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Article History

Received: 7 January 2026

Accepted: 16 April 2026

First Online: 3 May 2026

Declarations

:

: The authors declare no competing interests.

: All procedures involving human participants were approved by the Institutional Review Board of Qinhuangdao Vocational and Technical College (Protocol Number: IRB-2024-MH-0142). Each participating institution obtained local ethical approval consistent with their institutional requirements. The study was conducted in compliance with the Declaration of Helsinki and all applicable national regulations regarding the protection of human research participants.

: Written informed consent was obtained from all individual participants included in the study. Participants were provided with detailed information about the research purpose, data collection procedures, types of data collected, data storage and anonymization protocols, and privacy protection measures. Participants retained the right to withdraw at any time without adverse consequences, and all withdrawal requests were honored promptly with complete data deletion.

: All participants provided consent for the publication of de-identified, aggregate research findings. No identifiable personal information or data that could lead to participant identification is included in this manuscript.