Family is the first social organization in which a person lives, and it is basically a center of help, relief, and healing, and it should decrease the mental pressure on its members and pave the way for their growth and prosperity (Mollamohamadi, 2018). One of the mental pressures that is very common today and endangers the foundations of families is domestic violence (Kumar, 2020). Violence towards spouse is one of the major problems of many countries including Iran, which brings many negative cultural, physical, and mental consequences for the victims. A cultures view of family, women and violence, social structure and laws governing a society, economic status, and peoples general opinions and beliefs are among the issues that can help to explain domestic violence in any society on a macro level (Megan et al., 2020). Domestic violence is the most common form of violence with the highest probability of repetition and the least report to the police and the most social, psychological, and economic complications, which can seriously damage the foundations of a family and lead to its collapse (Yacoubi et al., 2016). Domestic violence refers to the aggressive and domineering behavior of a family member against another member or members of the same family (Ertan et al., 2020). Given that domestic violence is one of the common issues that has attracted the attention of many researchers across the world today, it is still considered a common social harm (Isvand and Pirouzmand, 2019). Family violence is one of the most important social harms that continue to exist in society despite intellectual and cultural progress. Among the various types of domestic violence, womens violence against men has received less attention (Mittal &Singth, 2020). Domestic violence is strongly effective on decreasing psychological well-being (Perin, 2018), marital satisfaction (Walter et al., 2016), marital intimacy (Karen et al., 2017), and quality of married life of couples (Shah Hosseini et al., 2018), and quality of parent-child relationship (Pourmand et al., 2016). In order to increase the compatibility of couples and decrease marital distress in their married life improve the mental health of couples and, as a result, improve family functioning, there are various therapeutic approaches, including cognitive-behavioral therapies (CBT) (McCrady et al., 2016). This therapy is an overarching term for a general set of therapies (Twohig, 2012). Cognitive-behavioral couple therapy (CBCT) is the combination of cognitive and behavioral factors in the treatment of couples with marital problems. The cognitive foundations of cognitive-behavioral couple therapy emphasize mutual recognition of couples and consider recognition as an integral part of the process of couple change. Finally, the philosophical basis of this perception is that change in behavior alone is not enough to correct dysfunctional interactions, but rather the way of thinking of people in incompatible behavioral patterns and relationships should be emphasized (Lv et al., 2021). In a study, Siddique et al. (2012) compared the effectiveness of cognitive-behavioral couple therapy and medication therapy on depression and mental health of married women. The results indicated that cognitive-behavioral couple therapy was more effective in decreasing the symptoms of depression and improving their mental health. Therefore, this method of therapy helps clients achieve a more valuable and more satisfying life through psychological flexibility (Forman and Butryn, 2015). One of the variables that appears to be affected by cognitive behavioral therapy is self-control. Self-control expresses the conformity of ones behavioral characteristics to the existing conditions and situation (Avazpour and Touzande, 2021) and it means how flexible or stable a person is in their situation (Moser et al., 2020). People who can prioritize realistic goals and balance emotions and reason when making decisions are self-controlled (Moayyeri, 2020). People who lack self-control are vulnerable to tempting and seductive moments (Demirtaş, 2020). Thus, they suffer from panic and stress and lose their calm in sensitive situations such as the occurrence of dangerous diseases, (Yang et al., 2021). People in corona conditions should have higher self-control in order to overcome their very high stress (Schnell & Krampe, 2020). Another variable that appears to be affected by cognitive behavioral therapy is mental health.

On the other hand, in recent years, the approach of positive psychology has a special opinion on the positive dimensions of human existence, that positive thoughts and emotions have a unique effect on the mental and physical health of a person. In this approach, the ultimate goal is to identify the constructs and methods that contribute to human well-being, happiness, and growth. Therefore, the factors that cause a person to adapt more and more to the needs and threats of life are the most fundamental constructs under the research of this approach (Sacco et al., 2021). Mental health is one of the factors that can be studied for its effect and relationship with the performance of marital relationships. In recent years, the pathological approach to the study of human health has been criticized. Contrary to this view that defines health as the absence of disease, the new approach emphasizes "being good" instead of "being bad or sick" (Din Mohammadi et al., 2021). From this point of view, the absence of symptoms of mental illnesses is not an indicator of health, but adaptability, happiness, self-confidence, and positive characteristics of this kind indicate health, and the main goal of a person in life is to flourish their capabilities (Roslan et al., 2017). The mental health of couples leads to expanding the capabilities of couples and their growth, strengthening the communication skills of couples (JavadiVala et al., 2021), resolving conflicts between couples (Tasew et al., 2021), expanding the personal goals of couples and families (Allahvardipour et al., 2021), and increasing intimacy between couples (Kataoka et al., 2018). One of the variables that appears to be affected by cognitive behavioral therapy is mindfulness. Intimate partner violence (IPV) remains a pervasive issue globally, profoundly affecting the mental and emotional wellbeing of women. This form of domestic violence, characterized by aggressive and domineering behavior within family settings, not only destabilizes the very foundation of familial support but also poses severe cultural, physical, and psychological repercussions for its victims (Ertan et al., 2020; Kumar, 2020; Megan et al., 2020). Despite the intellectual and cultural progress that societies worldwide have witnessed, domestic violence, especially against women, continues to be an alarming social harm (Isvand and Pirouzmand, 2019; Yacoubi et al., 2016). The consequences of IPV extend far beyond immediate physical harm, impacting psychological well-being, marital satisfaction, intimacy, and the overall quality of life for those involved (Karen et al., 2017; Perin, 2018; Shah Hosseini et al., 2018; Walter et al., 2016). Such violence also significantly affects the parent-child relationship, further perpetuating a cycle of emotional and social challenges (Pourmand et al., 2016). Amid these distressing realities, the quest for effective therapeutic interventions has never been more critical. Cognitive Behavioral Therapy (CBT) emerges as a beacon of hope in this context. As a comprehensive therapeutic approach, CBT aims to rectify dysfunctional interactions and thought patterns contributing to the distress experienced by couples facing IPV (Lv et al., 2021; McCrady et al., 2016). This therapy focuses on enhancing mutual recognition among couples, advocating for a shift not just in behavior but in the cognitive underpinnings of relationship dynamics. Such interventions have shown promising results in reducing depression symptoms, improving mental health, and fostering a more satisfying life, thereby indicating the potential of CBT in addressing the complex challenges posed by IPV (Forman and Butryn, 2015; Siddique et al., 2012).

This study delves into the profound impacts of IPV on womens self-control, mental health, and mindfulness-elements crucial for personal stability and wellbeing in crisis situations. Self-control, a pivotal aspect of human behavior, denotes the ability to adapt ones actions to situational demands, a trait often com-promised under the duress of IPV (Avazpour and Touzande, 2021; Demirtaş, 2020; Moser et al., 2020). Moreover, IPV markedly affects mental health, diminishing individuals adaptability, happiness, and self-confidence-core indicators of wellbeing (Din Mohammadi et al., 2021; Roslan et al., 2017). Mindfulness, defined by a non-judgmental, present-moment awareness, emerges as another critical domain influenced by IPV, affecting how individuals perceive and react to both internal and external stimuli (Donnell et al., 2020; Simon et al., 2018; Zarnaghash et al., 2015). Amid these challenges, this research posits cognitive behavioral therapy (CBT) as a transformative approach to mitigating the adverse effects of IPV on self-control, mental health, and mindfulness among women. By fostering psychological flexibility and providing tools for emotional and cognitive adaptation, CBT holds the promise of guiding IPV survivors towards a path of recovery and resilience. 

The study utilizes a semi-experimental design to explore the efficacy of CBT in enhancing self-control, mental health, and mindfulness, drawing on a sample of married women seeking support at the Andisheh Sabz Center in Qom in 1401. Through this investigation, we aim to underscore the pivotal role of CBT in addressing the multifaceted impacts of IPV, advocating for its broader application in therapeutic settings to support womens journey towards healing and empowerment.

This introduction sets the stage for a comprehensive examination of the interplay between IPV, CBT, and womens psychological wellbeing, laying the groundwork for a discussion on the mechanisms through which CBT can ameliorate the effects of IPV and enhance self-control, mental health, and mindfulness among affected women.

This research is semi-experimental and applied that was conducted with a pre-test-post-test design with a control group, and after determining and randomly placing the experimental and control groups (1 experimental group and 1 control group), cognitive-behavioral couple therapy was applied to the experimental group in the form of 12 sessions, each session lasting 1 hour (60 minutes), and a week after the completion of the therapy sessions, the experimental and control groups were subjected to a post-test. The statistical population of this research included all the women admitted to Andisheh Sabz Center with the subject of filing a case of domestic violence in 2022 who were referred to this center to receive counseling and psychotherapy services. Simple random sampling method was used in this study. Thus, 30 samples were randomly selected from the clients. The inclusion criteria were: being a woman, being married for at least 5 years, not taking any psychotherapeutic drugs, not attending any other psychotherapeutic course, and obtaining a high score in Haj Yahyas domestic violence questionnaire and individual consent in participating in psycho-therapeutic courses. Finally, they were randomly assigned to two equal groups of 15 people. The sample size was calculated by the mean comparison formula with a confidence coefficient of 95% and a test power of 80%. The criteria for exclusion from the research included the individuals lack of consent and willingness, the individuals suffering from one of the chronic (medical-psychiatric) problems and the use of certain medications, not filling the questionnaires completely, being absent in the intervention sessions for more than two sessions, participating in therapy sessions similar to the present study at the same time or 6 months ago and the subjects lack of willingness and consent. The implementation method is such that first the necessary coordination was made with the officials of AndishehSabz Center by explaining the purpose of the research, the method of its implementation, compliance with ethical considerations, and the method of publishing the results in the city. Then, we went to the center, and the intended sample was determined after 1 month. Then, the pre-test was conducted in this center during two sessions. The sessions were conducted separately and independently for each group according to approved health protocols. Then, 10 days after the completion of the intervention sessions, the post-test stage was conducted for all sample subjects. The hypotheses followed in the present research are as follows:

1. Cognitive behavioral therapies affect the self-control of women suffering from domestic violence.
2. Cognitive behavioral therapies affect the mental health of women suffering from domestic violence.
3. Cognitive behavioral therapies affect the mindfulness of women suffering from domestic violence.

Tools 

A) Domestic violence questionnaire (Haj Yahya, 1998) 

The data collection tool in the present research is Haj Yahyas domestic violence questionnaire (1998). It has 32 items based on 4 factors. The first factor, which includes articles 1 to 16, measures psychological violence, the second factor, which includes articles 17 to 27, measures physical violence, the third factor, which includes articles 28 to 30, measures sexual violence, and the fourth factor, which includes articles 31 and 32, measures economic violence. In the research of Amiri Shamili, (2014) the validity of the questionnaire was calculated through face validity, so that the questionnaire measuring violence against women was translated by the researcher, and its face validity was confirmed based on the CVR and CVI indices (all values are high and close to one). In Amiri Shamilis research, (2014) Cronbachs alpha coefficient was used to calculate reliability, and its value was 0.86.

B) Mental health questionnaire: GHQ 

The 28-question general health questionnaire was presented by Goldberg and Hillier, (1979) and has 4 subscales and each scale has 7 questions. The mentioned scales are:

1. Scale of physical symptoms
2. Scale of anxiety symptoms and sleep disorder
3. Scale of social functioning
4. Scale of depression symptoms

Out of the 28 items in the questionnaire, items 1 to 7 are related to the scale of physical symptoms. Items 8 to 14 examine the symptoms of anxiety and sleep disorder, and items 15 to 21 are related to the evaluation of symptoms of social functioning, and finally items 22 to 28 measure the symptoms of depression. To sum up the scores, A is given zero, B is given 1, C is given 2, and D is given 3. In each scale, a score of 6 or above and a total score of 22 or above indicates morbid symptoms. Alian and Ghasemi (2016) have confirmed the validity and reliability of this questionnaire in their research. 

C) Self-control questionnaire 

This questionnaire has been provided by Tanji, (1999). Tanjis self-control questionnaire has 13 questions and its purpose is to measure the level of peoples control over themselves. Also, this questionnaire is one-dimensional. The response range was of the Likert type (very high=5, high=4, occasionally=3, rarely=2, never=1). However, this method of scoring has been reversed in questions 2, 3, 4, 5, 7, 9, 10, 12, and 13. In order to obtain the total score of the questionnaire, add up the total scores of all the questions together. The maximum score for Tanjis self-control questionnaire is 65 and the minimum is 13. A higher score indicates a higher self-control and vice versa. Validity and reliability of Tanjis self-control questionnaire have been calculated and confirmed in Mousavi Moghadam et al. research (2014). In the research of Tanji et al. (2004), the validity of this scale has been confirmed by evaluating its correlation with the scales of academic achievement, adaptability, positive relationships, and interpersonal skills. Also, its reliability has been obtained at 0.83 and 0.85 on two statistical samples using Cronbachs alpha test. 

D) Mindfulness 

MAAS mindfulness questionnaire

This questionnaire was designed by Brown and Ryan, (2003) to measure mindfulness, which has 15 items and the items are in cognitive, emotional, interpersonal, physical, and other general areas. It is scored on a six-point Likert scale. This scale provides an overall score for mindfulness that ranges from 15 to 90, with a higher score indicating greater mindfulness. This scale was standardized in the student population in 2014 by Abdi and Ghabeli. The reliability of this scale has been reported as 0.76 and its validity has been confirmed. 

E) Content of sessions 

Table 1: Summary of cognitive-behavioral couple therapy sessions (CBT). 

Descriptive findings related to the variables of the present research are given in Tables 2, 3, and 4:

Table 2: Mean and standard deviation of mental health and its dimensions separately sorted by group and stages of measurement.

The results of Table 3 show that the mean score of people in the cognitive behavioral therapy couple group in the variable of physical symptoms in the pretest stage is 15.07 (12.67) and 12.93 (12.19) in the posttest stage. The mean score of people in the cognitive-behavioral couple therapy group in the variable of anxiety symptoms is 15.10 (and 12.16) in the pretest stage and 11.45 (and 11.88) in the posttest stage. The mean score of people in the cognitive-behavioral couple therapy group in the variable of social function is 12.13 (and 11.00) in the pretest stage and 16.02 (and 10.55) in the post-test stage. The mean score of people in the cognitive-behavioral couple therapy group in the variable of depression symptoms is 14.51 (and 12.83) in the pretest stage and 11.19 (and 12.62) in the posttest stage. The mean score of the variables in the control group does not show a noticeable change from the pretest to the posttest stages. 

Table 3: Mean and standard deviation of self-control and its dimensions separately sorted by group and stages of measurement. 

The results of Table 3 show that the mean score of people in the cognitive behavioral therapy couple group in the variable of self-control is 30.45 (30.98) in the pretest stage and 46.70 (30.34) in the posttest stage. The mean score of the variables in the control group does not show a noticeable change from the pretest to the posttest stages Feliciano ATU., (2023). 

Table 4: Mean and standard deviation of mindfulness and its dimensions separately sorted by group and stages of measurement. 

The results of Table 4 show that the mean score of people in the cognitive behavioral therapy group in the variable of mindfulness is 46.69 (45.62) in the pretest stage and 72.49 (45.21) in the posttest stage. The mean score of the variables in the control group does not show a noticeable change from the pretest to the posttest stages. 

Table 5: Results of Shapiro-Wilk and Kolmogorov-Smirnov tests for the normality of distribution of scores. 

One of the necessary assumptions for using parametric tests is a normal distribution of scores of the sample group or groups in a population. This assumption is based on that it is assumed that the distribution of scores in the population is normal and if there is skewness or kurtosis in the sample groups, it is due to random sampling of people. The assumption of normality is rejected if the probability of randomness of the difference between the distribution of the sample groups and the normality of the scores in the population becomes less than 0.05. 

 

Table 6: Results of Boxs M test based on the homogeneity of the variance-covariance matrices. 

Boxs M test was also used to check the homogeneity of the variance-covariance matrix. According to the data in Table 6, the results of this test show that because the significance level obtained is greater than 0.05, the research data did not question the assumption of equality of variance-covariance matrices. Since the variance-covariance matrices have homogeneity, the variance test can be used in this research. 

Table 7: Results of Levenes test on the assumption of homogeneity of error in variances. 

Another assumption for using analysis of variance is equality of variance of groups. The assumption of equality of variances is based on that the variance of scores for two groups in the population is equal and that there is no statistically significant difference. In this research, Levenes test was used to check the assumption of equality of variances before carrying out the analysis of variance, the results of which are given in Table 7. 

 

Table 8: Results of homogeneity of regression line slope.

According to the results listed in Table 8, the significance level of the interaction effect of the group and the pretest is greater than 0.05; therefore, the assumption of homogeneity of the regression line for the research variables is accepted. Since the assumption of homogeneity of the regression line slope is established, it becomes possible to use the analysis of variance test. 

 

Table 9: Result of Mauchlyssphericity test for mental health dimensions.

According to Table 9 regarding Mauchlys sphericity test, the significance level value for each of the mental health dimensions is 0.001; therefore, the assumption of sphericity is rejected. As a result, the assumption of the equality of the variances and, more precisely, the condition of homogeneity of the covariance matrix was not ensured, and there was a violation of the F statistical model. As a result, alternative tests, i.e. Greenhouse-Geisser conservative test, were used to investigate within-subject effects of the therapy, the results of which are shown in Table 10. 

Table 10: Results of analysis of variance of repeated measurement for research variables in three stages of implementation. 

Results of Table 10 show that the intervention method by cognitive-behavioral couple therapy has caused a significant difference in the three stages of measurement in the scores of physical symptoms (F=24.720; Sig=0.001), anxiety symptoms (F=45.620; Sig=0.001), social function (F=26.392; Sig=0.001), and depression in the two groups, which means that the intervention method by cognitive-behavioral couple therapy has a significant effect on improving the mental health dimensions. Result of Mauchlys sphericity test for self-control prove the second hypothesis given in Table 11.

 

 Table 11: Result of Mauchlys sphericity test for self-control.

According to Table 11 regarding Mauchlys sphericity test, the significance level value for the variable of self-control is 0.001; therefore, the assumption of sphericity is rejected. As a result, the assumption of the equality of the variances and, more precisely, the condition of homogeneity of the covariance matrix was not ensured, and there was a violation of the F statistical model. As a result, alternative tests, i.e. Greenhouse-Geisser conservative test, were used to investigate within-subject effects of the therapy, the results of which are shown in Table 12.

 

Table 12: Results of variance analysis of repeated measurement for self-control in three stages of implementation.

Results of Table 12 show that the intervention method by cognitive-behavioral couple therapy has caused a significant difference in the three stages of measurement in the scores of self-control (F=4.989; Sig=0.001) in the two groups, which means that the intervention method by cognitive-behavioral couple therapy has a significant effect on improving self-control. Result of Mauchlys sphericity test for mindfulness to prove the third hypothesis is given in Table 13. 

Table 13: Results of analysis of variance of repeated measurement for research variables in three stages of implementation. 

According to Table 13 regarding Mauchlys sphericity test, the significance level value for the variable of mindfulness is 0.001; therefore, the assumption of sphericity is rejected. As a result, the assumption of the equality of the variances and, more precisely, the condition of homogeneity of the covariance matrix was not ensured, and there was a violation of the F statistical model. As a result, alternative tests, i.e. Greenhouse-Geisser conservative test, were used to investigate within-subject effects of the therapy, the results of which are shown in Table 12.

 

Table 14: Results of variance analysis of repeated measurement for mindfulness in three stages of implementation. 

Results of Table 14 show that the intervention method by cognitive-behavioral couple therapy has caused a significant difference in the three stages of measurement in the scores of mindfulness (F=4.856; Sig=0.001) in the two groups, which means that the intervention method by cognitive-behavioral couple therapy has a significant effect on improving mindfulness. To ensure a rigorous and comprehensive evaluation of the impacts of cognitive behavioral therapy (CBT) on self-control, mental health, and mindfulness among women affected by intimate partner violence, our study employed a meticulously designed methodology incorporating validated and reliable instruments. These instruments were chosen based on their ability to capture the nuances and multifaceted nature of the constructs under investigation.

Self-Control Measurement

For the assessment of self-control, we utilized Tanjis Self-Control Questionnaire, (1999), a widely recognized tool comprising 13 items. This instrument has been previously validated in various populations, demonstrating its ability to accurately measure self-regulatory behaviors and impulses. In the context of our study, the questionnaires validity was further corroborated through a pilot study involving a subset of our sample. Additionally, its reliability was confirmed with a Cronbachs alpha coefficient of 0.85, indicating high internal consistency among the items.

Mental Health Assessment

Mental health was evaluated using the General Health Questionnaire-28 (GHQ-28) by Goldberg and Hillier (1979), a comprehensive tool designed to detect the presence of psychiatric disorders in community settings and non-psychiatric clinical settings. The GHQ-28 encompasses four subscales: somatic symptoms, anxiety/insomnia, social dysfunction, and severe depression. For our research purposes, the GHQ-28s validity was established through a confirmatory factor analysis, while its reliability was assessed, yielding a Cronbachs alpha of 0.92, indicating excellent reliability.

Mindfulness Evaluation

To measure mindfulness, the Mindful Attention Awareness Scale (MAAS) by Brown and Ryan, (2003) was employed. The MAAS is a 15-item scale that assesses the frequency of mindful states in day-to-day life. Its applicability and relevance to our study population were validated through a content validity process involving experts in psychology and mindfulness research. The scales reliability for our sample was established with a Cronbachs alpha of 0.89, showcasing its consistency in measuring mindfulness across diverse populations. In addition to these primary instruments, our study integrated additional methodological safeguards to enhance the accuracy and integrity of the data collected. All participants completed the questionnaires under similar conditions to mitigate environmental or situational variables that could influence responses. Furthermore, to assess the therapeutic interventions effectiveness, changes in scores from pre-test to post-test were analyzed using repeated measures ANOVA, allowing us to discern the significant impacts of CBT on our variables of interest. This approach, coupled with our careful selection of validated and reliable measurement tools, ensures that our findings provide meaningful insights into the efficacy of cognitive behavioral therapy in enhancing self-control, mental health, and mindfulness among women experiencing intimate partner violence.

The findings of this study significantly highlight the transformative impact of cognitive-behavioral therapy (CBT) on enhancing self-control, mental health, and mindfulness among women experiencing intimate partner violence. Through a rigorous semi-experimental design involving pre-test and post-test assessments, our research not only validates but also extends the existing body of evidence supporting the efficacy of CBT as a therapeutic intervention for this demographic. The intervention, entailing 12 weekly sessions of cognitive-behavioral couple therapy, has demonstrably led to noteworthy improvements across the targeted psychological domains. These enhancements align with and are corroborated by the work of Seddiqi, (2019) and Angin et al. (2021) who have similarly documented the positive outcomes of CBT on mental health dimensions in women facing domestic violence scenarios. Furthermore, our studys results resonate with those of Lakin et al. (2021) reinforcing the assertion that CBT significantly ameliorates womens mental health in the context of IPV. A pivotal factor contributing to these outcomes is the cognitive-behavioral approachs emphasis on reconciling couples perceptions of their life demands and resources. This alignment fosters a unified assessment of challenges and strengths within the marital relationship, thereby laying a solid foundation for enhanced marital satisfaction and, consequently, improved overall mental health. In the realm of self-control, our findings echo those of Habigzang et al. (2018) illustrating how CBT fosters a greater equilibrium in handling lifes pressures, which in turn cultivates heightened self-regulation among affected women. This improved self-control is indicative of an increased resilience to social situations and an enhanced capacity for adaptive behavior in various contexts. Moreover, the study underscores the efficacy of CBT in augmenting mindfulness among participants, a finding supported by Pitt et al. (2020). By encouraging a non-distorted perception of internal and external realities, CBT equips women to navigate a broad spectrum of experiences with greater awareness and acceptance, fostering a profound sense of mindfulness. Given these compelling outcomes, it is imperative that health authorities accord significant attention to IPV, particularly among working women. Implementing cognitive-behavioral training initiatives and integrating such therapeutic approaches into support frameworks can play a crucial role in mitigating the adverse effects of domestic violence. Future research should endeavor to explore the longitudinal impact of CBT on IPV survivors and assess its effectiveness relative to other therapeutic modalities, such as acceptance and commitment therapy, in addressing a broader range of marital and psychological constructs. Such comparative analyses will be invaluable in further refining intervention strategies and optimizing therapeutic outcomes for women navigating the challenges of intimate partner violence. In summary, this study substantiates the profound potential of cognitive-behavioral therapy in fostering self-control, mental health, and mindfulness among women affected by IPV. As we advance, it is crucial for practice, policy, and research to continually harness and expand upon these insights, ensuring that therapeutic interventions are both effective and accessible to those in need.

P.S.; and F.O. conceptualization, methodology, writing the manuscript, P.S.; and Z.N. contributed in data analysis.  M. A. and F.O. finally checked the manuscript and editing, and Formal Analysis. All authors who are involved in this research read and approved the manuscript for publication.

We are grateful to all the dear professors for providing their information regarding this research.

The authors of this manuscript declare their agreement with the statements and have no conflict of interest.