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Article History

Received: 2 April 2024

Accepted: 4 July 2025

First Online: 21 July 2025

Competing interests

: The authors declare no competing interests.

: This study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. Ethical review was conducted by the Medical and Experimental Animal Ethics Committee of Beijing Institute of Technology. The first-round of the study was reviewed on August 18, 2023, and determined to pose no ethical risk, qualifying for an exemption from formal ethical approval (reference number: BIT-EC-HM-2023005). In response to reviewer comments during the second-round review (specifically, Question 3), a second-round survey was conducted and reviewed by the same committee on February 12, 2025, which again granted an exemption (reference number: BIT-EC-HM-2025007).

: Informed consent was obtained from all participants prior to data collection in both rounds of the study. The first round was conducted from September 28 to October 20, 2023, and the second round from February 18 to March 6, 2025. Specifically, participants were provided with a written statement outlining the purpose of the study, assurances of anonymity and confidentiality, and a clarification that their responses would be used solely for academic research. We also informed the participants that the survey participation was entirely voluntary, and completion of the survey was considered to indicate informed consent.