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A formal cooperation letter was submitted to the respective university administrations, and official permission was obtained prior to data collection. The study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Participation was entirely voluntary. Written informed consent was obtained from each study participant before enrollment. Participants were informed about the purpose of the study, procedures, risks\/benefits, confidentiality, and their right to withdraw at any time without any consequences. All information collected from participants was kept confidential, and no personal identifiers were recorded. Data were anonymized and used only for research purposes.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable. No identifying images, personal identifiers, or clinical details of individual participants are included in this manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"117"}}