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Article History

Received: 3 July 2025

Accepted: 4 April 2026

First Online: 10 April 2026

Declarations

:

: This study was deemed exempt from formal ethics review by the Ethics Committee of the First Affiliated Hospital of Army Medical University (Address: Gaotanyan Main Street 29, Shapingba District, Chongqing 400038, China. Tel: +862368754814, Fax: +862368754814). The committee determined that the study posed minimal risk to participants and did not require full ethical review. However, all participants were still provided with detailed information about the study’s purpose, procedures, potential risks and benefits, and their rights to withdraw at any time without any penalty. Written informed consent was obtained from each participant prior to their involvement in the study, and the study was conducted in accordance with the principles of the Declaration of Helsinki. All video recordings were de-identified immediately after scoring and stored on a password-protected hospital server. Participants were informed that videos would be used solely for research assessment and then deleted. Additionally, all individuals depicted in the photographic sequences provided in Supplementary Figure gave written informed consent for the publication of their images.

: All participants provided written informed consent, which included consent for the publication of anonymized data collected during the study.

: The authors declare no competing interests.