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Article History

Received: 14 July 2025

Accepted: 2 March 2026

First Online: 12 March 2026

Ethical considerations

: The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Shandong University (No. ECSBMSSDU2023-1-85, Oct. 2023). Informed written consent was obtained from all participants prior to their involvement in the study.

: Written informed consent was obtained from all individual participants prior to their inclusion in the study. The consent process was conducted by the principal investigator, between 12 and 15 Jan 2024, after providing each participant with detailed written information about the study’s purpose, procedures, potential risks and benefits, data confidentiality, and their right to withdraw at any time without penalty. The consent covered participation in the study, use of anonymised data for analysis, and publication of results. All participants were assured of the confidentiality and anonymity of their responses. No personal identifiable information, images, or sensitive data has been disclosed or published.

: The authors declare no competing interests.