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Article History

Received: 1 August 2024

Accepted: 11 September 2025

First Online: 10 November 2025

Competing interests

: The authors declare no competing interests.

: This study strictly adheres to the ethical principles of the Declaration of Helsinki. All participants provided informed consent before the commencement of the study, with their anonymity and confidentiality fully protected, and participation was entirely voluntary. According to the “Ethical Review Measures for Life Sciences and Medical Research Involving Humans” issued by the National Health Commission of China and relevant departments in February 2023, this study meets the conditions for exemption from ethical review: conducting research using anonymized human information data that does not cause harm to the human body and does not involve sensitive personal information or commercial interests. Therefore, this study does not require submission of ethical approval to the institution and further ethical review.

: Participants were fully informed about the purpose of the study, the voluntary nature of their participation, their right to withdraw at any time without penalty, and the intended use of their data. They were also assured that their anonymity would be maintained and that no personal or identification information would be collected or disclosed. Informed consent was provided in written form during the data collection process, between January 2023 and September 2023.