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Article History

Received: 19 August 2025

Accepted: 22 April 2026

First Online: 29 April 2026

Competing interests

: The authors declare no competing interests.

: This study was reviewed and approved by the Ethics Committee of Nanjing Medical University (Approval No. 006-2025; Date of Approval: January 5, 2025). The approval covered the entire scope of the research, including all procedures involving human participants, data collection methods, recruitment strategies, the informed consent process, and data storage and protection protocols. The methodological approach was reviewed and approved as part of the aforementioned protocol. All procedures performed in this study were in accordance with the ethical standards of the 1964 Helsinki Declaration and its later amendments.

: To ensure the ethical integrity and reliability of the research process, the following measures were implemented: Informed Consent: All participating students were fully informed of the study’s purpose, content, and methodology and provided their informed consent through the signing of consent forms, explicitly indicating their voluntary participation and agreement to the use of their data for the purposes of this study. The informed consent was obtained from March 3, 2025, to March 7, 2025. Anonymity: All collected data were anonymized to protect the privacy of participants. Data Security: All data was stored on secure servers with appropriate security measures in place to prevent data leakage or misuse.