nervous system in atopic dermatitis and psoriasis. Dermatol Res Pract. 2012;2012(1):11.","journal-title":"Dermatol Res Pract"},{"key":"405_CR16","doi-asserted-by":"publisher","first-page":"103","DOI":"10.2147\/CCID.S126850","volume":"11","author":"M Heisig","year":"2018","unstructured":"Heisig M, Reich A. Psychosocial aspects of rosacea with a focus on anxiety and depression. Clin Cosmet Investig Dermatol. 2018;11:103.","journal-title":"Clin Cosmet Investig Dermatol"},{"issue":"1","key":"405_CR17","doi-asserted-by":"publisher","first-page":"0227909","DOI":"10.1371\/journal.pone.0227909","volume":"15","author":"SW Henning","year":"2020","unstructured":"Henning SW, Jaishankar D, Barse LW, Dellacecca ER, Lancki N, Webb K et al. The relationship between stress and vitiligo: evaluating perceived stress and electronic medical record data. PLoS One. 2020;15(1).","journal-title":"PLoS One"},{"issue":"1","key":"405_CR18","doi-asserted-by":"publisher","first-page":"7","DOI":"10.2340\/00015555-1188","volume":"92","author":"AL Su\u00e1rez","year":"2012","unstructured":"Su\u00e1rez AL, Feramisco JD, Koo J, Steinhoff M. Psychoneuroimmunology of psychological stress and atopic dermatitis: pathophysiologic and therapeutic updates. Acta Derm Venereol . 2012;92(1):7.","journal-title":"Acta Derm Venereol"},{"issue":"5","key":"405_CR19","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1111\/bjd.16116","volume":"178","author":"I Snast","year":"2018","unstructured":"Snast I, Reiter O, Atzmony L, Leshem YA, Hodak E, Mimouni D, et al. Psychological stress and psoriasis: a systematic review and meta-analysis. Br J Dermatol . 2018;178(5):1044\u201355.","journal-title":"Br J Dermatol"},{"issue":"1","key":"405_CR20","doi-asserted-by":"publisher","first-page":"59","DOI":"10.15537\/smj.2018.1.21231","volume":"39","author":"GA Bin Saif","year":"2018","unstructured":"Bin Saif GA, Alotaibi HM, Alzolibani AA, Almodihesh NA, Albraidi HF, Alotaibi NM, et al. Association of psychological stress with skin symptoms among medical students. Saudi Med J. 2018;39(1):59\u201366.","journal-title":"Saudi Med J"},{"issue":"4","key":"405_CR21","doi-asserted-by":"publisher","first-page":"550","DOI":"10.2340\/00015555-2291","volume":"96","author":"C Schut","year":"2016","unstructured":"Schut C, Mollanazar NK, Sethi M, Nattkemper LA, Valdes-Rodriguez R, Lovell MM, et al. Psychological stress and skin symptoms in college students: results of a cross-sectional web-based questionnaire study. Acta Derm Venereol. 2016;96(4):550\u20131.","journal-title":"Acta Derm Venereol"},{"key":"405_CR22","doi-asserted-by":"publisher","first-page":"876561","DOI":"10.3389\/fmed.2022.876561","volume":"9","author":"AR Mahadi","year":"2022","unstructured":"Mahadi AR, Rafi MA, Shahriar T, Seemanta S, Rabbani MG, Akter M et al. Association between hair diseases and COVID-19 pandemic-related stress: a cross-sectional study analysis. Front Med (Lausanne). 2022;9:876561.","journal-title":"Front Med (Lausanne)"},{"issue":"1","key":"405_CR23","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/0022-3999(93)90120-5","volume":"37","author":"S Levenstein","year":"1993","unstructured":"Levenstein S, Prantera C, Varvo V, Scribano ML, Berto E, Luzi C, et al. Development of the perceived stress questionnaire: a new tool for psychosomatic research. J Psychosom Res. 1993;37(1):19\u201332.","journal-title":"J Psychosom Res"},{"issue":"4","key":"405_CR24","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1046\/j.1365-2133.2003.05596.x","volume":"149","author":"F Dalgard","year":"2003","unstructured":"Dalgard F, Svensson \u00c5, Holm J, Sundby J. Self-reported skin complaints: validation of a questionnaire for population surveys. Br J Dermatol. 2003;149(4):794\u2013800.","journal-title":"Br J Dermatol"},{"issue":"3","key":"405_CR25","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1111\/j.1365-2230.1994.tb01167.x","volume":"19","author":"AY FINLAY","year":"1994","unstructured":"FINLAY AY. Dermatology Life Quality Index (DLQI)-a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994;19(3):210\u20136.","journal-title":"Clin Exp Dermatol"},{"issue":"10","key":"405_CR26","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","volume":"166","author":"RL Spitzer","year":"2006","unstructured":"Spitzer RL, Kroenke K, Williams JBW, L\u00f6we B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092\u20137.","journal-title":"Arch Intern Med"},{"issue":"9","key":"405_CR27","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","volume":"16","author":"K Kroenke","year":"2001","unstructured":"Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606\u201313.","journal-title":"J Gen Intern Med"},{"issue":"5","key":"405_CR28","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1213\/ANE.0000000000002864","volume":"126","author":"P Schober","year":"2018","unstructured":"Schober P, Schwarte LA. Correlation coefficients: Appropriate use and interpretation. Anesth Analg. 2018;126(5):1763\u20138. https:\/\/journals.lww.com\/anesthesia-analgesia\/fulltext\/2018\/05000\/correlation_coefficients__appropriate_use_and.50.aspx","journal-title":"Anesth Analg"},{"key":"405_CR29","volume-title":"RStudio: Integrated Development for R","author":"RStudio Team","year":"2020","unstructured":"RStudio Team. RStudio: Integrated Development for R. Boston, MA: RStudio, PBC; 2020."},{"key":"405_CR30","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2022","unstructured":"R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2022."},{"key":"405_CR31","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-24277-4","volume-title":"ggplot2: Elegant Graphics for Data Analysis","author":"H Wickham","year":"2016","unstructured":"Wickham H. ggplot2: Elegant graphics for data analysis. New York: Springer-; 2016."},{"issue":"6","key":"405_CR32","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1177\/00207640211066734","volume":"68","author":"\u0130D \u00c7imen","year":"2022","unstructured":"\u00c7imen \u0130D, Alvur TM, Co\u015fkun B, \u015e\u00fck\u00fcr NE\u00d6. Mental health of Turkish medical students during the COVID-19 pandemic. Int J Soc Psychiatry. 2022;68(6):1253\u201362.","journal-title":"Int J Soc Psychiatry"},{"key":"405_CR33","doi-asserted-by":"publisher","first-page":"2395","DOI":"10.2147\/RMHP.S273333","volume":"13","author":"B Saddik","year":"2020","unstructured":"Saddik B, Hussein A, Sharif-Askari FS, Kheder W, Temsah MH, Koutaich RA, et al. Increased levels of anxiety among medical and non-medical university students during the COVID-19 pandemic in the United Arab Emirates. Risk Manag Healthc Policy. 2020;13:2395\u2013406.","journal-title":"Risk Manag Healthc Policy"},{"key":"405_CR34","doi-asserted-by":"crossref","unstructured":"Vala N, Vachhani M, Sorani A. Study of anxiety, stress, and depression level among medical students during COVID-19 pandemic phase in Jamnagar city. Natl J Physiol Pharm Pharmacol. 2020;(0):1.","DOI":"10.5455\/njppp.2020.10.07205202031072020"},{"issue":"1","key":"405_CR35","doi-asserted-by":"publisher","first-page":"95","DOI":"10.4269\/ajtmh.20-1302","volume":"104","author":"H Essangri","year":"2021","unstructured":"Essangri H, Sabir M, Benkabbou A, Majbar MA, Amrani L, Ghannam A, et al. Predictive factors for impaired mental health among medical students during the early stage of the COVID-19 pandemic in Morocco. Am J Trop Med Hyg. 2021;104(1):95\u2013102.","journal-title":"Am J Trop Med Hyg"},{"key":"405_CR36","doi-asserted-by":"publisher","first-page":"459","DOI":"10.3389\/fpsyt.2020.00459","volume":"11","author":"J Liu","year":"2020","unstructured":"Liu J, Zhu Q, Fan W, Makamure J, Zheng C, Wang J. Online mental health survey in a medical college in China during the COVID-19 outbreak. Front Psychiatry. 2020;11:459.","journal-title":"Front Psychiatry"},{"key":"405_CR37","doi-asserted-by":"crossref","unstructured":"Levis B, Benedetti A, Thombs BD. Accuracy of patient health questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ. 2019;l1476.","DOI":"10.1136\/bmj.l1476"},{"key":"405_CR38","doi-asserted-by":"crossref","unstructured":"Alabdallat Y, Albakri KA, Al-Hanaqtah BM, Al-Dajani MH, Saleh OM, Harvey H. The Association between Smartphone Addiction, Depression and Anxiety among Medical Students in Jordan. Jordan Med J. 2023;57(1).","DOI":"10.35516\/jmj.v57i1.1102"},{"key":"405_CR39","doi-asserted-by":"crossref","unstructured":"Odero SA, Mwangi P, Odhiambo R, Mumbua Nzioka B, Shumba C, Ndirangu-Mugo E et al. Psychometric evaluation of PHQ\u20139 and GAD\u20137 among community health volunteers and nurses\/midwives in Kenya following a nation-wide telephonic survey. Front Psychiatry. 2023;14.","DOI":"10.3389\/fpsyt.2023.1123839"},{"key":"405_CR40","doi-asserted-by":"publisher","first-page":"775374","DOI":"10.3389\/fpubh.2021.775374","volume":"9","author":"A Eleftheriou","year":"2021","unstructured":"Eleftheriou A, Rokou A, Arvaniti A, Nena E, Steiropoulos P. Sleep Quality and Mental Health of Medical Students in Greece During the COVID-19 Pandemic. Front Public Health [Internet]. 2021 9:775374.","journal-title":"Front Public Health"},{"issue":"2","key":"405_CR41","doi-asserted-by":"publisher","first-page":"e0171079","DOI":"10.1371\/journal.pone.0171079","volume":"12","author":"SM Boudon","year":"2017","unstructured":"Boudon SM, Vuorinen A, Geotti-Bianchini P, Wandeler E, Kratschmar DV, Heidl M, et al. Novel 11\u03b2-hydroxysteroid dehydrogenase 1 inhibitors reduce cortisol levels in keratinocytes and improve dermal collagen content in human ex vivo skin after exposure to cortisone and UV. PLoS ONE. 2017;12(2):e0171079.","journal-title":"PLoS ONE"},{"issue":"4","key":"405_CR42","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1111\/ijd.12864","volume":"55","author":"HJ Kim","year":"2016","unstructured":"Kim HJ, Park JB, Lee JH, Kim IH. How stress triggers itch: a preliminary study of the mechanism of stress-induced pruritus using fMRI. Int J Dermatol. 2016;55(4):434\u201342.","journal-title":"Int J Dermatol"}],"updated-by":[{"DOI":"10.1007\/s44192-026-00588-0","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000}}],"container-title":["Discover Mental Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s44192-026-00405-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44192-026-00405-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s44192-026-00405-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T10:30:24Z","timestamp":1789036224000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s44192-026-00405-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["405"],"URL":"https:\/\/doi.org\/10.1007\/s44192-026-00405-8","relation":{},"ISSN":["2731-4383"],"issn-type":[{"value":"2731-4383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"11 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 September 2026","order":6,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":7,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s44192-026-00588-0","URL":"https:\/\/doi.org\/10.1007\/s44192-026-00588-0","order":9,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The Institutional Review Board of Jodan University Hospital approved this study (IRB No.https:\/\/doi.org\/10\/2023\/7810). The study was conducted in accordance with the ethical standards of the Declaration of Helsinki. A copy of the approval letter is attached to the submission. Written informed consent was obtained from all participants prior to participation in the study.","order":1,"name":"Ethics","label":"Ethical approval and Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"69"}}