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Article History

Received: 23 April 2025

Accepted: 4 May 2026

First Online: 23 May 2026

Competing interests

: The authors declare no competing interests.

: According to the National Guidelines for Scientific Research Ethics Review issued by the Chinese government (Article 32, Item 2), research utilizing anonymized data that poses minimal risk and does not involve life sciences, medical issues, or sensitive personal information is exempt from ethical review. The full guideline is available at: . This study meets all exemption criteria: it involved a voluntary questionnaire, did not collect biospecimens or health records, and all responses were fully anonymized. The study also adheres to the ethical principles set forth in the Declaration of Helsinki.

: All participants provided informed consent electronically prior to beginning the online survey. The study was conducted using Credamo , a professional online survey platform widely used for academic research in China. Participants were recruited through the platform’s sampling system and were clearly informed of the study’s purpose, the voluntary nature of participation, their right to withdraw at any time, and that all responses would be anonymized and used solely for academic purposes. Consent was obtained by requiring participants to confirm their agreement on an electronic consent page before accessing the questionnaire. The first wave of data collection took place on October 9, 2024, and the second wave on December 11, 2024. No identifiable personal data were collected during the entire research process.